Guest guest Posted March 14, 2008 Report Share Posted March 14, 2008 I do recall some recent research that a constant, higher level of vitamin K intake is ultimately more easily controlled than trying to limit too much. Sorry, I don't have the article -I know I sent it to my sister who loves her greens, and is on warfarin. ne Holden had posted it a few months ago, so maybe still in archives. I'd suggest you look at basing recommendations on updated research as well, since just limiting Vit. K surely places clients at risk of osteoporosis. Personal story: (My sister was started on warfarin at 54 y/o after an infected heart valve following routine tooth cleaning - she was otherwise VERY healthy, but did have a minor heart murmur and had taken antibiotics prior to the tooth cleaning - by the time they figured out why she was feeling so bad, the infected valve needed replacement, and she nearly died - BUT, a person cannot consume a low Vit K diet for 30-40 years -she plans to live that much longer- it's in our genetics - without significant consequences. After only 5 years on coumadin, she already has osteopenia - but at least was able to get back to running 7 mile races AFTER the valve replacement.) Jan Patenaude, RD, CLT In a message dated 3/14/2008 10:42:55 A.M. Mountain Daylight Time, hulst_jill@... writes: Please share this info. I have been " nominated " to be on a warfarin team for our facility - I'm not sure what it means. I know it regarding JCAHO safety plan. Let me know what your facility will be doing. Jill Hulst LifeCare Medical Center Roseau, MN Collier <_LCollier@shs-LCollie_ (mailto:LCollier@...) > wrote: There is a new JCAHO goal referring to warfarin and dietary. What have others done? Our pharmacy department is working on a reporting deal but I need to know what to do with the info. Are you not giving these folks ANY high vitamin K foods? If you are...how much per meal/day/etc? Collier, RD Clinical Nutrition Manager 9507 Hospital Avenue PO Box 17 Nassawadox, VA 23413 fax This e-mail and any attachments may be confidential or legally privileged. If you received this message in error or are not the intended recipient, immediately destroy the e-mail message and any attachments or copies. You are prohibited from retaining, distributing, or disclosing any information contained herein. Please inform us of the erroneous delivery by return e-mail. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Thank you for your cooperation. [Non-text portions of this message have been removed] --------------------------------- Never miss a thing. Make Yahoo your homepage. [Non-text portions of this message have been removed] Jan Patenaude, RD, CLT Consultant, Writer, Speaker Director of Medical Nutrition Signet Diagnostic Corporation (Mountain Time) (toll free) Fax: DineRight4@... Mediator Release Testing and LEAP Diet Protocol for Irritable Bowel Syndrome, Migraine, Fibromyalgia and more, caused by food sensitivity IMPORTANT - This e-mail message is intended only for the use of the individual or entity to which it is addressed, and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this message in error, you are hereby notified that we do not consent to any reading, dissemination, distribution or copying of this e-mail message. If you have received this communication in error, please notify the sender immediately by e-mail and telephone ( toll free) and destroy the transmitted information. E-mail transmission cannot be guaranteed to be secure or error-free as information could be intercepted, corrupted, lost, destroyed, arrive late, incomplete, or contain viruses. The sender therefore does not accept liability for any errors or omissions in the contents of this message, which arise as a result of e-mail transmission. **************It's Tax Time! Get tips, forms, and advice on AOL Money & Finance. (http://money.aol.com/tax?NCID=aolprf00030000000001) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 14, 2008 Report Share Posted March 14, 2008 Please share this info. I have been " nominated " to be on a warfarin team for our facility - I'm not sure what it means. I know it regarding JCAHO safety plan. Let me know what your facility will be doing. Jill Hulst LifeCare Medical Center Roseau, MN Collier wrote: There is a new JCAHO goal referring to warfarin and dietary. What have others done? Our pharmacy department is working on a reporting deal but I need to know what to do with the info. Are you not giving these folks ANY high vitamin K foods? If you are...how much per meal/day/etc? Collier, RD Clinical Nutrition Manager 9507 Hospital Avenue PO Box 17 Nassawadox, VA 23413 fax This e-mail and any attachments may be confidential or legally privileged. If you received this message in error or are not the intended recipient, immediately destroy the e-mail message and any attachments or copies. You are prohibited from retaining, distributing, or disclosing any information contained herein. Please inform us of the erroneous delivery by return e-mail. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of the company. Thank you for your cooperation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 14, 2008 Report Share Posted March 14, 2008 , The JCAHO standard is actually a patient care safety goal. The elements of the OVERALL goal include: 1. The hospital evaluates it's medication management system for risk points and identifies areas to improve safety. 2. The hospital identifies opportunities for improvement by routinely evaluating the literature for new technologies or successful practices that have been demonstrated to enahnce safety in other organizations to determine if it can improve it's own medication management system. 3. The hosptial reviews internally generated reports to identify trends or issues in it's medication management system. 