title: Screening for Atrial Fibrillation--A Cross-Sectional Survey of Healthcare Professionals in Primary Care.
abstract: BACKGROUND
  Screening for atrial fibrillation (AF) in primary care has been recommended; however, the views of healthcare professionals (HCPs) are not known. This study aimed to determine the opinions of HCP about the feasibility of implementing screening within a primary care setting.
  
  
  METHODS
  A cross-sectional mixed methods census survey of 418 HCPs from 59 inner-city practices (Nottingham, UK) was conducted between October-December 2014. Postal and web-surveys ascertained data on existing methods, knowledge, skills, attitudes, barriers and facilitators to AF screening using Likert scale and open-ended questions. Responses, categorized according to HCP group, were summarized using proportions, adjusting for clustering by practice, with 95% C.Is and free-text responses using thematic analysis.
  
  
  RESULTS
  At least one General Practitioner (GP) responded from 48 (81%) practices. There were 212/418 (51%) respondents; 118/229 GPs, 67/129 nurses [50 practice nurses; 17 Nurse Practitioners (NPs)], 27/60 healthcare assistants (HCAs). 39/48 (81%) practices had an ECG machine and diagnosed AF in-house. Non-GP HCPs reported having less knowledge about ECG interpretation, diagnosing and treating AF than GPs. A greater proportion of non-GP HCPs reported they would benefit from ECG training specifically for AF diagnosis than GPs [proportion (95% CI) GPs: 11.9% (6.8-20.0); HCAs: 37.0% (21.7-55.5); nurses: 44.0% (30.0-59.0); NPs 41.2% (21.9-63.7)]. Barriers included time, workload and capacity to undertake screening activities, although training to diagnose and manage AF was a required facilitator.
  
  
  CONCLUSIONS
  Inner-city general practices were found to have adequate access to resources for AF screening. There is enthusiasm by non-GP HCPs to up-skill in the diagnosis and management of AF and they may have a role in future AF screening. However, organisational barriers, such as lack of time, staff and capacity, should be overcome for AF screening to be feasibly implemented within primary care.
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Jaspal S
authors.initials: JS
authors.lastname: Taggar
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Tim
authors.initials: T
authors.lastname: Coleman
authors.affiliation: Division of Epidemiology & Public Health, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Jones
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology; D001291:Attitude of Health Personnel; D002947:Cities / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004506:Education, Nursing; D004562:Electrocardiography; D058006:General Practice / Q000193:education; D058005:General Practitioners / Q000193:education; D006801:Humans; D008403:Mass Screening; D009726:Nurses; D011320:Primary Health Care; D006113:United Kingdom / Q000453:epidemiology