The anticoagulant service is responsible for monitoring approximately 3500 patients in the community in Bolton who have been prescribed oral anticoagulant medications, such as warfarin, by their GP. Anticoagulant medicines (links to external website) are used to reduce blood clots forming in the bloodstream where they are not needed so that they do not obstruct the flow of blood. We advise patients and make sure that their medication levels are safe and effective.
We are a nurse led service based at Waters Meeting Health Centre, with additional support from a consultant haematologist (blood specialist) at the Royal Bolton Hospital. There are morning and afternoon clinic sessions at Waters Meeting but there are also a number of clinics run at other health centres in the Bolton area (see opening times and clinics).
The treatment programmes involve a comprehensive introduction to anticoagulant medications, drug counselling, monitoring and dose adjustment, plus advice to patients, carers and professionals on matters relating to anticoagulant therapy (ACT).
When patients attend clinic, their international normalised ratio (INR) (links to external website) will be tested to measure how fast their blood clots and make sure that the dosage of medication being taken is correct. A one-stop-shop approach means that patients leave the clinic with their current INR, their drug dose and a date for their next appointment.
The service also provides Vitamin K to patients who have a very high INR (greater than 8) as this means that they have an increased risk of bleeding as their blood will not always clot when it should. The provision of Vitamin K reduces the risk of bleeding and therefore the number of hospital attendances.
We support patients with special needs who are referred to us (see below) by assessing their individual needs and making every attempt to meet those individual needs. We can, for example:
- Arrange home visits for patients who are housebound and need to access our services.
- Provide phone translators during appointments for non-English speaking patients.
- Provide a daily ACT dose chart in extra large font for patients with poor vision.
- Consider cultural needs, such as the provision of home testing to Muslim women for a short period after childbirth.
- Work closely with families and carers to improve the safety of patients with mental health or compliance problems.