Standardized Education Program Research Articles

Identifying resources available to physicians for management of financial toxicity: A Fellow-driven QI initiative.

294 Background: Insufficient patient-physician cost communication stems in part from limited physician awareness of actionable interventions when cost issues arise. Oncologists report low awareness of resources to help patients with financial toxicity and often feel underprepared to discuss and navigate this issue. Methods: All oncology fellows (n = 19) at the University of California, Los Angeles were invited to participate in QI project during the fall of 2019. As part of the curriculum, fellows were individually paired with an experienced attending and asked to review a hypothetical case of financial toxicity. The case described an elderly widow on Medicare, living hours from the cancer center who was non-adherent to her oral cancer therapy due to high copays. Participants were asked to identify at least four financial toxicity risk factors in the case, and to identify resources and strategies that a physician could use help navigate her financial concerns. A cost-health literacy survey was administered at baseline and at the conclusion of the curriculum to evaluate the impact of the program. Results: Of 19 participants, 16 completed the case based scenario. Nine categories of risk factors were identified (63% of participants identified an insurance issue, 44% lack of social support, 44% drug cost, 50% fixed income, 50% distance from treatment center, 31% logistical transportation concern). Physician directed solutions were primarily focused on three categories: drug cost, insurance issue, and transportation concerns. Together, an institutional specific financial toxicity tip sheet was generated for further dispersal at the cancer center. After participation in the intervention, more fellows agreed/strongly agreed that they could help a patient experiencing financial toxicity (62% v 6%, p = 0.005). Conclusions: A focused intervention can increase awareness of resources and strategies available to physicians in the management of patient financial concerns, which may impact physician engagement with issues of financial toxicity. Standardized education programs to further educate physicians on financial toxicity management strategies is warranted.

A study on the factors associated with posttraumatic growth of helping professionals in suicide prevention

The purpose of the study was to examine the factors associated with posttraumaitc growth of helping professionals in suicide prevention. Study sample consisted of 319 helping professionals who are social workers, doctors, nurses, and psychologists with at least 3 years of working experience in mental health settings. Data were collected through a self-report online survey and a multiple regression model was conducted to examine the factors associated with posttraumatic growth. Study results demonstrate that age was likely to increase a level of postraumatic growth, and social workers and nurses were more likely to have a higher level of posttraumatic growth when compared to doctors. In addition, a higher level of deliberate rumination and social support tended to increase a level of posttraumatic growth among helping professionals in suicide prevention. Study findings suggest that the development of psychological support system is essential for facilitating deliberate rumination and a variety of support systems should be given to helping professionals in suicide prevention. Furthermore, policymakers should develop standardized protocols and educational programs to enhance posttraumatic growth of helping professionals by incorporating unique characteristics of each agency.

Rhythmic Physical Activity Intervention: Exploring Feasibility and Effectiveness in Improving Motor and Executive Function Skills in Children.

IntroductionIncreasing literature has emerged investigating the importance of considering the qualitative characteristics of physical activity (PA) interventions and sports as well as considering the role of motor competence in the exercise–cognition interplay. The purpose of this pilot study was to examine the feasibility and effectiveness of a rhythmic PA intervention compared to a standard physical education program, on motor and hot and cool executive function (EF) skills.MethodsChildren ages 6–11 were enrolled in one of the two programs: a rhythmic program (n = 22) and a physical education program (n = 17), both meeting for 30 min, twice per week, for 7 weeks. The rhythmic program emphasized moving to the beat of music and moving in various rhythmic patterns with whole body movements, clapping, and drumsticks. The children also created their own rhythmic patterns and socially engaged with other children by working in pairs and sharing their routines with the group. The physical education group engaged in ball skills, locomotor patterns, team sports, and moving through stations in small groups, with no emphasis on rhythm. Pretest and posttest measurements included measurement of balance (Movement ABC-2), cool and hot EF (Flanker, SWAN), and social factors, whereas throughout the implementation period data on affective valence, enjoyment, cognitive engagement, perceived exertion, and PA levels were collected at every lesson in both groups.ResultsThe rhythmic program used in this study was feasible, scalable, affordable, and able to be implemented with minimal preparatory time. Children in both groups (rhythmic and physical education) engaged in a similar level of PA and had similar positive experiences from the programs. Both groups improved in balance and cool EF, and there were significant correlations in the change scores between balance and cool EF, as well as between cool EF with hot EF and socio-emotional factors.DiscussionThis study contributes to the literature by exploring the potential value of rhythmic programs as a vehicle in helping children develop motor and EF skills while deriving joy and positive social interactions from the program.

