Date of Award

2013

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Candice Rome

Abstract

As a response to the 2011 National Patient Safety Goals (NPSG), a Coumadin Team, consisting of a Physician Chair, Pharmacists, and Registered Nurses, was formed at Mission Health System to focus on International Normalized Ratio (INR) testing, Coumadin dosing, and patient education. The goal of this team has been to identify and eliminate barriers that prevent the stabilization of INRs within the prescribed goal range, and to ensure that all patients receive education about Coumadin therapy in order to prevent harm and reduce readmission rates related to Coumadin therapy. The purpose of this study is to compare readmission rates within the same timeframe in consecutive years, before and after the Coumadin Team was initiated, to determine if these measures have in fact been an effective avenue to reaching the 2011 NPSG. In a retrospective chart review 556 patients with active Coumadin orders from July 1 - July 31, 2010 were compared to 417 patients with active Coumadin orders from July 1 - July 31, 2011 to determine if readmission rates in the 90 days following hospitalization were in fact lower as a result of one-to-one Coumadin therapy education by a Registered Nurse. Research results have confirmed that in 2010 Coumadin related readmissions occurred at a rate of 7.2% of the total patient group, while in 2011 Coumadin related readmission occurred at a rate of 1.4% of the total patient group, giving a net reduction of Coumadin readmission rates of 5.8% after the initiation of the Coumadin Team.

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