Abstract
Back ground: Valvular heart disease, a chronic illness with high mortality rate, is difficult to treat
and prone to complications, especially from warfarin. In 2009, before implementing the network of care in
Health region 13, we found that about 50 cases of total 217 cases (23.04%) had been brought back to the
hospital due to warfarin using. Because of this problem, the network of care for warfarin use has been set up in January 2010 to look after these patients for continuity of care and to maintain wafarin level. Objective:
To study the result of implementing network of care for post-operative valvular heart disease patients
who use warfarin. Setting: Health region 13 Method: The study is divided into 3 phases;1) situation
analysis 2) developing network of care guideline and 3) implementing and evaluation. The data were
collected during January to March 2009 by questionnaire, depth interview, observation and focus group
discussion. A descriptive statistic and content analysis were used to analyze the data.
Result: During January to March 2009, only 9 patients (8.11 % & 0.48% of post operative patients & of
1,881 patients who use warfarin during that time respectively) came back to the hospital due to warfarin
using ( 5 due to overdose & 4 due to valve dysfunction ). From 15 committed hospitals, 13 hospitals were
ready for implementation, 9 & 4 were community hospitals & general hospitals respectively. Conclusion:
The network of care with guideline, monitoring and supervisioon can improve the quality of life by decreasing
the complication of warfarin use.