Using Facebook Live to Enhance the Reach of Nutrition Education Programs

This Great Educational Materials article describes the University of Kentucky Nutrition Education Program (KYNEP) delivery of Healthy Choices for Every Body (HCEB), a nutrition education curriculum, through Facebook Live (Facebook, Inc, Menlo Park, CA) to extend the reach of nutrition education to low-income adults who face barriers in participating in face-to-face nutrition education classes. The purpose of this article was 2-fold: to demonstrate how to use Facebook Live to deliver a standard nutrition education program to low-income audiences, and to illustrate potential similar learning outcomes between in-person and Facebook Live delivery methods of the same nutrition education content.

Standardised patient education in adrenal insufficiency: a prospective multi-centre evaluation.

Patients with adrenal insufficiency (AI) suffer from impaired quality of life and are at risk of adrenal crisis (AC) despite established replacement therapy. Patient education is regarded an important measure for prevention of AC and improvement of AI management. A standardized education programme was elaborated for patients with chronic AI in Germany. Longitudinal, prospective, questionnaire-based, multi-centre study. During 2-h sessions, patients (n = 526) were provided with basic knowledge on AI, equipped with emergency cards and sets and trained in self-injection of hydrocortisone. To evaluate the education programme, patients from eight certified centres completed questionnaires before, immediately after and 6-9 months after training. 399 completed data sets were available for analysis. Questionnaire score-values were significantly higher after patient education, indicating successful knowledge transfer (baseline: 17 ± 7.1 of a maximum score of 29; after training: 23 ± 4.2; P < 0.001), and remained stable over 6-9 months. Female sex, younger age and primary cause of AI were associated with higher baseline scores; after education, age, cause of AI and previous adrenal crisis had a significant main effect on scores. 91% of patients would dare performing self-injection after training, compared to 68% at baseline. An improvement of subjective well-being through participation in the education programme was indicated by 95% of the patients 6-9 months after participation. Patient group education in chronic AI represents a helpful tool for the guidance of patients, their self-assurance and their knowledge on prevention of adrenal crises. Repeated training and adaptation to specific needs, for example, of older patients is needed.

Factors Related to Nurses’ Knowledge and Attitudes Toward Pain in Hospitals in Low-Income Areas

BackgroundEffective pain management is closely related to nurses' knowledge and attitudes toward pain. Limited studies have been performed related to nurses’ knowledge and attitudes toward pain in hospitals in low-income areas. AimsThis study surveyed the knowledge and attitudes of nurses toward pain management in county hospitals from low-income areas in Hunan Province, China. Setting and participantsThe study included 4,668 registered nurses working in 48 county hospitals in low-income areas in China. MethodsA cross-sectional study examined the knowledge and attitudes of nurses with regard to pain using the Chinese version of the Knowledge and Attitude Survey Regarding Pain (KASRP) via the WeChat application. ResultsThe 4,668 registered nurses completed the survey; of these, 43.6% indicated they had never received continuing education for pain. The mean percentage score for KASRP was (40.3 ± 7.95), and none of the respondents achieved a percentage score of >80%. Further, of the 40 items, only two had a correct rate of >80%. Continuing pain education did not significantly affect KASRP. Multiple stepwise linear regression showed that education level, ethnicity, professional title, position, and department were independent influencing factors for KASRP scores. ConclusionAlmost all nurses in county hospitals of low-income areas had deficiencies in various aspects of pain management knowledge. Better educated nurses with higher professional title or management position, those from the Han ethnicity, and those from the oncology department had higher mean KASRP scores. Current continuing education programs for pain did not improve the pain management capability of the nurse. High-quality and standardized pain educational programs should be implemented to improve pain management.

Oncocardiology: new challenges, new opportunities.

