The Accident and Emergency department at the New Royal Infirmary of Edinburgh, were keen to explore quality improvement methodologies to improve their clinical pathway for patients admitted with a suspected acute ischemic stroke. For patients with a ‘life-threatening’ haemorrhage, it is vital for the clinician to ascertain whether the patient is on warfarin. A diagnostic laboratory test, called an ‘international normalised ratio’ (INR), indicates whether a warfarin reversal agent, called beriplex requires to be administrated to the patient. By introducing a Point of Care INR test (this is performed at the patient’s bedside), instead of using a centralised laboratory, could have the potential to reduce the overall turnaround time to deliver a INR result and facilitate prompt, earlier specialist treatment for a patient with an acute ischemic stroke.
