Patient Teaching Guide: Coumadin Therapy

Thanks for the teaching material! You are correct...it is nurses and nurse practitioners that teach patients.May I suggest changing the "ask your doctor" to "ask your heatlh care provider"? As a NP, I often prescribe and manage patients on coumadin - and I do so independently - meaning there are no physicians involved. There is something subtle in the words "ask your doctor" that underminds both nurses and nurse practitioners.Thanks,BarbaraNP

Barbara, Thanks so much for the input. I will change that. You are correct. NP's do an awesome job! Bugaloo

Quote from BugalooCoumadin is, simply put, a "blood thinner". It thins your blood to prevent blood clots from forming.

Blebs, Thanks for your input. You must realize that I created this article as a guide for patients with no formal medical training or knowledge whatsoever. If you get too technical, some patients simply do not "get it". This was not written for a nursing or medical journal, but for our patients. But thanks for taking the time to comment.

And I applaud your efforts. Like I said, it's nitpicky, but there are far too many people thinking that their blood is "thinned" to the consistency of water, when in fact, there is no thinning at all, just inhibition of vit k uptake. I'm just trying to get people to understand that their blood is not like oil where the mechanic put 10w40 oil in and taking Coumadin makes it 5W30.

Good morning everyone.It's encouraging to learn medical personnel are interested in teaching anti-coagulated patients about this potentially dangerous drug. This information is sorely needed.Let me tell you a bit about myself. I'm not a nurse, received a mechanical heart valve 9 years ago, was advised by my surgeon that "warfarin is just a little pill you take every day requiring blood tests every so often". If given the opportunity I'd like to see those words shoveds down her throat. Horribly inaccurate and misleading to say the least.The vein i my arm was torn during right-sided heart catheterization and was tied shut. It took almost a year before I became aware of its non healing status.During my 9 years of warfarin use I have a lot about the eccentricities of this drug. Because of the permanently damaged vein in my riight arm and the subsequent scarring from many vein draws from the left vein I was motivated to use the "finger stick" method of blood tests using a home monitor and have been home testing since 2004. I check the blood at home, e-mail the results to my INR manager to the University Health Network in Toronto resulting in a 98% stability rate. During these years I have learned more about warfarin than the nurse in my PCP's office.In a perfect world patients on warfarin therapy would be accurately informed about this potentially dangerous drug. Dangerous because the medical personnel they will probably encounter are so ill-informed about warfarin they persistently refer to it as a "blood thinner". After all blood thinner and anti-coagulation are both two words. Why not be "professional" and use the correct term". Patients are more afraid of stroking not bleeding out and shouldn't be constantly concened about minor injuries. Good luck educating the medical community about warfarin management. I feel sorry for every patient undertaking this hazardous course of treatment.I welcome your comments and you should feel free to contact me via e-mail or and on this board. Be as brutally frank as I have been.

dear bugaloo (and blebs)i concurr with blebs about the accuracy of the information on warfarin in the article. it is not a "blood thinner". more disturbing is bugaloo, your response indicating that you must mislead or provide incorrect information to patients, because "they will not get it". i believe that patients can understand that warfarin prevents the clotting mechanism in blood.they should not be mislead, simply because you have the false and paternalistic belief that patients can not comprehend basic information about their diseases or drugs. vancouverbc

nice of you to share. Thank you.

This is a really nice and informal teaching plan - as you stated in the opening. thank you so much for taking the time to post it - I am writing up a teaching plan for this very thing right now as a 2nd semester student. I wanted to get some ideas on where to start with this - very helpful. As for some of the responses - that is about as catty as walking in to the L&D unit. Even in 2nd semester - I know that you have to tailor the plan to the slowest kid in the class - then if they are able to grasp you can go deeper into detail. I don't know how you all are taught to teach your patients - but we are taught to start on a 5th grade level as far as language and basic concepts are concerned. It does no good to say a bunch of fancy things if the patient doesn't speak the language. After all, it is very much like learning Latin - without the conjugations of course. No need to come down so hard on someone for sharing - I think she already made it out of nursing school.just sayin' - we can be constructive in our critiscisms.Anyway, I thought it was a very good plan. Again, thank you for taking the time to post it, it was an effective tool for me.

Quote from blebsone should avoid binge eating of high vit k content foods, but should otherwise eat them as always and have the coumadin dose adjusted for that diet. people need these nutrients and some managers have told them to avoid them altogether. best thing you can do is allow a person to eat like they normally do, never bring up the vit k thing and then it won't be so hard to stabilize them, because they won't be trying in vane to reduce their vit k intake.

You are correct!