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A pre- post-evaluation of implementing an inpatient warfarin monitoring and education program

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Author(s): Armstrong EP | Chemodurow L | Christensen S | Johnson ES

Journal: Pharmacy Practice
ISSN 1885-642X

Volume: 9;
Issue: 2;
Start page: 101;
Date: 2011;
Original page

Keywords: Warfarin | Inpatients | Pharmacy Service | Hospital | United States

ABSTRACT
Objective: The purpose of this study was to evaluate whether a new anticoagulation management program resulted in better monitoring of warfarin, increased warfarin patient education prior to discharge, and fewer bleeding complications associated with warfarin.Methods: A retrospective chart review was conducted of all patients who were inpatients and received warfarin from April 1, 2008 to July 31, 2008 (control group) and from April 1, 2009 to July 31, 2009 (after implementation of the new anticoagulation program). The frequency of warfarin-related laboratory orders that included international normalized ratios (INRs), complete blood counts (CBCs), and documented patient education by pharmacy, nursing, and dietary services were determined before and after program implementation. Also, data was collected to determine frequencies of bleeding complications associated with warfarin.Results: There were 112 patients in the pre- and 115 patients in the post-program group. After implementation of the inpatient warfarin management program, obtaining baseline INRs increased from 74% to 90% (p=0.001). Orders for baseline CBCs increased from 85% to 94% (p=0.026). Obtaining CBCs every 3 days increased from 54% to 74%, (p
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