Anaphylaxis Preparedness Initiative for Allergen Immunotherapy: Implementation of an Online Training Module

Abstract

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 5 0.013), using epinephrine from 9/21 (42.9%) to 16/21 (76.2%) (p 5 0.028), and recognizing anaphylaxis from 10/21 (47.6%) to 18/21 (85.7%) (p 5 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%); p50.15), using epinephrine (12/24 (50.0%) to 14/24 (58.3%); p 5 0.56), and recognizing anaphylaxis (15/24 (62.5%) to 17/24 (70.8%); p 5 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.