The Effects of An Anticoagulation Program on Patient Compliance Following Total Joint Replacement

2.50
Hdl Handle:
http://hdl.handle.net/10755/622716
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
Clinical Practice Guideline(s)
Research Approach:
Translational Research/Evidence-based Practice
Title:
The Effects of An Anticoagulation Program on Patient Compliance Following Total Joint Replacement
Author(s):
Stone-Corr, Aisha
Additional Author Information:
Aisha Stone Corr, DNP, BSN, RN; aisha.shani@yahoo.com
Advisors:
Jones, Terri; Sheppard, Katherine; Bassey, Mary
Degree:
DNP
Degree Year:
2017
Grantor:
Capella University
Abstract:

Patients undergoing major orthopedic surgery have shown the potential for deep vein thrombosis (DVT) ranging from 46% to 60% postoperatively. To avoid this risk, home rehabilitation is recommended, including nursing and/or physical therapy, proper monitoring of international normalized ratios (INRs), and anticoagulant medication compliance. This quality improvement initiative was done to address the gap in care of inadequate tools for the clinicians to properly manage anticoagulant dependent patients as well as the inconsistency of anticoagulation therapy management and care. Applying the five steps of the Iowa model of evidence-based practice, an anticoagulation therapy program was created including an organizational clinician certification. The primary outcome variable involved patients’ INR values; secondary outcomes included patient satisfaction scores, evaluation of the number of rehospitalizations and patient adverse events; monthly rating scores from Medicare’s Home Health Compare; and collaboration of the organization’s root cause analysis team. No significant improvements were observed in the primary outcomes during data collection. However, Press Ganey patient satisfaction ratings related to medication education and disease process teaching showed an improvement. Home Health Compare ratings remained the same. Other quality improvement studies may benefit from the lessons learned, and continued efforts to improve anticoagulation in orthopedic surgery patients are needed.

Keywords:
Warfarin; International Normalized Ratio; Deep Vein Thrombosis; Orthopedic Surgery Patients; Medication Compliance
CINAHL Headings:
Orthopedic Surgery--Adverse Effects; Orthopedic Surgery; Venous Thrombosis; Venous Thrombosis--Prevention and Control; Arthroplasty, Replacement; Arthroplasty, Replacement--Adverse Effects; Anticoagulants; Patient Compliance; Medication Compliance
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2017-09-21T19:05:39Z
Date of Publication:
2017-09-21

Full metadata record

DC FieldValue Language
dc.contributor.advisorJones, Terrien
dc.contributor.advisorSheppard, Katherineen
dc.contributor.advisorBassey, Maryen
dc.contributor.authorStone-Corr, Aishaen
dc.date.accessioned2017-09-21T19:05:39Z-
dc.date.available2017-09-21T19:05:39Z-
dc.date.issued2017-09-21-
dc.identifier.urihttp://hdl.handle.net/10755/622716-
dc.description.abstract<p><span>Patients undergoing major orthopedic surgery have shown the potential for deep vein thrombosis (DVT) ranging from 46% to 60% postoperatively. To avoid this risk, home rehabilitation is recommended, including nursing and/or physical therapy, proper monitoring of international normalized ratios (INRs), and anticoagulant medication compliance. This quality improvement initiative was done to address the gap in care of inadequate tools for the clinicians to properly manage anticoagulant dependent patients as well as the inconsistency of anticoagulation therapy management and care. Applying the five steps of the Iowa model of evidence-based practice, an anticoagulation therapy program was created including an organizational clinician certification. The primary outcome variable involved patients’ INR values; secondary outcomes included patient satisfaction scores, evaluation of the number of rehospitalizations and patient adverse events; monthly rating scores from Medicare’s Home Health Compare; and collaboration of the organization’s root cause analysis team. No significant improvements were observed in the primary outcomes during data collection. However, Press Ganey patient satisfaction ratings related to medication education and disease process teaching showed an improvement. Home Health Compare ratings remained the same. Other quality improvement studies may benefit from the lessons learned, and continued efforts to improve anticoagulation in orthopedic surgery patients are needed.</span></p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectWarfarinen
dc.subjectInternational Normalized Ratioen
dc.subjectDeep Vein Thrombosisen
dc.subjectOrthopedic Surgery Patientsen
dc.subjectMedication Complianceen
dc.titleThe Effects of An Anticoagulation Program on Patient Compliance Following Total Joint Replacementen_US
dc.typeDNP Capstone Projecten
thesis.degree.grantorCapella Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.-
dc.primary-author.detailsAisha Stone Corr, DNP, BSN, RN; aisha.shani@yahoo.comen
thesis.degree.year2017en
dc.type.categoryFull-texten
dc.evidence.levelClinical Practice Guideline(s)en
dc.research.approachTranslational Research/Evidence-based Practiceen
dc.subject.cinahlOrthopedic Surgery--Adverse Effectsen
dc.subject.cinahlOrthopedic Surgeryen
dc.subject.cinahlVenous Thrombosisen
dc.subject.cinahlVenous Thrombosis--Prevention and Controlen
dc.subject.cinahlArthroplasty, Replacementen
dc.subject.cinahlArthroplasty, Replacement--Adverse Effectsen
dc.subject.cinahlAnticoagulantsen
dc.subject.cinahlPatient Complianceen
dc.subject.cinahlMedication Complianceen
This item is licensed under a Creative Commons License
Creative Commons
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.