VAD 911: Process Improvement for First Responders Treating Ventricular Assist Device Patients.

Ventricular assist devices (VAD) complications including stroke, device failure, gastrointestinal bleeding, and infection all can manifest in the outpatient environment. Often, first responders do not have the knowledge base to respond appropriately. This study conducted an assessment of first responders generalized knowledge and self-reported competency regarding VAD use, provided an education course, and tested for improvement immediately after and 1 month postintervention. Two hundred thirty-six first responders participated from communities with known VAD patients. Responses indicated poor knowledge, experience, and competency. Twenty-one percent had seen a manufacturer training video, 26% had attended prior training, and 38% knew who to contact with a VAD emergency. Generalized knowledge of VAD therapy was poor with majority not understanding use of anticoagulation, when to initiate chest compressions and assessment variations. Self-reported competency was low with 80% of participants reporting unsafe to marginal about VAD awareness. Comparison of 1 month postintervention to preintervention, generalized knowledge improved by a minimum of 38% for each question and competency increased by over 50%. From this study comes the recommendation that VAD centers must include the community first responders as part of their discharge planning for the VAD patient and improve community outreach to ensure appropriate patient outcomes.