Warfarin is the most commonly prescribed oral anticoagulant. The management of warfarin is challenging, and current guidelines fail to include a model to assist practitioners in optimizing therapeutic dosing. The traditional model and the anticoagulation clinic (AC) model of warfarin management were compared and results found the AC model optimum.

BackgroundVulnerable populations are more likely to present to non-dental healthcare locations with dental issues. Oral health screening in those settings, such as primary care, is an effective way to identify individuals with unmet oral health needs and facilitate dental referrals.ObjectiveTo implement and evaluate the integration of oral health screening at an outpatient transitional primary care clinic in Maryland.MethodsThe quality improvement project occurred over 12 weeks. The project leader obtained support from institutional stakeholders, collaborated with dentistry, provided evidence-based resources, and developed referral strategies. Patients received a pre-screen at registration. Primary care providers used an oral health assessment tool (OHAT) for further screening and/or gave a dental referral.ResultsApproximately 108 patients completed pre-screen: 73% had not seen dentist in the past 12 months; 12% had current oral problem or pain; 53% had no established dentist; <5% had a completed OHAT; 20% referred to existing dentist; 56% received dental resource listing.ConclusionsOral health disparity continues to exist among vulnerable populations.Implications for NursingOral screening by advanced practice nurses is an effective way to identify patients with unmet oral health needs and to promote dental referral.

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