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The effect of a nurse-led patient education program for oral anticoagulant therapy on the incidence of thromboembolic and hemorrhagic episodes after surgical heart valve replacement

Rokeia Eltheni, Konstantinos Giakoumidakis, Hero Brokalaki, Nikolaos V. Fotos, Christos Charitos, Ilias Samiotis, George Fildissis.




Abstract
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Introduction: Although, the effects of patient education on the effective anticoagulant management, among patients undergoing heart valve replacement with mechanical prosthesis, have been reported, the evidence of this association remains inconclusive.
Aim: To investigate the effect of a nurse-led patient education program for oral anticoagulant therapy on the incidence of thromboembolic and hemorrhagic episodes after surgical heart valve replacement.
Methods: A quasi-experimental study was conducted. Patients were allocated to a) a control group (n=100), including those who received the usual education on oral anticoagulants, and b) an intervention group (n=100), with those who attended a nurse-led education program, postoperatively, including verbal courses and written material through an education booklet. We investigated the incidence of hemorrhagic and thromboembolic episodes 3 months after patients’ hospital discharge. Patients’ socio-demographic and clinical characteristics were obtained using a structured short questionnaire and through the medical and nursing patient records review. Patients’ follow up data were collected via phone interviews.
Results: The baseline characteristics were similar for both groups. Patients who received nurse-led education on oral anticoagulant therapy had a significantly lower 3-month incidence of hemorrhagic episodes compared with controls (1% vs 14%, p

Key words: Anticoagulants, complications, heart valve replacement, patient education, patient outcomes






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