Patients with cancer are at a higher risk of cardiovascular disease, which contributes to significant morbidity and mortality. The rapid progress in the field of oncological treatments has led to a steady increase in long-term cancer survivors. Care for cardiovascular complications is therefore becoming increasingly important. In addition, the establishment of new oncological therapies has resulted in the identification of previously unknown cardiovascular side effects. Oncocardiology aims to detect and treat cardiovascular diseases associated with cancer and cancer therapy. Continuous scientific, clinical, and structural developments are necessary as the basis for the best care of the growing number of affected patients. This review summarizes current developments in the field of oncocardiology with regard to advances in cancer therapy and challenges in clinical oncocardiology work. Cardiovascular side effects by targeted cancer therapies are characterized and recent advances in the field of cardiovascular diagnostics are outlined. Developments to better integrate oncocardiology into the medical care system and perspectives for modern, patient-oriented care are shown. In light of the coronavirus disease 2019 (COVID-19) pandemic, current challenges and opportunities are highlighted. The relevance of profitable further advances in oncocardiology including standardized guidelines and educational programs is delineated as a mandatory requirement for the successful development of oncocardiology.

P-04-15 From Spain to Colombia: Adaptation Process of Competences for Adolescents With a Healthy Sexuality Program (COMPAS)

In Latin America, unplanned pregnancies and sexually transmitted infections (STIs) in youth are two main public health problems. Colombia accounts for one of the highest prevalence rate of HIV and STIs in this population; however, a national standardized sex education program for adolescents is still not available. Competences for adolescents with a Healthy Sexuality (COMPAS for its acronym in Spanish) - a school-based sexual health promotion intervention for Spanish adolescents - was adapted for Colombian youth. We hypothesized that COMPAS key elements would be translated and its effectiveness would be retained. This research describes the adaptation process that resulted in an adapted version for youth in Colombia. A mixed-method approach was used to conduct this systematic cultural adaptation process that involved 100 Colombian young girls and boys. Adaptation process included these steps: 1) Consulting international researchers and community stakeholders, 2) Capturing the lived experiences of a diverse sample of Colombian youth,

Effect of Training Program on Nurses' Performance and Health Outcomes for Patients with Diabetic Ketoacidosis

Background: Diabetic ketoacidosis is a life-threatening complication of diabetes, and is the most common cause of death. The effective management of patients with diabetic ketoacidosis depends on a knowledgeable and skillful nurse who play a central role in managing those patients. Aim: The aim of this study was to evaluate the effect of training program on nurses’ performance and health outcomes for patients with diabetic ketoacidosis. Study design: a quasi-experimental study (pre-test-post-test design) was utilized to fulfill the aim of the study. Subject: A convenient sample consisted of 40 nurses worked at intensive care unit at El-Fayoum University Medicine Hospitals, and 25 adult patients with diabetic ketoacidosis. Tools: Three tools were used; self-administered questionnaire; an observational checklist and patients’ health outcomes assessment tool. Results: This study found that, the mean level of nurses′ total knowledge was (4.75±1.5) which statistically significant increase post implementing of the training program (34±1.5) and the mean nurses′ total practice was (114.3±59.1) which statistically significant increase post implementing of the training program (823.04±2.6). Moreover, there was statistically significant improvement in health outcomes among patients with diabetic ketoacidosis post implementation of the program. Conclusion: This study concluded that the training program had positive effect on nurses’ performance and health outcomes for patients with diabetic ketoacidosis. Recommendations: The study recommended conducting a standard educational programs in intensive care units for improving nurses staffing, enhancing the patient care level and the quality of care provided to this group of patients.

The assessment of the impact of a training process on the habituation of the vestibular-vegetative system, using a special rotational test as a condition of maintaining flight safety.

The authors formulated a hypothesis that, on completion of the training program by cadets, their vestibular habituation would increase, measured by the time of the duration of the test on the unlocked looping, in contrast to the initial values and the control group. The research involved 35 male cadets, first-year students of the Polish Air Force Academy in Dęblin. The examined persons were on average 20 years of age. They were divided into 2 groups. Group A (N = 25, tested) continued training on Special Aviation Gymnastic Instruments (SAGI). The cadets were a homogeneous group of participants in the jet pilot course, selected by the Military Aeromedical Board. Group B (N = 10, control) conducted the standard physical military education program. Groups A and B were tested on the unlocked looping before and after the training process. In the training process, the groups had heart rate (HR) monitored. The cadets in group A on the test in the unlocked looping, at the beginning of the training period, had an average score of 468.5±96.6 s, and on completion of the training period 575.6±47.9 s, which is a statistically significant difference at p < 0.000001. Similarly, the examined individuals in group B received an average score of 396.2±31.8 s, and at the end of the training period 473.4±72.0 s, which is a statistically significant difference at p < 0.01. In group A, a statistically significant decrease in the average HR value was observed. In group B, there was a statistically significant increase in the average HR value. The exercises on SAGI have a beneficial impact on improving the habituation of the vestibular organ in training cadets in examination II, as opposed to examination I and the control group. Int J Occup Med Environ Health. 2020;33(4):497-506.

