Wednesday, February 19, 2014

Complications Associated With Oral Anticoagulation Therapy


Review of recent evidence with translation to practice for the advanced practice nurse (APN) role is presented using a case study module for “Complications Associated With Oral Anticoagulation Therapy.” The study results showed that bleeding complications were most often due to gastrointestinal bleeding associated with anticoagulants (dabigatran 80% and warfarin 48%). The implications and clinical relevance of these findings for APNs are discussed highlighting best evidence.

The purpose of this study was to compare bleeding complications associated with dabigatran and warfarin in a sample of patients with a diagnosis of anticoagulant-related bleeding complications admitted through the ED. Using a prospective medical record review of eligible patients, the authors abstracted data on the basis of agree-upon definitions of all variables, for example, “major” and “life-threatening” hemorrhages were differentiated on the basis of reduction in hemoglobin measurements and the number of units of blood transfused over a period of time, and they performed a blind review of a sample of their records to ensure interrater reliability. The investigators provide only the briefest of descriptions of their data analysis, stating, “Descriptive statistics were used and 95% confidence intervals were calculated.” They do not elaborate any further.


Howard, Patricia Kunz PhD, RN, CEN, CPEN, NE-BC, FAEN, FAAN

Advanced Emergency Nursing Journal:
doi: 10.1097/TME.0b013e3182a9e9a2
Research to Practice

 

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