For people who are prescribed blood thinners, or anticoagulants, such as Coumadin®/warfarin, life becomes a balancing act. If the blood becomes too thin, trimming a toenail too close can mean a visit to the ER. If the blood is too thick, clots can form causing serious medical problems such as heart attacks and strokes. To help manage the delicate balance, MDI Hospital now offers an anticoagulant or “Coag” Clinic.
The clinic, located in the Hospital’s Cooper-Gilmore Health Center, is open Monday through Friday from 8am to 4pm.
Blood thinners are often prescribed for patients with atrial fibrillation (an irregular heart rhythm), pulmonary embolism, and after artificial heart valve surgery or orthopedic procedures.
They are prescribed because the body may be making blood clots or the patient’s medical condition promotes unwanted blood clots.
“The goal of anticoagulation therapy is to achieve therapeutic blood levels through careful administration of blood thinners,” explained Jean Bell, RN, who runs the Hospital’s Coag Clinic. She explains that “therapeutic” levels are attained when the blood is thin enough to avoid clotting, but not so thin that the patient is at risk of heavy bleeding, which can come from something as seemingly harmless as a small nick or cut.
Many things can cause blood levels to go out of therapeutic range, from interactions with over-the-counter medications to missed doses, so achieving and maintaining therapeutic blood levels requires careful oversight of a trained professional.
To develop the knowledge and skill required to provide this type of care, Ms. Bell, a registered nurse, underwent an 8-week Anticoagulation Therapy Management Certification Program. Her colleague, Pam Caine, Coordinator of the Hospital’s Care Management Department is also certified, and provides backup to Ms. Bell.
Most oral anticoagulation therapy in the United States is managed by the patient’s physician. Having a clinic devoted solely to management of anticoagulants ensures that the patient not only receives the necessary supervision, but the education and follow-up that helps them understand and more effectively participate in their own care.
In addition, “several studies have shown that dedicate anticoagulation clinics provide better treatment, resulting in fewer complications than anticoagulation managed in physician’s offices,” stated Edward Gilmore, M.D., the clinic’s Medical Director. “A clinic that is dedicated to education and management allows the patient and provider to become proactive in anticoagulation management,” added Ms. Bell.
“The patients also like knowing that someone is focusing on this crucial aspect of their health care, ” explained Ms. Bell. “We’re able to develop a relationship that encourages open, honest communication. In that environment, we can help them understand and problem solve.”
The clinic, which officially opened in December 2006, is a service of the Hospital’s Care Management department, which provides care support for patients inside and outside the Hospital.
For more information on MDI Hospital’s Coag Clinic, call 288-5082, extension 656.