Impact of an immuno-oncology (IO) education/monitoring program on patient’s self-efficacy and adverse event reporting from immune checkpoint inhibitors (ICIs).

2032 Background: ICIs have unique side effects of immune related adverse events (irAEs). For early detection and management of irAEs, at a large community hospital we implemented a standard IO nursing baseline assessment, education and monitoring program. We studied it’s impact on a patient’s irAE reporting and self-efficacy (confidence to manage symptoms) of ICIs. Methods: Prospective study conducted at William Osler Health System, Brampton, Canada from May 2018-December 2019. Patients aged &gt; = 18, English speaking that received an ICI for cancer were included. Patients underwent a standardized baseline nursing assessment and education class. Patients identified at the assessment as high risk (risk of grade 3/4 irAE &gt;20%) had weekly nurse proactive calls. Cancer Behaviour Inventory – Brief Version (CBI-B) (Heitzmann et al, 2011) was used to evaluate patient’s self-efficacy. Results: Eighty patients were enrolled. Median follow up of 4.1 months. Baseline demographics: median age 69, 70% males, 77% Caucasian, 81% ECOG 0/1, 66% had English as their first language and 19% highest education was elementary, 30% high school, 26% trade diploma and 21% post-secondary. Fourty-one percent had limited cancer health literacy (measured by CHLT6 (Dumenci et al, 2014)). ICIs prescribed were 70% monotherapy anti-PD1/PDL1, 13% combination nivolumab/ipilimumab, 17% anti-PD1/PDL1 + chemotherapy/other therapies. Majority had a diagnosis of non-small cell lung cancer (55%), melanoma (19%) and renal cell carcinoma (9%). A statistically significant improvement in the average CBI-B scores were found pre and post baseline assessment/education (p &lt; 0.001) and this improvement was maintained over time at follow-up visits (non-significant change in scores from post education results). Fourty-three percent of patient’s experienced &gt; 1 irAE. Most were grade 1/2 at time of detection (65%). Method of detection was mainly by patient self-reporting (62%), followed by proactive calls (27%). Only 3 patients had detection of an irAE with an ER visit. Rate of discontinuation of ICIs due to toxicity was 8.8%. Conclusions: In this diverse patient population with almost half of patients having limited cancer health literacy, a standardized IO baseline assessment, education and monitoring program resulted in improved patient self-efficacy with most irAEs detected by self-reporting and proactive calls. Our IO program can be a model for other oncology programs.

A Retrospective Records-Based Cohort of 1,082 Pediatric Forensic Cases Presenting to the Emergency Department

IntroductionThis study was conducted to determine the pediatric forensic case type and demographic characteristics of patients presenting to the emergency department. MethodsThis study was a medical record–based cohort design, with a descriptive correlational analysis. Records were retrieved from the emergency department of a university hospital, in the Central Anatolia Region, for visits between 2013 and 2018. The study population comprised 1,082 cases that were evaluated at the emergency department, as forensic cases, in children aged 0 to 18 years. The data were assessed, using descriptive statistical analyses and chi-square test. ResultsA total of 24.1% of the pediatric cases were female, and 75.9% were male. The most frequent type of forensic cases, was from assault (55.2%), followed by 16.3% with sharp object injuries, 13.7% fall from height, 3.9% traffic accidents, 2.9% exposure to drugs and chemicals, and 8.0% from other causes. Most pediatric forensic cases, were adolescents (aged 13-18 years). There were significant differences by sex for assault (34.9% girls vs. 61.6% boys), fall from height (20.7% girls vs. 11.4% boys), exposure to drugs and chemicals (8.0% girls vs. 1.2% boys), and sexual abuse (6.1% girls vs. 1.0% boys) types of forensic cases. DiscussionThe study results have implications for nurses and health professionals to increase awareness of high-risk groups and diagnoses. This evidence can be used to inform standard protocols and education programs about pediatric forensic cases in emergency care.

