Photo courtesy of NCI
Nurse explaining information to a patient
Online education programs for nurses can improve the administration of prophylaxis for venous thromboembolism (VTE), a new study suggests.
The research was spurred by a documented need to boost the administration of prescribed VTE prophylaxis in hospitalized patients.
Data had shown that patients’ refusal of VTE prophylaxis frequently resulted in nurses not administering the prescribed therapy.
The new research indicates that online education modules helped nurses communicate to patients the need for VTE prophylaxis and therefore improved rates of use.
“We teach in hopes of improving patient care, but there’s actually very little evidence that online professional education can have a measurable impact. Our results show that it does,” said Elliott Haut, MD, PhD, of The Johns Hopkins University School of Medicine in Baltimore, Maryland.
Dr Haut and his colleagues reported these results in PLOS ONE.
For this study, the researchers developed 2 online education modules about the importance of pharmacologic VTE prevention and tactics for better communicating its importance to patients.
One of the modules was “dynamic,” requiring nurses to select responses to clinical scenarios, such as how to respond to a patient who was refusing a prophylactic medication dose. The other module was “static,” involving a PowerPoint slide show with a traditional voice-over explaining the information.
The study included 933 permanently employed nurses on 21 medical or surgical floors at The Johns Hopkins Hospital.
Between April 1, 2014, and March 31, 2015, 445 nurses on 11 of the floors were randomized to the dynamic education arm of the study, and 488 nurses on 10 floors were enrolled in the static arm.
To track non-administration of VTE prophylaxis, the researchers retrieved data from the hospital’s electronic health record system. The team collected data for 1 year and divided it into 3 time periods: baseline, during the educational intervention, and post-education.
Over the entire study period, 214,478 doses of pharmacologic VTE prophylaxis were prescribed to patients on the 21 hospital floors.
After education, non-administration of prescribed VTE prophylaxis decreased from 12.4% to 11.1% (conditional odds ratio [cOR]=0.87, P=0.002).
Nurses who completed the dynamic education module saw a greater reduction in non-administration—from 10.8% to 9.2% (cOR=0.83)—than nurses who completed the static education module—14.5% to 13.5% (cOR=0.92). However, the difference between the study arms was not significant (P=0.26).
“Our study adds to evidence that the way something is taught to professionals has a great influence on whether they retain information and apply it,” said Brandyn Lau, of The Johns Hopkins University School of Medicine.
“Active learning seems to get better results than passive learning, showing that it’s not just what you teach, but also how you teach it.”
“Now that we’ve shown the modules can be effective in improving practice, we want to make [them] available to the more than 3 million nurses practicing in the US,” Dr Haut added.
