PubMed Health⌕ Search

PubMed · 14763315

Development and implementation of a nurse-managed anticoagulation program.

Abstract

Nurse-managed anticoagulation is an emerging trend in primary care with the potential to improve the quality, efficiency, and responsiveness of outpatient anticoagulation services. Research indicates that specially trained nurses, using portable international normalized ratio (INR) monitors and decision-support systems, safely and effectively perform independent warfarin-dose adjustment. This article describes the development, implementation, and preliminary evaluation of a nurse-managed anticoagulation program as well as key lessons learned in the process. Factors for success included (a) availability of portable INR monitors, (b) designation of specially trained anticoagulation nurses, (c) use of an effective decision support system, and (d) support from staff and management.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Tom T Shimabukuro, Joan Kramer, Maura McGuire. Development and implementation of a nurse-managed anticoagulation program.. https://doi.org/10.1111/j.1945-1474.2004.tb00466.x

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The Assessment of Depression Inventory (ADI): an appraisal of validity in an outpatient sample.

In this study we examined the validity of the Assessment of Depression Inventory (ADI) using outpatient participants. The ADI Depression scale (Dep) was compared to three other measures used to assess depression: Beck Depression Inventory-II (BDI-II), Zung Self-Rating Depression Scale (ZSDS), and Personality Assessment Inventory (PAI). Correlations between the ADI and these three measures were significant. An analysis of the discriminant ability of the ADI Dep scale resulted in sensitivities, specificities, positive predictive power, negative predictive power, hit rate, and area under the curve (92.3%) that were supportive of the scale's effectiveness. The ADI Feigning scale (Fg) was compared to the six PAI validity scales. The Fg scale correlated significantly with the PAI Negative Impression Management (NIM) and Positive Impression Management (PIM) scales, and the Malingering (MAL) and Defensive (DEF) indexes. Directionality was as would be predicted. The ADI did not correlate with the two PAI validity scales derived by discriminant analysis function.

Ambulatory Care↗

How normalised is HIV care in the UK? A survey of current practice and opinion.

OBJECTIVES: The prognosis for individuals infected with HIV has changed dramatically over the past 10 years, with patients living longer and requiring other specialist services. It is apparent that access of other healthcare professionals to clinical information about a patient's HIV care differs between centres in the UK. Lack of awareness of an individual's HIV status may compromise their clinical care. AIM: To establish current practice and identify the views of clinicians caring for patients infected with HIV. METHODS: Lead consultants in all genitourinary medicine departments in the UK were invited to complete a questionnaire regarding use of combined HIV and hospital notes and ability of general practitioners and other hospital specialists to access information about individual patient's HIV care. Clinician's opinions on the "normalisation" of HIV management were also sought. RESULTS: Combined notes (outpatient and inpatient) were used by 12% (16/130) of respondents. The patient's identifying number was used to request blood tests in 86%. Of the respondents, 42% had encountered difficulties in communication that affected delivery of care for an HIV-positive patient. CONCLUSIONS: Centres using combined notes identified a higher frequency of communication with other doctors and specialties, suggesting a higher standard of care. Physicians involved in HIV care should consider combining patients' HIV and hospital notes for improved clinical care.

Ambulatory Care↗