A randomized controlled trial of a nurse-led education pathway for asthmatic children from outpatient to home.

Education for asthmatic children in the outpatient department is insufficient. To evaluate the efficacy of a nurse-led education pathway, a standard education programme, on children with asthma. One hundred and eighty participants enrolled and were randomly assigned to either the control group or the intervention group. The intervention group received predetermined step-by-step education sessions based on the self-designed education pathway, while the control group received usual care. Asthma control, health-related quality of life, and health-care utilization measures were taken at baseline and at follow-up visits between February 2016 and May 2018. Significantly higher scores for health-related quality of life and inhaler technique at the third-month visit and asthma control test at the sixth-month visit were seen in the intervention group. The numbers of unscheduled physician visits and school absences were lower in the intervention group than in the control group within 6 months. However, no significant differences were observed in emergency department visits and hospitalizations. The nurse-led education pathway could be considered effective for children with asthma visiting the outpatient department.

Process and Renewal of Pancreatobiliary Cerification System

As the average life expectancy in Korea continues to rise, the number of elderly patients with pancreatobiliary disease is also expected to increase. Thus, it has been important to perform safe and quality-controlled endoscopic retrograde cholangiopancreatography in nowadays. However, there has been no standard educational programs of endoscopic retrograde cholangiopancreatography and quality control system, so Korean Pancreatobiliary Association has a plan to make credentialing organizations especially for pancreatobiliary certification. In this article, we would like to discuss the suitable framework and practical problems about the process and renewal of pancreatobiliary certification system.

ENHANCING SPORTING PERFORMANCE IN FIGURE SKATERS AGED 7–8 YEARS BASED ON DEVELOPING COORDINATION ABILITIES AND OPTIMIZING PSYCHOPHYSIOLOGICAL INDICATORS

Aim. The aim of this article is to develop coordination abilities in figure skaters aged 7–8 years from the initial training group with the help of a special educational and training program. Materials and methods. The study was conducted on the premises of the Trud sports complex in Togliatti. Twenty figure skaters aged 7–8 years from the initial training group participated in the experiment. All participants were divided into 2 subgroups: the experimental group (EG) and the control group (CG), 10 girls each. The main difference between groups was the use of a special exercise program in the experimental group aimed at the development of coordination abilities in figure skaters. In the control group, classes were held according to the standard educational program. The diagnostic technique included the computer program “Researcher of temporal and spatial properties of a person version 2.1”. Results. The article provides an experimental justification for the use of a set of exercises of special physical training (SPT) for the development of coordination abilities in skaters 7–8 years old. It was shown that at the initial stage of the pedagogical experiment (PE), the psychophysiological and motor indicators in the experimental and control groups did not differ significantly. Having introduced a set of exercises in the experimental group, we received a significant improvement in the spatio-temporal indicators and motor coordination compared to the control group. Conclusion. Using a set of exercises for the development of coordination abilities in figure skaters allows improving the ability of young skaters to move on ice and developing the locomotor functions of young skaters with improved coordination abilities.

To Infinity and Beyond: Developing a Nursing Cellular Therapy Program of Care

Topic Significance & Study Purpose/Background/Rationale For nurses to be proficient in caring for patients with cellular treatment protocols, the need for a formal, standardized educational program and practice standards for nursing care is critical. The use of cellular therapy is growing beyond standard of care for malignancy and hematologic disease. Cellular therapy administration in multiple clinical care settings makes it difficult to ensure all nurses have the same level of knowledge and practice which could result in gaps of care for patients. Researchers are actively investigating adoptive cell transfer including Tumor Infiltrating Cells, Dendritic Cells, Chimeric Antigen Receptor T-Cells, as well as other cellular therapies. The need for a formalized Cellular Therapy Program of Care was identified to standardize education and practice for nurses within the oncology, transplant, medical surgical, ambulatory, pediatric, and intensive care specialties. Methods, Intervention, & Analysis Trends in approved therapies as well as new research protocols show an increase in use of cellular therapies. Additionally, application of cellular therapy has expanded to diseases other than cancer and encompasses multiple routes of administration, e.g. intradermal, intraperitoneal, and intrathecal. Nursing programs of care that have not traditionally administered cellular products may begin to implement these treatments. Findings & Interpretation A multi-disciplinary team developed a standardized approach for education and practice that includes; education in cellular science and chemotherapy, standards of practice and procedures on cellular administration, training in complications of cellular medicine, competency assessment, and standardized documentation practices Discussion & Implications The Nursing Cellular Therapy Program of Care is in its early stages and outcome evaluation will be measured through patient quality indicators, documentation compliance, and ongoing competency evaluation. Formalization of a cellular program standardizes nursing practice and ensures patient safety.

A study on the differences in legal practices in child abuse cases with examples from different countries

Sex crimes against children is a global problem. The rate of such crimes are significant even societies with high levels of education and income. This study aimed to address necessary measures to minimize this problem by discussing the data and laws regarding sex crimes against children in five countries.The study reviewed scientific data on sex crimes against children in India, Canada, the Netherlands, UK and Turkey and the relevant penal codes in these countries, and compared the respective articles and practices. India is one of the countries with the highest number of child sexual abuse cases. The most interesting aspect of the Canadian law is that the law mentions peer relationships. It is noted that the criminal justice system in the Netherlands is, as opposed to many other countries, based on principles of rehabilitation and resocialization. The longer penalty times are striking in UK Sexual Offences Act 2003.The data from Turkish Statistical Institute shows that the number of sexual abuse cases are extremely high in Turkey.Child sexual abuse is a frequent problem in the world. Unfortunately, related studies, training and legislative regulations are not sufficient to solve this problem. It is observed that abuse cases increase in countries having weak and middle economies; however, the opposite evaluation is not completely correct. It can’t be suggested that standard education programs, increased levels of income and the securing of justice are the only solutions. Sexual abuse training through standard methods are insufficient to prevent this problem. Educational specialists need to develop new educational methods to address the problem. The rehabilitation of child victims is as important as punishment of offenders. This study advocates that necessary steps should be taken for the widespread establishment of Child Protection Centers, which play a significant role in the rehabilitation and treatment of victims.

Home Gastrostomy Feeding Education Program: Effects on the Caregiving Burden, Knowledge, and Anxiety Level of Mothers.

It is highly important for healthcare professionals to give discharge education to families to increase their knowledge of gastrostomy care and complications and to inform them about the correct behaviors. The purpose of the present descriptive pretraining and posttraining evaluation study was to investigate the effects of a standardized, evidence-based discharge education program prepared for children with gastrostomy tubes on the caregivers' knowledge, anxiety levels, and caregiving burden. The primary caregivers of children with a gastrostomy tube (n = 30) were interviewed on the first day of the education program and the first week and third month after the program, and a pretest/posttest, the Zarit Caregiver Burden Scale and the State-Trait Anxiety Inventory were applied. Complications were determined by assessing the number of unplanned clinic visits and complications in the study group compared with the historical control group (historical comparison; n = 30). The study revealed that the knowledge levels of mothers increased in the first week and third month after training, and their caregiving burden and state-trait anxiety levels significantly decreased. Although some complications arising from the enteral nutrition process were observed, it was found that the complications were fewer, and the difference was statistically significant compared with the group that did not receive the standardized, evidence-based discharge education program. The standardized education program should be recommended because caregivers managed the home care process more successfully, and the stress, anxiety, and difficulties experienced during homecare decreased.

Education Program to Improve the Adherence to Guidelines for Use of Blood Transfusions in Sickle Cell Disease

