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Development and implementation of a nurse-managed anticoagulation program.

Tom T Shimabukuro1, Joan Kramer, Maura McGuire

  • 1Johns Hopkins School of Nursing, University of Maryland School of Nursing, USA. tshimabu@jhsph.edu

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
|February 7, 2004
PubMed
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Nurse-managed anticoagulation programs, utilizing trained nurses and portable monitors, safely adjust warfarin doses in primary care. This approach enhances the quality and efficiency of outpatient anticoagulation services.

Area of Science:

  • Primary Care Medicine
  • Nursing Practice
  • Pharmacology

Background:

  • Outpatient anticoagulation management is crucial for preventing thromboembolic events.
  • Traditional models often face challenges in quality, efficiency, and responsiveness.
  • Nurse-led initiatives offer a promising alternative for optimizing patient care.

Purpose of the Study:

  • To describe the development and implementation of a nurse-managed anticoagulation program.
  • To evaluate the preliminary outcomes and identify success factors for such programs.
  • To highlight the role of nurses in independent warfarin dose adjustment.

Main Methods:

  • Development and implementation of a structured nurse-managed anticoagulation program.
  • Utilization of trained nurses with portable International Normalized Ratio (INR) monitoring devices.

Related Experiment Videos

  • Integration of a decision-support system for warfarin dose adjustments.
  • Preliminary evaluation of program effectiveness and key operational factors.

    • Main Results:

    • Specially trained nurses can safely and effectively manage warfarin dosing independently.
    • Portable INR monitors and decision-support systems facilitate efficient dose adjustments.
    • Key success factors include nurse training, technology availability, and organizational support.

    Conclusions:

    • Nurse-managed anticoagulation is a viable and effective model for primary care settings.
    • This program has the potential to improve the quality, efficiency, and responsiveness of anticoagulation services.
    • Successful implementation requires dedicated resources, trained personnel, and robust support systems.