Background: The IHI Global Trigger Tool for Measuring Adverse Events provides an easy-to-use method for accurately identifying adverse events (harm) and measuring the rate of adverse events over time. It is also strongly recommended by the Food and Drug Administration (FDA), the Joint Commission on Accreditation that Hospitals must have active surveillance system for safe use of medications and detection of any Adverse event in system.

Aims: Tabba heart institute provides specialty base cardiac services. All hospitalized patients went through high risk procedures and they treated with high risk medications. Aim of the study is to closely monitored the adverse event of patients on warfarin whose INR goes >6 during hospitalization and checked for evidence of bleeding. Warfarin is an important drug required more vigilance for patient safety.

Methods: Retrospective data of one year is evaluated from a key performance indicator to monitor the INR >6 of all hospitalized patients. The data is measured through = INR >6 of hospitalized patients/ total number of patients on warfarin *100.

Results: Software driven data for INR >6 was evaluated from the period of January 2019 to December 2019. The mean percentage of INR resulting >6 is 12.6%, which is a trigger. Highest percentage of INR >6 reported in month of August 2019 (26.67%). Reasons for INR >6 include poor patient compliance, lack of focused guidance to the patients and drug-drug interactions.

Conclusions: Our study results strongly recommends pharmacist supervised Warfarin therapy counseling should be initiated for this high risk cardiovascular population. Also, there is an opportunity to evaluate data for bleeding events on INR >6 that might also result in mortality.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/monitoring-of-adverse-event-of-inr6-using-ihi-global-trigger-tool-in-cardiology-hospital-pakistan/