Pulmonary Embolism Clinical Trial
Official title:
Adherence to Clinical Guidelines in the Diagnosis of Pulmonary Embolism in an Emergency Department. Analysis of the Clinical Impact of a Training Intervention (APEED)
The purpose of this study is to analyze the clinical impact of an educational intervention on adherence to Clinical Practice Guidelines in an Emergency Department (ED), by using a standardized training, for improving diagnostic sensibility and reducing unnecessary scans, adverse effects and stays in the ED.
The Hospital de la Santa Creu i Sant Pau Emergency Department (ED) implemented a training
program between May and June 2015 to improve compliance and adherence to recommended clinical
practice and optimize the diagnosis and management of patients with suspected Pulmonary
Embolism (PE). The training program was standardized, systematic and continuous, with
subsequent reinforcement to ensure implementation. This paper aims to evaluate the clinical
impact of the training intervention. The establishment of training measures to improve
adherence to guidelines implies clinical practice improvement and benefits patients and
health system. Moreover, it is a simple and inexpensive intervention, and can be easily
reproduced in other ED.
All adult patients (<18 y) with suspected pulmonary embolism attended at Emergency Department
will be included. Retrospective information from two different periods (before and after the
training intervention) will be collected. First period: 1/1/2012 - 31/12/2012 and second
Period: 01.06.2015 - 30/11/2015, pre and post intervention.
OBJECTIVES
A. Primary:
1. Analyze adherence to guidelines for the evaluation of suspected PE in the ED.
2. Determine the clinical impact of training intervention (change in adherence to
guidelines after training measures among staff in Emergency Department)
3. Implementation and consolidation of a systematic, standardized, continuous training
intervention for improving processes and results.
B.- Secondary
1. Analyze PE cases (presentation, clinical features, treatment, clinical evolution)
2. analyze the clinical differences in three subgroups of patients with PE: young patients
(<50 years), elderly patients (<65 years) and cancer
3. Analyze the value of D-dimmer corrected by age in diagnostic algorithms
4. Analyze the results of a new algorithm (EPC + Dimmer corrected age) in the elderly
population group (<65 years).
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