Warfarin Management in Practice

Abstract

OPEN ACCESSOctober 7, 2015Warfarin Management in Practice Jane Graham, Rob Noble, Jecko Thachil, MRCP, FRCPath Jane Graham Central Manchester University Hospitals NHS Foundation Trust Google Scholar More articles by this author , Rob Noble Central Manchester University Hospitals NHS Foundation Trust Google Scholar More articles by this author , Jecko Thachil, MRCP, FRCPath Central Manchester University Hospitals NHS Foundation Trust Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.10234 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: This team-based learning (TBL) session was developed to equip clinicians and undergraduates with the background knowledge and practical skills to manage patients on warfarin who present with bleeding, potential bleeding, or a high international normalized ratio in the absence of bleeding. The resource was developed in response to identification of patient safety issues and poor compliance to recommended guidelines surrounding the management of patients on warfarin. Methods: The prereading material contained in the resource is provided to students approximately 1 week before the session. During the session, students engage in an individual readiness assurance test before being grouped into teams where they complete a group readiness assurance test and a series of team application exercises. Results: This session has been successfully implemented in various formats to a broad range of practicing United Kingdom clinicians. Learner reactions to the session, as evidenced by anonymous feedback and verbal comments to faculty, have been positive. The session works well for both large and small groups and for those with differing clinical backgrounds and experience. Analysis of readiness assurance testing results (both individual and group) demonstrates evidence of knowledge acquisition relating to the session's defined learning objectives. Group interaction with the team application scenarios and interteam debates provides evidence of increased analytical skills and clinical application of the learning objectives to real-life practice. Discussion: TBL is well established within undergraduate and postgraduate medical education, ensuring knowledge acquisition, application of knowledge to real-life cases, and development of auxiliary skills such as teamwork. This resource has been developed to be a highly versatile tool. The content is relevant to both undergraduate and postgraduate education, enabling delivery of clinically relevant continuing education to practicing clinicians. The session has been designed to enable applicability to a global audience. Educational Objectives By the end of this module, learners will be able to: Describe the pharmacological actions, interactions, and monitoring of warfarin.Appropriately prescribe and administer treatment for a patient on warfarin with actual or potential major bleeding, including prothrombin complex concentrate, and vitamin K.Define major bleeding.Manage patients on warfarin with minor bleeding.Appropriately action a high international normalized ratio in the absence of bleeding.Assess which patients on warfarin are at highest risk of bleeding. ReferencesHaidet P, Levine RE, Parmelee DX, et al. Guidelines for reporting team-based learning activities in the medical and health sciences education literature, Acad Med.2012;87(3):292–299. http://dx.doi.org/10.1097/ACM.0b013e318244759eMedline, Google ScholarKhogali SE. Team-based learning: a practical guide: guide supplement 65.1—viewpoint, Med Teach.2013;35(2):163–165. http://dx.doi.org/10.3109/0142159X.2013.759199Medline, Google ScholarParmelee DX, Michaelsen LK. Twelve tips for doing effective team-based learning (TBL), Med Teach.2010;32(2):118–122. http://dx.doi.org/10.3109/01421590903548562Medline, Google ScholarParmelee DX, Michaelsen LK, Cook S, Hudes PD. Team-based learning: a practical guide: AMEE guide no. 65, Med Teach.2012;34(5):e275–e287. http://dx.doi.org/10.3109/0142159X.2012.651179Medline, Google ScholarTeam-Based Learning Collaborative Web site. http://www.teambasedlearning.org/. Accessed August 12, 2015.Google Scholar Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Instructor's Guide.docx Preparatory Material Warfarin.docx RAT Warfarin Tutor.docx RAT Warfarin Student.docx IRAT Answer Sheet.docx tAPP Warfarin Tutor.doc tAPP Warfarin Student.doc tAPP Answer Cards.docx Resource Template Warfarin.docx 1. Warfarin-Chest 2012.docx 2. Warfarin Reversal-ASH 2011.pdf 2. Warfarin Reversal-BCSH 2011.pdf 2. Warfarin Reversal-Chest 2012.docx 3. PCC-eMC Beriplex.docx 3. PCC-eMC Octaplex.docx 3. PCC-FDA Kcentra.pdf To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationGraham J, Noble R, Thachil J. Warfarin Management in Practice. MedEdPORTAL. 2015;11:10234. https://doi.org/10.15766/mep_2374-8265.10234 Copyright & Permissions© 2015 Graham et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsEducationBlood Coagulation FactorsClinical Laboratory TechniquesTeam-Based LearningLearningAnticoagulantsWarfarinHemorrhageTBL Disclosures None to report. Funding/Support None to report. tabs.loading