Background: An expert panel convened by the NHLBI in 2014 provided guidelines and indications for blood transfusions in patients with sickle cell disease (SCD). These recommendations were to help conserve the use of blood transfusions in SCD patients in order to reduce the complications of iron overload, transmission of blood-borne pathogens and development of alloantibodies. In a retrospective review of SCD patients who received blood during inpatient admissions we identified deviations from guideline recommendations including transfusions for pain, and asymptomatic drops in hemoglobin(hgb). A standardized education program was subsequently developed and implemented to improve compliance with NHLBI recommendations for transfusion use in hospitalized patients with SCD. Methods: A standardized education program was developed based on American Society of Hematology (ASH) and NHLBI recommendations. This program included a PowerPoint presentation which was delivered to small groups of hematologists, hospitalists, emergency room and primary care physicians, nurse practioners and medical residents who regularly manage inpatient SCD admissions. A post-test of knowledge was administered and completed by 65 individuals. Additionally, the ASH pocket guide app was placed on physician's smartphones. Following completion of the program, transfusion use and indications were reassessed over the next 6 months. The hospital database was screened for admissions of patients with the diagnosis of SCD (HbSS, HbSβ0, HbSβ+, HbSC) who were billed for a blood transfusion between 8/1/2015 to 8/31/2016. This served as the baseline data. All patients were &gt;18 years of age. Each chart was reviewed individually to assess the clinical setting and reasons for transfusion. The following parameters were documented: age, sex, length of hospital stay (LOS), hgb at time of transfusion, baseline hgb, number of units transfused, documented reason for transfusion, presence of alloantibodies and ferritin level. We defined the infusion of blood as a transfused event which included single or multiple units of blood. We excluded transfusions given for acute bleeding. Following the educational program, this same methodology was used to collect a second cohort of SCD patients admitted to the hospital between 1/2/2019-6/22/2019 wherein the indications and outcomes of blood transfusion were compared with the first, pre-educational cohort. Results: In phase one (pre-education cohort), a total of 87 SCD patients were analyzed and the majority of inpatient transfusions were not indicated by national guidelines with only 34.5% of transfusion events meeting expert panel recommendations. In this phase of our study, we reviewed a second cohort of 53 SCD patients (post-education). A total of 123 units of blood were transfused. 73.5% of patients had HbSS disease, 22.6% had HbSβ0 disease and 3.77% had HbSC disease. The mean age was 32.5 years and 69.8% were female. Compared to management of patients prior to the education program, less blood was administered for the non-guideline indications of acute pain crisis (15% vs 28%) and Hgb drop &gt;2gm (9% vs 21%) (see Figure 1). The mean level of ferritin in the second cohort was 1751 and 7.54% of patients had alloantibodies, compared to the baseline group with ferritin of 2483 and alloantibodies of 17%. The average LOS in the baseline group was 9 days and in the second cohort was 8.4 days with an average LOS for uncomplicated pain or a drop of hemoglobin in the baseline group of 8.9 days and in the second cohort of 6.6 days. The most common indicated guideline reasons for transfusion in both cohorts were for symptomatic anemia and acute chest syndrome. Conclusion: This educational program was able to reduce transfusion use in SCD patients who were hospitalized for vaso-occlusive crises and asymptomatic anemia. There was a trend towards decrease in LOS for patients when they had less transfusions. Face to face education in combination with the use of the readily available ASH pocket app on smartphones are effective tools to increase adherence to national guidelines for transfusion in SCD. Disclosures Cohen: Global Therapeutics: Other: Trial for GBT440.

International Society on Thrombosis and Haemostasis core curriculum project: Core competencies in laboratory thrombosis and hemostasis

BackgroundLaboratory analyses of blood samples are essential for diagnostics and therapy monitoring of patients with bleeding and thromboembolic diseases. Following publication of the core curriculum for clinical thrombosis and hemostasis, the International Society on Thrombosis and Haemostasis (ISTH) recognized that thrombosis and hemostasis laboratory specialists require distinct competencies that differ from medical doctors working clinically with patients. To address this gap the ISTH formed a working group of international hemostasis and thrombosis laboratory specialists to develop an evidence‐based core curriculum for laboratory specialists. ObjectiveThis research sought consensus from the international community on core competencies required for laboratory specialists in thrombosis and hemostasis. MethodsA draft list of 64 competencies was developed and an online stakeholder survey was circulated electronically to 15 302 ISTH members and contacts in the wider international community. The results were analyzed and used to develop the final approved core curriculum. ResultsThree hundred and thirty responses contained meaningful data, with broad international representation of specialists. No draft competencies were excluded, and 58 were rated as “does” or “shows how.” The Leik measure of consensus for most competences was “moderate” (n = 30) or “fair” (n = 32). ConclusionsThe development of an international core curriculum for laboratory specialists provides a foundation for the development and enhancement of education and quality management of the laboratory. Although there is no formal designation for laboratory specialists, international governing bodies and regulatory organizations are encouraged to consider the diagnostic core curriculum for development and accreditation of more standardized educational programs and formal assessment across jurisdictions.