An Oral Anticoagulant Patient Education Session to Improve Patient Safety

Abstract

Purpose: The purpose of this quality improvement (QI) project is to improve rural patients’ knowledge of oral anticoagulation therapy to increase safety at home and improve patient outcomes. Background: Older adults diagnosed with atrial fibrillation, venous thromboembolism, and who undergo post-heart valve replacement are frequently prescribed oral anticoagulant therapy (OAC) to prevent the devastating consequences of cerebral vascular accidents (CVAs) and myocardial infarction (MI). Rural older adults are at a higher risk of developing atrial fibrillation, have limited access to specialty care, and may experience higher mortality rates compared to their nonrural counterparts. Despite life-saving OAC benefits, these medications pose risks for major bleeding and significant harm if used inappropriately. Busy primary care clinics are challenged to achieve the standard of care for anticoagulation education, including provider-patient face-to-face interaction accompanied by written resources and utilization of the teach-back method. Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, this QI project in a rural primary care clinic will utilize a pre-test and post-test design to evaluate a ten-minute session of anticoagulant patient education (APE) created by the Project Manager, synthesizing evidence-based practice OAC guidelines. Participants completed a pre-test and post-test questionnaire to measure their medication safety knowledge and self-reported confidence of use with a Likert scale. The 10-minute APE session included an anticoagulant safety handout and verbal discussion of the risks, benefits, proper use, and precautions for the anticoagulant. Results: The average increase in knowledge gain reflected in the post-survey 7.92% (direct) and 7.5% (traditional). The survey question with the most amount of improvement (12.5%) was the direct OAC survey questions three and five. Conclusion: Findings from this QI project will be utilized to develop a ten-minute educational video to be shown in clinic lobbies, allowing patients to receive education while waiting for their appointments. Despite modest improvements, results support the value of ongoing patient education and highlight the strong baseline knowledge among participants.