OC-061 Algorithm and Case-Based Educational Intervention Improves Nursing Staff Confidence in Management of Patients On Direct Oral Anticoagulants (DOACS) in Endoscopy

Abstract

Introduction The increased use of DOACs in medicine, is a challenge for endoscopy unit staff, faced with new anticoagulants, new national guidance based on low quality evidence, and new renal function tests to interpret. Guidance by Veitch (2016) and a systematic review by Woodhouse (2013) suggest practical management algorithms for DOACs in endoscopy, which we aimed to summarise into an interactive case based teaching session, to improve nursing confidence. Methods We developed an hour long teaching course for all endoscopy nurses in our District General Hospital. Small groups discussed previous experience of DOACs, a brief interactive seminar introduced a locally tailored treatment algorithm based on Veitch (2016) and Woodhouse (2013) (Figure 1). Participants were formatively assessed on identifying DOACs, interpreting renal function and applying a management algorithm to common clinical cases. Subjective confidence on each learning objective was assessed pre- and post-educational intervention, using Likert scales graded 1 (strongly disagree) to 5 (strongly agree), and analysed using a paired T-test. Free text responses were collected and phenomenological analysed. Results 18 endoscopy nursing staff undertook training in two sessions. Mean subjective confidence scores improved significantly, in all learning objectives (Table 1). Eleven free text comments praised the use of case studies and the algorithm, as “real life scenarios help to consolidate my learning”. Others commented this teaching should be “cascaded to referrers”. Conclusion Case based learning activities, using an algorithm approach, amongst nursing staff, significantly increased confidence in managing DOACs in endoscopy. This format is readily reproducible in other endoscopy units, and a useful framework to further educate referrers to endoscopy, and patients taking DOACs. References 1 Woodhouse C, et al. Frontline Gastroenterology 2013;4:213–218. 2 Veitch AM, et al. Gut 2016;65:374–389. Disclosure of Interest None Declared