Quality improvement in an anticoagulation clinic: development of a new treatment protocol

J Nurs Care Qual. 2012 Apr-Jun;27(2):161-70. doi: 10.1097/NCQ.0b013e31823e83fd.

Abstract

We sought to improve patient outcomes and efficiency in our anticoagulation clinic through development of a new protocol for managing heart valve patients with subtherapeutic international normalized ratio (INR) tests. The new protocol standardized use of 1 anticoagulation agent while warfarin was retitrated, timelines for INR retesting, and target INR levels depending on the type of valve implanted. The new protocol provided significant improvements in patient care; however, outcomes for clinic operating efficiency were mixed.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care Facilities / organization & administration
  • Ambulatory Care Facilities / standards*
  • Anticoagulants / therapeutic use*
  • Clinical Protocols / standards*
  • Efficiency, Organizational
  • Female
  • Heart Valve Prosthesis Implantation / nursing*
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Nursing Administration Research
  • Nursing Evaluation Research
  • Pilot Projects
  • Practice Patterns, Nurses' / organization & administration*
  • Quality Improvement / organization & administration*
  • Treatment Outcome
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Warfarin