The development of service model for warfarin clinic in outpatient department, Nongphok hospital

Abstract

Purposes : To study the situation, develop a model, and evaluate the service model of the warfarin clinic in outpatient department, Nongphok hospital.

Design :  Action research.

Materials and Methods : Participants in the research include doctors, pharmacists, medical technicians. And professional nurses working in the outpatient department, 15 people and 50 patients receiving warfarin, conducted in 3 phases including the situation analysis phase processing period and performance evaluation period. Collect data from searching in the HIS program, observing, making inquiries, group meeting. Tools used for evaluation including a questionnaire to assess patient's knowledge and behavior in warfarin use, INR results, major-minor bleeding complications and content analysis.

Main findings : The results of the study were warfarin clinic service model in Nongphok Hospital. The results of the model evaluation found that Patients' knowledge about warfarin was assessed at 86.00%. The average score was 14.94 points. Warfarin use behavior was at the most good level, 56.00%, at the fair level, 44.00%. The percentage of INR within the target range (2-3.5) increased from 54.18% to 62.58%. Minor bleeding complications were found: 12 cases, Major bleeding 1 case. Results of content analysis. Four problems arising from the use of warfarin were found as follows: Awareness of blood clotting values, drug use and behavior in terms of receiving medicine according to appointment.

Conclusion and recommendations : The development of service model for warfarin clinic should be appropriate according to the context of each area. In order to achieve effective use of warfarin and reduce adverse reactions from warfarin.