Resident Handbook - UC Davis Health System

2. Give the patient educational material, including Anticoagulation Patient Education andWarfarin – Effects of Foods and Supplements.3. Have the patient sign the Warfarin Therapy Agreement which addresses the use ofwarfarin, including risks and benefits and the need to take as directed and perform bloodtesting as directed.4. Initiate a Warfarin Flow Sheet which will be added to the patient’s chart. The flow sheetwill be used to document• each PT/INR result• date drawn• any adjustment made to the warfarin dose• time for the next draw• patient current phone number• patient notification.The provider will fill the following information on the Warfarin Flow Sheet:1. Indications for warfarin2. INR goals for therapy3. Duration of use4. Initial warfarin dose5. Time for next PT/ INR drawProviders will also give patients a six month standing lab order for Protime (PT/INR) with3x/week maximum frequency.Once patients are entered into the Warfarin Log, the nursing staff will track patients on a weeklybasis to see which patients are in need of PT/INR.The data coordinator will send out a quarterly report to providers so they can verify that all oftheir patients who take warfarin have been entered into the log. Nursing staff will also receive acopy.PT/INR lab results will be processed as follows:1. When patients have their PT/INR drawn, nursing staff will put lab results in the patient’schart along with a pink Warfarin Chart Flag.2. Resident chart will then go to the C1 Clinic doc for review.3. The C1 Clinic Doc will indicate any warfarin dose adjustments and when the nextPT/INR should be drawn.4. The chart will then go to the Nursing Desk.5. The Desk Nurse will contact the patient and provide instructions for the patient, anddocument in the Warfarin Flow Sheet.6. Faculty patient results will be processed in the same fashion, with faculty covering theirown patients and those assigned to other faculty members who are unavailable (accordingto the “Faculty Covering Labs for Faculty” schedule).7. All patients residing in a care facility must have a physician signed ‘MEDICATIONORDERS/CHANGES’ sheet that will be faxed to the facility.Page 126 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc