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December 03-04, 2018 | Lisbon, Portugal
Public Health, Women's Health, Nursing and Hospital Management
Page 60
Joint Event
Journal of Community Medicine & Health Education | ISSN : 2161-0711 | Volume 08
Neck of femur fracture patients on warfarin: How to optimize them and achieve the best practice tariff?
F Joy and J Taylor
Arrowe Park Hospital, UK
Introduction:
Management of a patient with a neck of femur (NOF) fracture is a key aspect of orthopedic trauma care, with around 75,000
new cases in the United Kingdom annually costing the health care over £2 billion. A person on anticoagulation (warfarin) and the time
spent on its reversal prior to surgery is identified to be a cause not only on patient outcome but also losing the best practice tariff (BPT).
Aim:
The aim of the study was to establish the impact of this cohort of population had on achieving the BPT and how we could improve it. \
Materials & Methods:
Retrospective data was collected over a period of 12 months using the national hip fracture data base (NHFD). A
percentage of 10% of the identified cohort was delayed to theatre due to high international normalized ratio (>1.5) and failed to achieve
BPT. This cost the trust a loss of around £43,200.
Results:
Introduction of a simple hand held warfarin testing device (cost only £800/-) in accident and emergency was done and appropriate
patients had an instant INR check. If INR >1.5 a stat 2 mg intra venous Vit K (IVK) is initiated and INR was rechecked at six hrs and if
indicated further IVK is administered.
Conclusion:
Using this simple device and its introduction in the A&E department, we can avoid the time lost for the anticoagulation
reversal. This will mean improved patient care and compliance with BPT and can be achieved in this cohort of NOF fracture patients.
rthondickal@gmail.comJ Community Med Health Educ 2018, Volume:8
DOI: 10.4172/2161-0711-C7-051