Abstract
A large proportion of home care patients with varying diagnoses take warfarin. The clinicians providing skilled patient teaching to these patients and their caregivers must first have scientific knowledge of how and why vitamin K is so important to general health. Only then can an educational plan be developed that will result in positive patient outcomes. This article provides a comprehensive approach to all aspects of providing services for patients on warfarin.
Last week your patient's warfarin dose had to be increased-after a stable International Normalized Ratio (INR) for more than 1 year. Today two more patients on warfarin exhibited signs of over anticoagulation: one patient with numerous petechiae, the other with a large hematoma on her thigh. You recall the many over-the-counter (OTC) medications and herbs that can interfere with or potentiate warfarin (Neafsey, 2004), but after interviewing your patients, you rule out changes in self-medication as the cause of their warfarin instability.