4. The hospital acts to implement improvements based on the following * Evaluation of it's medication management system * review new technologies * external data * successful practices that have been demonstrated to enhance safety 5. The performance of new and modified medication management processes is measured 6. The hospital uses information from data analysis to identify subsequent changes to improve it's medication management system. Under this umbrella of medication management is requirement 3E: Reduce the likelihood of patient harm associated with the use of anticoagulation therapy. Under the 3E requirement there are certain elements that need to be in place to reach this patient safety goal. I won't go in to all of them at this time and if anyone wants me to fax them a copy, please send me your fax number. The nutrition/dietary service element reads as such: When dietary services are provided by the organization, the service is notified of all patients receiving warfarin and responds according to it's established foo/drug interaction program. Basically, you have to have in place what your policy says it will do. In my case, I have simple homegrown patient teaching sheets that I change as Bristol Myers Squibb changes their teaching materials (keeping up with technology piece)....example: recently we added cranberry to the list of foods to avoid. I also run a report every day that identifies all patients on coumadin (identifies patients piece). I see all these patients for education (patient education piece) and I stamp their kardex card (kept in the department) " no cranberry " . That identifies them to the nutrition services staff as patients on coumadin. It is also our policy not to limit greens and we advise patients to eat identified foods in the hospital as they would at home. I recommend that a multidisciplinary team be set up to plan this process as it helps in the long run. Our team has been meeting for about 5 months and includes pharmacy, nutrition, outpatient/clinic personnel, information services, nursing, and administration. Good luck......email me with questions! Cece This message is intended for the use of the addressee only and may contain information that is privileged and confidential. If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited. Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege. If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately. Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 14, 2008 Report Share Posted March 14, 2008 Ceece Trying to reach you please email me Carol Carol " You'll never do a whole lot unless you're brave enough to try. " Dolly Parton Re: warfarin , The JCAHO standard is actually a patient care safety goal. The elements of the OVERALL goal include: 1. The hospital evaluates it's medication management system for risk points and identifies areas to improve safety. 2. The hospital identifies opportunities for improvement by routinely evaluating the literature for new technologies or successful practices that have been demonstrated to enahnce safety in other organizations to determine if it can improve it's own medication management system. 3. The hosptial reviews internally generated reports to identify trends or issues in it's medication management system. 4. The hospital acts to implement improvements based on the following * Evaluation of it's medication management system * review new technologies * external data * successful practices that have been demonstrated to enhance safety 5. The performance of new and modified medication management processes is measured 6. The hospital uses information from data analysis to identify subsequent changes to improve it's medication management system. Under this umbrella of medication management is requirement 3E: Reduce the likelihood of patient harm associated with the use of anticoagulation therapy. Under the 3E requirement there are certain elements that need to be in place to reach this patient safety goal. I won't go in to all of them at this time and if anyone wants me to fax them a copy, please send me your fax number. The nutrition/dietary service element reads as such: When dietary services are provided by the organization, the service is notified of all patients receiving warfarin and responds according to it's established foo/drug interaction program. Basically, you have to have in place what your policy says it will do. In my case, I have simple homegrown patient teaching sheets that I change as Bristol Myers Squibb changes their teaching materials (keeping up with technology piece)....example: recently we added cranberry to the list of foods to avoid. I also run a report every day that identifies all patients on coumadin (identifies patients piece). I see all these patients for education (patient education piece) and I stamp their kardex card (kept in the department) " no cranberry " . That identifies them to the nutrition services staff as patients on coumadin. It is also our policy not to limit greens and we advise patients to eat identified foods in the hospital as they would at home. I recommend that a multidisciplinary team be set up to plan this process as it helps in the long run. Our team has been meeting for about 5 months and includes pharmacy, nutrition, outpatient/clinic personnel, information services, nursing, and administration. Good luck......email me with questions! Cece This message is intended for the use of the addressee only and may contain information that is privileged and confidential. If you are not the intended recipient of this message, be notified that any dissemination or use of this message is strictly prohibited. Un-intended transmission does not constitute waiver of attorney-client privilege or any other privilege. If you have received this message in error, please delete all copies of the message and its attachments and notify the sender immediately. Thank you. Quote Link to comment Share on other sites More sharing options...
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