Objective: The purpose of this study was to determine the level of knowledge and compliance with American Heart Association (AHA) recommended guidelines for sudden cardiac death (SCD) risk screening of providers completing prescreening exams and school officials requiring prescreening exams.
Methods: Retrospective review was completed on 704 patient pre-participation exams (PPEs) between 1/1/2014 and 12/31/2015. Patient demographics and evidence of AHA screening recommendation documentation were collected. Surveys were sent to providers within Gundersen Health System who perform PPEs and to school officials within the service area to assess knowledge and compliance with AHA recommendations.
Results: There were relatively equal numbers of females and males in the sample population (46% and 54%) with a mean age of 14.3. More than half of the PPEs were the first for the patient. Evidence of documentation was found on average 67% of the time for personal history criteria with the exception of prior high blood pressure at 58%. Provider survey responses indicated assessment of personal history items at always or most of the time between 81% and 100%. Evidence of documentation for family history criteria was found on average 66% of the time with the exception of a relative with unexplained fainting or seizures at 54%; whereas survey data indicated assessment rates at 71% and 97% (always or most of the time). Physical exam criteria were found documented on average 93% of the time in the electronic medical record (EMR), with the exception of Marfan syndrome screen at only 52%. Providers reported on the survey that assessment was always or most of the time done between 30% and 100% of the time. Awareness of the AHA 14-point prescreening recommendations was reported by only 50% of providers completing exams and 0% of the school officials.
Conclusions: Knowledge and awareness of the AHA 14-point recommendations for PPEs is low in our area. Providers recall performing recommended assessments at a higher rate than what was found documented in the EMR. This study has highlighted an area for improvement and opportunities for educational efforts both within our system and in collaboration with our community.