The Development of a Care Model for Patients Receiving Warfarin Drug in Pakkred Hospital, Nonthaburi Province by Using Design Thinking as a Base

Abstract

   Objective : To develop a model of care for patients receiving warfarin in Pakkred Hospital, Nonthaburi Province using design thinking as a base by data from a-20 question test, the INR, thrombosis event, bleeding disorder, and patient and their relatives’ satisfaction. Methods and Materials : This study was a developmental research. The concept was designed by our 6-people multidisciplinary team from 1^st January-31^st July 2019. At the same time period, we enrolled 60 voluntary participants receiving warfarin with the percentage of INR within the target less than or equal to 50% or experiencing adverse drug reactions. Thereafter, we implied the concept to them from 1^st August- 31^st December 2019. The research was divided into 4 phases 1) learning situation 2) model development 3) model testing 4) model evaluation. The tools used in the research consists of 1) the format and guidelines of care for patients receiving warfarin which designed and developed by the researcher 2) the three data collection forms (patient data, test their knowledge and the INR) 3) Evaluation forms of the patients and their relatives’ satisfaction. Results : Average score on knowledge regarding drug use increased from 15.932.583 to 19.830.526 (P< 0.001), while the percentage of time of the INR in target range of treatment increased from 40.68% to 52.15%. Percentage of bleeding disorders decreased from 2.26% to 0.61%. Interestingly, patients and relatives were satisfied with the highest level at 89.45%. Comment and Suggestion : These results showed that the development model improved indicators significantly and the innovative model could be used to improve patient care in the future.