Date
7-15-2024
Department
School of Nursing
Degree
Doctor of Nursing Practice (DNP)
Chair
Tonia Kennedy
Keywords
Atrial fibrillation, anticoagulation, stewardship, evidence-based practice
Disciplines
Nursing
Recommended Citation
Hawker, Ryleigh, "Anticoagulation Stewardship Initiative for the Outpatient Management of Atrial Fibrillation" (2024). Doctoral Dissertations and Projects. 5809.
https://digitalcommons.liberty.edu/doctoral/5809
Abstract
Anticoagulation prescribing for patients with atrial fibrillation at a local primary care and urgent care office has largely been conservative and unstandardized, leaving patients at risk for cardioembolic strokes. As more and more patients are diagnosed with this condition, the greater the need becomes for appropriate management within these settings. This includes preventing strokes with anticoagulation and utilizing an integrative or collaborative approach between specialty and non-specialty centers. The Anticoagulation Stewardship Initiative is the first step in promoting effective and safe anticoagulation practices in primary and urgent care centers, while simultaneously streamlining care for newly diagnosed patients. Some of the greatest barriers to achieving this goal, however, are emotionally and intellectually driven. This quasi-experimental evidence-based practice project aimed to overcome these challenges with targeted education and an anticoagulation decision pathway. As a result, clinically significant improvements in confidence with using risk assessment tools, knowledge of anticoagulants, perceived decision-making role, and comfort level with prescribing in certain clinical scenarios was observed among participants. These findings suggest that emotional and intellectual barriers to guideline-based prescribing can be overcome with education and decision aids.
