Clinical Efficacy of Nurse Based in Monitoring When Using Warfarin in the Long-Term Care Setting

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Karen Stukes (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Eric Gill

Abstract: Background: 1.6 million Americans reside in the long-term care setting/nursing homes. About12% of these patients receive Warfarin for various medical conditions such as A Fib, PE’s andDVT’s. Warfarin remains the leader in anticoagulation therapy in the long-term care setting. Medication errors when using Warfarin can range from double dosing, late dosing, or misseddosing, and poor INR monitoring. For patients these errors have potential injury and/or deathimplications from subtherapeutic/supratherapeutic INR’s. Some require ED visits, treatment withVT K or holding medication. Purpose: To standardize the monitoring of INR levels for patients on Warfarin in the long-term care setting. Also decrease the incidence of incorrectly monitored INR levels, which can lead to incorrect or untimely dosing of Warfarin and adverse outcomes or effects. Method: This project used the PDSA model. The Plan included notifying nursing staff of upcoming changes to the process. The Do included collecting 2 months of retrospective data and 2 months of prospective data. The Study included analyzing the collected data and the Act was the implementation and preparing for the next phase. Results: Results showed overalldecrease in non-therapeutic INR’s, decrease in people requiring various forms of treatment fornon-therapeutic INR’s and a decrease in dosing errors as reasons for non-therapeutic INR.Positive outcomes in relation to Warfarin use in long term care at the intervention site. Numberof therapeutic INR’s were increased substantially in comparison to non-therapeutic INR’s.Potential adverse effects were prevented with new process. Conclusion: Utilizing one RNworking alongside the principal investigator allowed for a clearer and more precise model toidentify any problems within the INR monitoring system. This included the collection of INRs’along with the timely logging of INR’s and proper NP dosing of Warfarin.

Additional Information

Language: English
Date: 2023
Warfarin use, long-term care, nursing home, a-fib, DVT, PE, CVA

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Clinical Efficiency of Nurse Led INR monitoring when using Warfarin in the Long-Term Care Setting [Poster] described resource includes the related resource either physically or logically.