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Heart Failure Anticoagulation Teach-Back Education and Readmissions

Description

Heart failure affects millions of Americans each year. Treatment of advanced heart failure with reduced ejection fraction and left ventricular failure is sometimes treated with implantation of a left-ventricular assist

Heart failure affects millions of Americans each year. Treatment of advanced heart failure with reduced ejection fraction and left ventricular failure is sometimes treated with implantation of a left-ventricular assist device. While living with this life-sustaining machine, anticoagulation with Coumadin is necessary. Many of these patients are readmitted within 30-days of being discharged for pump clots, gastro-intestinal bleeds and even strokes. Patients are often discharged without adequate education on Coumadin management, which promotes inadequate self-care and medication non-adherence.

In current practice, healthcare providers lecture information in a quick manner without the evaluation of patients’ comprehension. Research suggests implementing the teach-back method during education sessions to assess for comprehension of material to improve medication adherence. Healthcare providers should implement Coumadin teach-back education to heart failure patients with left-ventricular assist devices to improve quality of life, increase medication adherence and decrease 30-day hospital readmission rates.

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  • 2020-04-25

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Using a Longitudinal Case Study to Teach Warfarin Concepts to Prelicensure and Postbaccalaureate Nursing Students: A Peer Evaluation

Description

The purpose of this study was to determine whether a peer nursing student who presents a longitudinal case study on warfarin in a pharmacology course classroom influences prelicensure and postbaccalaureate

The purpose of this study was to determine whether a peer nursing student who presents a longitudinal case study on warfarin in a pharmacology course classroom influences prelicensure and postbaccalaureate nursing students' knowledge and perceived knowledge about warfarin. The study was a descriptive design that used a convenience sample of baccalaureate nursing students enrolled in two pharmacology courses. All participating students answered warfarin case-study questions and completed a self-demographic questionnaire, a knowledge pretest and posttest, and a self-efficacy questionnaire after the activity, which evaluated students' knowledge and perceived knowledge on 11 warfarin concepts. For all students (N = 89), the number of correct answers improved significantly between pretests and posttests for Items 2-11 (p < .0001; Wilcoxon signed-rank tests), which evaluated students' knowledge on warfarin's site of action, associated laboratory values, use of vitamin K, and food-drug interactions. However, no significant difference was seen in the number of correct answers for warfarin's mechanism of action. Comparing prelicensure and postbaccalaureate groups by Mann-Whitney tests, no significant difference was seen for pretest total scores (median 7.00, n = 55; median 7.50, n = 34; respectively; p = .399). Similarly, no difference was seen for posttest total scores by groups (prelicensure: median = 9.00, n =54; postbaccalaureate: median = 10.00, n = 32; p = .344). Overall, students in both groups agreed that they could identify and explain all 11 warfarin concepts. The Pearson correlation between the total posttest and total self-efficacy scores for the combined group was .338 (p = .003), demonstrating a low but significant correlation between students' posttest total scores and their perceived warfarin knowledge, as evaluated by the self-efficacy questionnaire.

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  • 2014-12