Date of Award

Spring 5-2020

Document Type

DNP Project

Project Team Faculty Member

Dr. Kim White

Project Team Faculty Member

Dr. Kelley McGuire


anticoagulants, warfarin, coumadin, xarelto, pradaxa, eliquis


Proper adherence regarding high-risk medications such as oral anticoagulants (OAC) is essential for reducing the incidence of adverse events such as thrombosis or major bleeding when dosages are missed or inappropriately administered.

The goal of this project was to reduce these events by supplementing current educational practices at a metropolitan cardiac electrophysiology office with new medication education protocols, the development of specific medication informational handouts, and provider training. Providers and staff were provided with medication specific education for Vitamin K Antagonists (VKA) such as warfarin and Non-Vitamin K Agonists (NOACs) such as dabigatran, rivaroxaban, and apixaban for those patients initiating anticoagulant therapy and the associated medication handouts.

Formal interviews conducted post implementation revealed that while the education was practical and beneficial for their patients, altering the office culture to include the supplemental education as a standard of care was a major barrier. Further follow up and analysis would need to be conducted to evaluate the long-term impact of this intervention. While small in number, early indicators reveal the cancellations of patient procedures relative to questionable anticoagulation status has decreased. Expansion of this project to other commonly prescribed medications may be helpful in improving medication adherence and reduction of adverse events.

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