title: European cardiac nurses' current practice and knowledge on anticoagulation therapy.
abstract: BACKGROUND
  Successful management of warfarin, new anti-thrombotic agents and self-monitoring devices requires that health care professionals effectively counsel and educate patients. Previous studies indicate that health care professionals do not always have the knowledge to provide patients with the correct information.
  
  
  OBJECTIVE
  The purpose of this study was to investigate European cardiovascular nurses' knowledge on the overall management of anticoagulation therapy and examine if this knowledge was influenced by level of education and years in clinical practice.
  
  
  METHODS
  A questionnaire including 47 items on practice patterns and knowledge on warfarin, new anticoagulants, warfarin-drug and warfarin-food interactions, and self-management of International Normalized Ratio (INR) was distributed to the attendants at a European conference in 2012.
  
  
  RESULTS
  The response rate was 32% (n=206), of whom 84% reported having direct patient contact. Warfarin was the most common used oral anticoagulation in daily practice. One third offered their patients both patient self-testing and patient self-management of INR. The mean total score on the knowledge questions was 28±6 (maximum possible score 53). Nurses in direct patient care had a higher mean score (p=0.011). Knowledge on warfarin and medication-interactions were low, but knowledge on warfarin-diet interactions and how to advise patients on warfarin as somewhat better.
  
  
  CONCLUSIONS
  European cardiac nurses need to improve their knowledge and practice patterns on oral anticoagulation therapy. This area of knowledge is important in order to deliver optimal care to cardiac patients and to minimise adverse effects of the treatment.
authors.affiliation: 1Department of Heart Disease, Haukeland University Hospital, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Oterhals
authors.forename: Christi
authors.initials: C
authors.lastname: Deaton
authors.forename: Sabina
authors.initials: S
authors.lastname: De Geest
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.forename: Mattie
authors.initials: M
authors.lastname: Lenzen
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.forename: Jan
authors.initials: J
authors.lastname: Mårtensson
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: David R
authors.initials: DR
authors.lastname: Thompson
authors.forename: Tone M
authors.initials: TM
authors.lastname: Norekvål
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D064646:Cardiovascular Nursing / Q000592:standards*; D004347:Drug Interactions; D005060:Europe; D005260:Female; D018565:Food-Drug Interactions; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019934:International Normalized Ratio / Q000451:nursing; D008297:Male; D008875:Middle Aged; D012646:Self Administration; D013927:Thrombosis / Q000188:drug therapy / Q000451:nursing* / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Anticoagulation; cardiovascular nurses; drug-nutrition interactions; patient counselling; practice patterns; self-management; warfarin