1. Patient education for the growing Coumadin population.
Jeanette M. Mullane
Patient education for the growing Coumadin population.

2. Why worry with Coumadin?
If you've worked within the medical field for any length of time, you've probably met or cared for someone on Coumadin also known as Warfarin.
What's wrong with Coumadin?
Coumadin requires blood-work, constantly, to determine therapeutic range.
Constant blood work = constant dosage changes for our patients. This constant change in medication routine can equal frustration and decrease compliance.
Who takes Coumadin?
Patients with A-Fib, thromboembolic disorders, and to reduce to risk of strokes or recurrent heart attacks.
I selected this issue to help increase patient education, increase compliance, and to take a stand against strokes.

3. WHAT CAN I DO TO HELP? Increase patient education!!
Provide verbal and written education.
Give the patient a form and ask them to record PT\INR lab values.
This will help discuss trends with the patient and will give them a visual of what THEY can control!
Many charting systems do not offer adequate areas to track and follow this information. By creating the “Warfarin Worksheet” we can chart, track, trend, and recall previous information. EMR systems can scan and save the worksheet into a patients permanent chart.
The worksheet will provide areas for lab values (past and present), supporting diagnoses, diet changes, antibiotic usage, side effects, and patient teaching topics.
Best of all, both patient and provider get a copy which will allow EVERYONE to be informed! INFORMATION IS POWER!

4. TAKING A STAND AGAINST THE SILENT KILLER!
If and when a new prescription for Coumadin is written the nurse will provide extensive one on one teaching with the patient utilizing written and verbal education.
What about the large patient base already on Coumadin?
Each patient who is already prescribed Coumadin will be given the same teaching at their next lab appointment.
Providing one on one teaching tailors the experience to their situation. Mass education will not allow the nurse to address each patients specific needs and concerns because every situation is different.

5. Warfarin Worksheet Patient Name: DOB: Reason for therapy:
Current Dosage:
Date\Result of last PT\INR:
Missed Doses: YES or NO
Dietary Changes (increase\decrease in green leafy vegetables):
Aspirin: YES or NO New Medications:
Unusual bleeding or new side effects:
Today's Date: Today's Result:
Changes to regimen: (IF NONE LIST THE CURRENT REGIMEN)
NEXT LAB APPOINTMENT:
Specify patient teaching:
Signature of patient:
Witness:
(Give a copy to patient and scan a copy into the chart)

6. Photo Courtesy of: studentnurses3.blogspot.com

7. Photo courtesy of: USPharmacists.com
Photo Courtesy of: NurseBluff.com
Photo courtesy of: USPharmacists.com

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