Adoption of new guidelines for the management of acute heart failure in the emergency department: An assessment on the quality of practice

Abstract

Background: Acute heart failure (AHF) is a disease with high incidence and mortality. Since 2016, new definitions were adopted for AHF requiring early management to improve prognosis. The aim of this study is to assess practices regarding management of AHF before and after a standardized educational workshop, which was delivered to emergency physicians and nurses during work shifts. Methods: 146 patients presenting AHF were selected in this prospective study. Patients were divided in three groups for three different periods, namely a first phase without educational workshops offered to emergency physicians and nurses, a second phase with educational workshops, and a third phase with assessment of practices after a six-month interval. Results: Systematic measurement of respiratory rare improved from 17% to 67% of cases. The acquirement of an echocardiography before the 24-hour delay improved from 21% to 100% of cases. The administration of diuretics also improved from 79% to 84% of cases. Conclusions: An improvement of diagnostic and therapeutic management was found. Educational workshops to emergency physicians and nurses improve the clinical recognition of AHF, reduces the delay of the acquirement of echocardiography, and treatment administration.