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Nurses Webinar: Nurse Led DOAC Clinic
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Nurses Webinar: Nurse Led DOAC Clinic

When: Wednesday, September 27, 2017
14:00 UTC

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Nurses Webinar: Nurse Led DOAC Clincs

September 27, 2017 14:00 - 15:00 UTC (10:00 ET)



Bunis Packham

In this presentation the speaker will share her personal experience of running a DOAC Clinic at the Royal Free Hospital in Barnet, United Kingdom and will highlight:

  • need for and key considerations of developing and running a nurse led DOAC clinic.
  •  mammoth task of change, innovation and problem solving approach
  • challenges on running traditional warfarin clinic and developing DOAC clinics
  • change that involves training , competency assessment of the whole team and training for the whole organisation
  • success and importance of leadership

Susan Jenkins

In this presentation the speaker will provide an overview of the North American models of anticoagulation management and focus on the University Health Network model of care and DOAC management. The objectives of the presentation are:

  • Highlight the importance of comprehensive anticoagulation management services
  • Review DOAC patient selection criteria
  • Review the current challenges and limitations of DOAC prescribing
  • Summarize our experience with DOACs
Moderator:  Maura Malone



Bunis Packham

Bunis designed, developed and leads the nurse – led anticoagulation and thrombosis service at Barnet and Chase Farm hospital. She has 7 anticoagulation specialist nurses working with her.  The service currently has >5000 patients on anticoagulation therapy. Pioneered a novel system whereby, the service is decentralised to enable all  groups of patients to have access to high standard and safe anticoagulation service nearer to their home. This in-turn has improved patients adherence to treatment and reduced non-attendance. This model had significantly reduced health inequalities and improved patients’ outcome and has won national award “Elderly Patients Prevention of Stroke” presented by the Health Secretary. 
We have successfully implemented an on-going monitoring system to prevent unsafe patients’ discharges, reducing waiting list for anticoagulation appointment, improving communication with patients and their GP, and offering bridging therapy. This approach has contributed to reducing hospital stay, readmission and mitigate risk when discharging patients on anticoagulation therapy. 

She has been involved in developing national guidance, NICE: Medicine Adherence 2009 and Medicine Optimisation 2015. She developed Thrombosis and Anticoagulation Course in collaboration with Middlesex University, aimed at both primary and secondary health professional. She involved in educational program for all health  professionals in order to ensure clinicians are educated to ensure patients  who are on anticoagulation therapy  journey throughout the hospital is safe and effective.
We perform regular audit in line with national guideline, including bleeding risk, stroke, abnormal INRs and we have used our audit finding to improve our service to where we are now. We have been involved in national research.

Maura Malone

Maura Malone has been a Clinical Nurse Specialist in Hemophilia and Thrombosis at Dartmouth Hitchcock Medical Center and Instructor in Medicine, Geisel School of Medicine at Dartmouth since 1991. She received her RN at St. Vincent’s Hospital, NYC, and BSN at VT College of Norwich University in 1981and MSN in 2001.  Ms. Malone provides comprehensive management for persons with hemophilia and other inherited bleeding disorders and is the nurse manager of thrombosis program and regional diagnostic coagulation clinic.  She initiated an international platform for nurses to formally participate at ISTH and is the Chair of the ISTH Nursing Committee. Currently serving on the American Thrombosis and Haemostasis Network (ATHN)  Thrombosis Committee to develop a national data base to better characterize the challenges with this patient population. Served as Nursing Co-Chair, on the Hemostasis and Thrombosis Research Society (HTRS) Committee 2012-2015; and the Center for Disease Control (CDC)  National Subcommittee on Women and Bleeding Disorders 2008 - 2012 Ms. Malone has co-authored publications on treatment management challenges on hemostasis disorders and presented regionally, nationally, and internationally on both bleeding and thrombosis disorders. Ms. Malone received the Advanced Practice Nurse Excellence Award in 2006, DHMC.

Additional bio coming soon!


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