Nursing Support to Pre-discharge patient with Newly Prescribed Oral Anticoagulants

Abstract Description

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Authors (including presenting author) :

Yip LW(1), Cheng PPP(2), Man WY(1), Wong HYA(1), Chow YM (1), Lau YLA(1)

Affiliation :

(1) Department of Medicine, Yan Chai Hospital (2) Central Nursing Division, Yan Chai Hospital

Introduction :

The clinical use of Oral Anticoagulant (OAC) is worldwide nowadays. It delivers primary and secondary prevention of venous and arterial thromboembolic occurrence. As recommended by international clinical guidelines, in order to use Warfarin or NOACs safely, patients should be educated on many important precautions, such as drug administration, alarming side effects, drug-drug interactions, and drug-food interactions. A program on “Transdisciplinary Support for Elderly Patients with Newly Prescribed Oral Anticoagulants” was carried out since Feb 2017. Positive result was revealed from this program. However, service gap was identified on those patients who were excruited in this program. Thus, a “Nursing Support to Pre-discharge patient with Newly Prescribed Oral Anticoagulants” program was elicited & started from June 2018.

Objectives :

To offer OAC information and health education to patients and /or carers. To provide tele conversation follow up. To compare patients’ OAC knowledge before and after receiving this service. To ensure the drug compliance & rectify any misunderstanding

Methodology :

Patients would be recruited into this nursing support program if they were under 60 years old, not living at home in Tsuen Wan district, or refused out-patient pharmacist’s counselling. Designated nurses were responsible for screening patients in wards. They would conduct a comprehensive OAC education with pre-discharge questionnaire. The OAC education focused on the alarming side effects, drug-drug interactions, and drug-food interactions. The pre-discharge questionnaire contained 10 questions in 7-Liket score. After discharge, the patient would be tele conversation by another designated nurse within 4-6 weeks. Nurses would check patient’s compliance and reviewed their knowledge by a post-counseling questionnaire.

Result & Outcome :

From June 2018 to November 2018, total 77 cases were recruited. Only 63 patients (81%) completed the 4-6 weeks post-counseling questionnaire. The mean scores of pre-counselling questionnaire was 2.2 ± 2.31 and the mean scores of post-counselling questionnaire was 6.9 ± 2.04 (P value < 0.01). The positive result reflects the effectiveness & efficacy on seamless nursing support upon patients’ discharge. Patient appreciated & welcome for the continuity care from this program.