IJCS | Volume 32, Nº2, May/June 2019

DOI: 10.5935/2359-4802.20180098 227 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(3)227-237 Mailing Address: Milena S. Marcolino Avenida Professor Alfredo Balena, 190 sala 246. Postal Code: 30130-100, Belo Horizonte, MG - Brazil. E-mail: milenamarc@gmail.com Implementation of an Acute Coronary Syndrome Simulation Training Strategy for Emergency Healthcare Professionals Maíra Viana Rego Souza-Silva, 1, 2 P riscilla Fortes de Oliveira Passos, 1, 2 Thais Ribeiro Lemos, 1, 2 Bárbara Campos Abreu Marino, 1, 2 T hatiane Dantas Dias, 2 G eisiane Sousa Braga Machado, 2 E dson Alexandre Silva Carvalho, 1, 2 Gabriel Almeida Silqueira Rocha, 1, 2 A ntonio Luiz Ribeiro, 1, 2 M ilena Soriano Marcolino 1, 2 Faculdade de Medicina, Universidade Federal de Minas Gerais, 1 MG - Brazil Centro de Telessaúde do Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), 2 MG - Brazil Manuscript received on March 10, 2018, revised manuscript on May 20, 2018, accepted on August 07, 2018. Abstract Background: The knowledge on the management of patients with acute coronary syndrome (ACS) is essential to reduce the gap between evidence and practice. Objective: To describe a simulation training strategy for emergency healthcare professionals and provide preliminary data on knowledge acquisition, learners’ confidence and prescription of medications after training. Methods: The trainingwas part of the implementation of twomyocardial infarction systems of care. It comprehended lectures and simulation-based learning using high and low-fidelity mannequins and actors. It was tested in two phases: the first one in Belo Horizonte and the second one in Montes Claros, both in the state of Minas Gerais. A test was applied before and after training to assess knowledge acquisition. Confidence to perform thrombolysis in ST- elevation myocardial infarction (STEMI) patients was assessed using a questionnaire, and the impact on medication prescription analyzed STEMI patients admitted to hospitals in Montes Claros. Results: In the first phase, 156 professionals answered both tests: 70% of them improved their results and the median number of right answers increased (6, interquartile range [IQR] 5-7; vs 7 ([IQR] 6-9; p < 0.05). In the second phase, 242 professionals answered both tests: 58% of the physicians and 83% of the nurses obtained better test scores. Participants referred a positive impact on their clinical practice, 95% reported feeling very secure when perform fibrinolysis after the training, and there was also an impact on medication prescription. Conclusions: There was an impact on the learners’ knowledge acquisition and confidence using our two-phase training model , with evidence of impact on performance. (Int J Cardiovasc Sci. 2019;32(3)227-237) Keywords: Acute Coronary Syndrome; Myocardial Infarction; Myocardial Reperfusion; Emergency Service Hospital; Quality Indicators, Health Care. Introduction The knowledge on the management of patients with acute coronary syndromes (ACS) is essential to any emergency healthcare provider. This condition is highly prevalent globally and potentially hazardous, responsible for 31% of all deaths in 2015. 1,2 It is also known that mortality is income-related and at least three quarters of deaths occur in low-and middle-income countries (LMICs), such as Brazil. 1 In this country, ACS is an important cause of hospitalization and the leading cause of mortality, accountable for almost 28% of deaths in 2014. 3,4 The gap between research knowledge and guideline recommendations to their utilization in clinical practice impacts on the quality of care delivered and clinical outcomes. 5,6 Therefore, it is necessary to provide means to keep staff updated on ACS guidelines aiming to enhance performance and, ultimately, to improve patient care.