Promoting Healthcare Safety And Quality By Assessing Anticoagulation Education Process

Abstract

We conducted a baseline study of warfarin patient education process by (1) assessing a healthcare facility’s current compliance with the education requirements for anticoagulation therapy, (2) assessing how effectively warfarin education was being provided in terms of patient’s knowledge and (3) identifying areas where process improvements were warranted. The facility is an acute care teaching hospital and a Level I Trauma Center with a pharmacist-managed outpatient anticoagulation clinic. We collected data from patients concerning (1) six warfarin knowledge domains (drug-nutrition interactions, drug-drug interactions, monitoring, drug information, dosing and adverse effects), (2) whether or not patients received warfarin education upon discharge and which healthcare professional provided this education (physician, pharmacist, nurse), (3) duration of warfarin therapy, (4) self-rated knowledge of warfarin, and (5) various demographics. Study results indicated the need to implement improvements to the education process to ensure that warfarin education is consistently and routinely provided to all patients prior to being discharged on warfarin with particular attention given to patients sixty years of age and older. Education provided should focus on drug-nutrition and drug-drug interactions, which were found to be areas of highest knowledge deficit. Improvements to the process of providing warfarin education at our hospital may additionally include implementation of a protocol to identify patients requiring education, and a standardized educational program with a pharmacist- managed warfarin discharge counseling service.