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Anaphylaxis Preparedness Initiative for Allergen Immunotherapy: Implementation of an Online Training Module
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Lisanne P. Newton, MD, Ahila Subramanian, MD, MPH, David M. Lang, MD FAAAAI
Rationale:  Systemic reactions from subcutaneous immunotherapy (SCIT) occur in 2-5/1000 injections. An anaphylaxis preparedness initiative was implemented at an institution with a main campus and 9 regional sites, with a volume of > 20,000 SCIT injections annually.   An online module to train staff to recognize and manage anaphylaxis was developed as part of the initiative.

Methods:  We assigned an online module for anaphylaxis preparedness to physicians and nurses involved with SCIT.  We used chi-square tests to compare pre/post- knowledge-based test questions and voluntary survey answers.

Results: We assigned the module to 73 physicians and 56 nurses. 32 physicians and 53 nurses completed the module and pre/post-test questions; 21 physicians and 24 nurses completed the pre/post-surveys.   Scores on test questions increased from 75.0% to 92.2% (p < 0.001) for physicians and 76.3% to 91.1% (p < 0.001) for nurses after completion. Physicians “very comfortable” treating anaphylaxis increased from 5/21 (23.8%) to 13/21 (61.9%) (p = 0.013), using epinephrine from 9/21 (42.9%) to 16/21 (76.2%) (p = 0.028), and recognizing anaphylaxis from 10/21 (47.6%) to 18/21 (85.7%) (p = 0.009). We observed only slight increases in the proportion of nurses “very comfortable” treating anaphylaxis (8/24 (33.3%) to 13/24 (54.2%); p=0.15), using epinephrine (12/24 (50.0%) to 14/24 (58.3%); p = 0.56), and recognizing anaphylaxis (15/24 (62.5%) to 17/24 (70.8%); p = 0.54); the majority reported high comfort levels.  All participants found the module “somewhat helpful” or “very helpful”.

Conclusions: This study supports an online training module as an essential component of a multi-faceted anaphylaxis preparedness initiative.