原创力文档a team-based approach to warfarin management in long term care a feasibility study of the medeinr electronic decision support system华法林的团队方法管理长期护理的可行性研究medeinr电子决策支持系统.pdfVIP
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a team-based approach to warfarin management in long term care a feasibility study of the medeinr electronic decision support system华法林的团队方法管理长期护理的可行性研究medeinr电子决策支持系统
Papaioannou et al. BMC Geriatrics 2010, 10:38
/1471-2318/10/38
R E S E A R C H A R T I C L E Open Access
Research article
A team-based approach to warfarin management
in long term care: A feasibility study of the
MEDeINR electronic decision support system
1 1 2 2 3
Alexandra Papaioannou* , Courtney C Kennedy , Glenda Campbell , Jacqueline B Stroud , Luqi Wang ,
4 1
Lisa Dolovich , Mark A Crowther for Improving Prescribing in Long Term Care Investigators
Abstract
Background: Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal
with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To
assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we
developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We
evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing
frequency, and experiences of staff in using the system.
Methods: For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128
residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to
MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR
was captured in the central computer database. The primary outcomes compared in a pre-post design were time in
therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on
warfarin. Secondary measures include
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