Selfmonitoring and selfmanagement of oral anticoagulation therapy practice

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Today’s healthcare practice is changing rapidly and thus, provision of patient care and management is shifting from institutional-based management to home-based care where patients can test their status and manage the condition, especially for medical conditions that are not curable but only manageable such as diabetes. One of the testing and management practice being prompted and is gaining popularity in the healthcare sector is the Oral Anti-Coagulation Therapy Practice for patients (Ansell, et al., 2005). This paper concerns the designing of a plan aimed at changing our patients habit from that of going to the lab in hospitals and other healthcare facilities just to get their International Normalized Ratio (INR) testing done to getting these patients who have the capacity to learn how to use a home based testing device for INR instead of seeking lab based testing. The idea behind this concept is the fact that this process is fairly simple and if patients are well educated, they can easily do the test accurately and without any hustle (Baglin, et al., 2005). Besides, home based INR testing devices will be able to give results required in a very short while, actually immediately, just like it is the case for those diabetic patients who normally test for their daily levels of glucose. This is not the case when they seek lab based testing since the process takes 24 hours to get the results due to the large number of patients who might need the same service and the fact that in many instances, the medical practitioners do not match the number of patients….
It is a medical fact that any change in the health, lifestyle or drugs in a patient’s life could quickly interfere and alter the oral anticoagulant’s effectiveness in managing such conditions. What makes it even worse is the fact that each patient reacts differently to these drugs thus the need for regular monitoring of the therapy. However, I tend to think, based on reviews done, that there are strategies that could be used to improve the situation and have these patients self-monitor and self-manage their condition. The evidence based model for change has been derived from a thorough theoretical and research literature that is related to various research utilizations, change theory and the current evidence-based practice within the field (Rosswurm, 1992). This model has a guideline to medical practitioners for changing the normal practice to evidence based practice. Various stages have been proposed for effective implementation of this model. These start with step one where the need for change in the healthcare practice is done. In regard to this, the carrying out of an Oral Anti-Coagulation Therapy at home has been identified as the need for change where patients would have to test and manage their condition at home as is opposed to seeking lab testing. The need is therefore to help patients test their condition at home to establish their INR level within the required range. The reason for doing this comes from the fact that patients have been dissatisfied with the current trend of lab based testing which takes longer to process. The quality of the data got will also be reliable since it will be fresh and immediately established for quick action to