Ask A Magnet Nurse: The Role of Anticoagulants

Sally Deal, FNP-BC

Smart Living: What are anticoagulants and how are they used in the hospital?

Sally Deal: Anticoagulants are medications that increase the amount of time that blood will clot, thereby preventing new blood clots from forming and existing blood clots from increasing in size. Hospitalized patients are at an increased risk for developing blood clots due to immobility which could lead to a Deep Vein Thrombosis (DVT) and Pulmonary Emboli (PE). Anticoagulation therapy such as Fragmin is usually short term for prophylaxis. Once the patient is up walking or discharged, the anticoagulation is discontinued.

Patients with certain illnesses such as stroke, atrial fibrillation, heart valve replacement or blood clots in their lungs (PE) or legs (DVT) are treated with higher dose anticoagulants and upon discharge are ordered oral anticoagulants such as warfarin (Coumadin).

SL: Why is it crucial to prevent blood clots?

SD: First let me clarify that a blood clot, or thrombus, is part of the body’s process of repairing injured blood vessels. But when a thrombus forms that is not part of that process, it can cause a heart attack, stroke, and other life-threatening medical conditions.

SL: St. Joseph’s/Candler has its own dedicated Anticoagulation Clinics. What kind of patients need to come to the clinics after their hospital stay?

SD: Patients on anticoagulants are referred to one of our three anticoagulation clinics (at Candler Hospital, in Bluffton, SC, or to the Oaks at the Marshes of Skidaway Island) by their physician for monitoring of anticoagulation levels and adjustments of the dose. Education is a very important part of the initial visit and is reinforced each time the patient is seen by one of our staff members. Many factors influence the anticoagulation level and include interactions with other medications and diet. Patients need to be able to verbalize what they do in the event they start a new medication, stop their warfarin (Coumadin), miss a dose, or have excessive bruising or begin bleeding.

Blood tests are performed frequently to ensure that the therapeutic range is achieved and maintained. As I said, many factors influence this therapeutic range and that is why all patients receiving anticoagulation are given extensive education. 
  • St. Joseph's Hospital Campus: 11705 Mercy Blvd., Savannah, GA 31419, (p) 912-819-4100
  • Candler Hospital Campus: 5353 Reynolds St., Savannah, GA 31405, (p) 912-819-6000
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St.Joseph's Hospital Campus: 912-819-4100

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