Anti-Coagulation Therapy
John Paul Home Care follows a strict anti-coagulation clinic protocol, whose purpose is to optimize therapeutic anticoagulation by minimizing patient bleeding risks, minimizing time to therapeutic anticoagulation and to increase patient education, monitoring and compliance.
Organization
When the patient requires anticoagulation therapy management, please contact John Paul Home Care at 248.731.7457 and ask for the nurse Bridget Scott-Lenhardt to receive the verbal order. If Mrs. Scott-Lenhardt is unavailable, please ask for nurse, Pam McCants.
Reports to Physician
Following a lab value or dosage adjustment for a patient a report will be sent by fax to the referring physician noting values, adjustments made, and information given to the patient orally or in written form.
Patient Monitoring
The patient may be questioned regarding the following at subsequent visits:
- Compliance with (and confirmation of) recommended dose
- Number of doses missed during the past 5-7 days
- Medications started or discounted since last visit
- Over the counter medications started or discounted since last visit
- Herbal products started or discounted since last visit
- Diet changes since last visit
- Change in exercise routine
- Recent acute illnesses
- Recent use of alcohol
- Peripheral edema
- Recent bruising or bleeding problems i. Minor bleeds (blood in urine, stool, bleeding gums, repeated nose bleeds, etc – the patient will be instructed to hold doses until bleeding resolves. Questionable cases will be referred to the outpatient physician. ii. Major bleeds – the patient will be referred to the outpatient physician.
Patient Education
Patient education on initial visit will include the following:
- Drug interaction screening with patient’s current drug regimen
- Herb interaction screening with herbals the patient may be taking
- Dietary considerations
- Importance of maintaining anticoagulation
- Signs of hypercoagulation
- Importance of compliance and follow-up monitoring
- Written information about herbal interactions, OTC interactions, dietary Vitamin K content, and warfarin information will be given to the patient
- Importance of medical alert identification
Follow up education will be conducted on subsequent visits. The patient will be questioned about signs of bruising and/or bleeding.