Keywords

Rheumatic Heart Disease, cardiac auscultation, simulation, Samoa

Abstract

Improving the Detection of Rheumatic Heart Disease in

Children Residing in Samoa

Shay Harding

College of Nursing, BYU

Master of Science

Rheumatic Heart disease (RHD) is the most common cause of heart related illness in individuals under 25 years of age and is a major health concern on the Pacific Islands of Samoa (Saxena et al., 2017). RHD related mortality among Samoan children is disproportionally high relative to the rest of the world; it is estimated to impact 10 out of every 1000 children there (Allen et al., 2017). The health care system in Samoa is limited in its resources, which impacts the timely diagnosis and treatment of RHD. Cardiac auscultation is a screening tool used in the identification of RHD. Rheumatic Relief is an organization that performs screenings for RHD using echocardiography and cardiac auscultation. The techniques used, although inexpensive, portable and rapid, do require individuals who are trained in cardiac auscultation. Purpose: The aim of this project was the implementation of cardiovascular auscultation simulation designed to instruct humanitarian volunteers in proper technique. Methods: An evidence based education program on cardiac auscultation was developed, which included an online module and an in person simulation session. 15 student participants completed an auscultation pre-test and a post-test following the education module. Students traveled to Samoa where they were supervised in auscultation techniques, in a clinical setting, as part of a larger rheumatic heart disease detection program. Outcomes: Pre and post tests showed that the training was effective in teaching cardiac auscultation skills. In the field, participants were confident with auscultation skills and detected a significant amount of cardiac murmurs despite some difficult environmental circumstances. Conclusion: Providing students with an evidence based cardiac auscultation training module does improve cardiac auscultation skills. However, cardiac auscultation alone is not adequate to diagnose RHD reliably and should be accompanied by echocardiography for accurate diagnosis.