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Medication Safety, v3 Outliers In 2011 there were three outlier submissions from two HCOs whose combined excess was nine more separations receiving warfarin as an inpatient who experience abnormal bleeding. The outlier HCO rate was 11.8 per 100 separations. Australasian Clinical Indicator Report 2004–2011 Page 11 © ACHS. This work is copyright. Requests and inquiries concerning reproduction and rights should be addressed to pos@achs.org.au
Medication Safety, v3 CI 5.2: Warfarin – INR * / prothrombin reading >5 (L) Rationale Warfarin is a widely used drug with a narrow therapeutic index and with potentially serious adverse reactions such as spontaneous bleeding. Numerator Denominator Total number of non same-day separations receiving warfarin as an inpatient with an INR reading greater than 5 Total number of non same-day separations receiving warfarin as an inpatient Year Dimensions of care: Accessibility Appropriateness Continuity Effectiveness Quality Improvement and Risk Safety Desirable level: Low High Not specified Type of Indicator: Process Outcome Structure No. HCOs Total numerator Total denominator Rate # Rate# (20) Rate # (80) Centile Gains Stratum Gains Outlier Gains 2004 36 282 7,472 3.77 2.85 7.70 69 78 55 2005 43 258 7,319 3.53 2.73 7.55 58 20 2006 35 289 5,598 5.16 3.04 8.11 119 83 4 2007 46 350 12,627 2.77 2.47 5.63 38 105 65 2008 35 305 8,221 3.71 1.53 7.10 179 75 2009 31 283 6,394 4.43 2.69 5.20 111 68 2010 29 233 8,343 2.79 2.40 6.56 33 45 13 2011 26 160 7,296 2.19 2.81 5.28 58 35 #per 100 separations In 2011 there were 35 submissions from 26 HCOs. The annual rate was 2.2 per 100 separations. Trends The fitted rate improved from 4.2 to 2.8, a change of 1.3 per 100 separations. This trend was also significant after allowing for the changing composition of HCOs contributing over the period. The rate change was 1.4 per 100 separations. Rates and centiles by year A Low rate is desirable 80 th centile rate x Aggregate rate Period average rate Fitted rate 20 th centile rate * The International Normalised Ratio is a test for blood clotting. Australasian Clinical Indicator Report 2004–2011 Page 12 © ACHS. This work is copyright. Requests and inquiries concerning reproduction and rights should be addressed to pos@achs.org.au
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