The effect of nurse-led care on stability time in therapeutic range of INR in ischemic stroke patients receiving warfarin

Purpose: The current study is designed in order to investigate the effect of nurse-led care (the supportive and educational measurements by nurses) on stability time in therapeutic range of INR in ischemic stroke patients receiving Warfarin. Method: In this quasi-experimental study, 80 ischemic stroke patients were investigated, 40 patients in experimental group and 40 in the control group referred to the nurse-based warfarin clinics affiliated to Shiraz University of Medical Sciences. The mean SD duration of the intervention was 144 +/- 84 days. The patients based on the percentage stability time in the therapeutic range of INR were classified into 3 groups of good control (>75%), medium control (60-75%), and poor control groups (<60%). The results were analyzed using qui-square and independent t-test according to these categories. Results: 38 patients in the experimental group and 39 in the control group had the therapeutic range of INR 2-3. The percentage of the stability time in the therapeutic range of INR (mean SD) in the experimental group was 64.08% +/- 18.7 and in the control group it was 44.58% +/- 25.12 (P < 0.001). The percentage of total INRs within the therapeutic range was 52.5% in the experimental group and 40.6% in the control group (P = 0.001). Conclusions: In conclusion, using the stroke prevention guidelines, thrombotic therapy protocols and familiarity with patients' diagnosis and risk factors in the experimental group led to more patients' stability time (The time that patients could remain stable within the INR therapeutic range) in their therapeutic range of INR as the best indicator of clinical performance. (C) 2016 Elsevier Inc. All rights reserved.