Anticoagulation

 Case for Change

 
 

 Case for Change

 
Anticoagulation therapy is a complex and labor-intensive intervention for which success depends upon correct dosing decisions, frequent monitoring, clear communication, and most of all patient compliance.  “Errors with these products [anticoagulants] are not necessarily more common but the consequences are clearly more devastating.”2 

The National Quality Forum (NQF) in Safety Objective #29 states that "Every patient on long-term oral anticoagulants should be monitored by a qualified health professional using a careful strategy to ensure an appropriate intensity of supervision."5  NQF goes on to outline explicit organizational policies and procedures necessary for effective management of patients taking anticoagulants.  In 2008 the Joint Commission adopted the NQF recommendations and released new anticoagulation guidelines.

 
IHC has produced the following Anticoagulation Toolkit for health care providers based on the NQF recommendations. The forms selected contain all of the data elements necessary to successfully manage patient anticoagulation therapy according to the National Quality Forum Safe Practices and the American College of Chest Physician’s Anticoagulation Management Guidelines.6  The objective of this initiative is to ensure effective and safe long-term anticoagulation therapy in all care settings in Iowa.

 
This toolkit will:
·         Use evidence based clinical guidelines to increase patient health
·         Increase provider education and provide links to CME opportunities related to anticoagulation
·         Provide patient tools and educational materials
·         Provide Iowa Hospital’s Anticoagulation Policies and Procedures
 
1 Gurwitz, JH, et al., Incidence and Preventability of Adverse Drug Events Among Older Persons in the Ambulatory Setting, JAMA. 289:1107-1116, March 5, 2003.
4 The Joint Commission. National Patient Safety Goals Hospital Program. http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/08_hap_npsgs.htm
6 Chest Vol 133, Supplement, June 2008, http://www.chestjournal.org/cgi/reprint/133/6_suppl/71S
 
 
 

  Toolkit

 

Evidence Based Clinical Guidelines

 

Education and Tools 

Online Continuing Medical Education Courses (Anticoagulation CME)

Anticoagulation Programs

  • Anticoagulation Therapy Management Certificate Program (WEBSITE)
    The University of Southern Indiana School of Nursing and Health Professions offers an interactive Internet continuing education program for health care professionals, who want to develop the knowledge and skills necessary for effective, coordinated anticoagulant therapy management. Continuing education credits vary based on discipline. The course is offered five times a year and costs $500.
     
  • University of Illinois at Chicago AntithrombosisTherapy Management: Module 1 Traditional Oral Anticoagulants
    Objectives: Discuss proper indications, duration and intensity for oral anticoagulation therapy. List proper monitoring parameters for patients receiving warfarin therapy. Identify key educational elements for patients on warfarin therapy. Recommend proper warfarin dosing and frequency of patient follow up. List side effects associated with oral anticoagulants. Identify drug-drug, drug-diet, drug-disease state interactions with warfarin.

    Please contact Betsy Amato at amatob@ihconline.org if you would like anticoagulation forms.

     

Implementation

Other

 

 
 
 

 Success Stories 

 
If you have a success story you would like to share, please contact Betsy Amato at amatob@ihconline.org.
 

 

Mentors

 
We would like to thank those individuals and organizations who have shared their materials and who have agreed to serve as mentors. Please contact IHC if your organization would like to contribute materials to this toolkit.
 
 
  • Central Community Hospital, Elkader, IA
    Contact: Karen Wahls, RN
    Email: wahlsk@mercyhealth.com
    Phone: 563-245-7043
     
  • Community Anticoagulation Therapy (CAT) Clinic, Cedar Rapids, IA
    Contact: Carla Huber, ARNP, MS
    Email: chuber@pcofiowa.com
    Phone: 319-558-4045
     
  • Guttenberg Hospital Anticoagulation Therapy Program, Guttenberg, IA
    Contact: Deb Preston
    Email: Deb.preston@guttenberghospital.org
    Phone: 563-252-5580
     
  • Madison County Anticoagulation Management Clinic, Winterset, IA
    Contact: Becky Paxton
    Email: bpaxton@madisonhealth.com 
    Phone: 515-462-5218
     
  • Mercy North Iowa, Mason City, IA
    Contact: Mike Ahrens
    Email: ahrensm@mercyhealth.com
     
  • University of Iowa Hospitals and Clinics, Iowa City, IA
    Contact: Lisa Mascardo
    Email: lisa-mascardo@uiowa.edu
    Phone: 319-356-2577
 
 

Resources

 

Anticoagulation

 
DVT
 
Stroke

Patient Specific Materials

 

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