Anticoagulation therapy safety goal has 11 implementation steps

The Joint Commission has outlined 11 implementation steps for meeting its national patient safety goal of reduced risk for anticoagulation therapy. They are:

• A defined anticoagulant management program should be implemented to individualize the care provided to each patient.
• Only oral unit-dose products and premixed infusions should be used, when available, to reduce compounding and labeling errors.
• Warfarin for each patient should be dispensed in accordance with established monitoring procedures.
• Approved protocols for the initiation and maintenance of anticoagulant therapy, appropriate to medication, medical condition, and drug interactions should be used.
• For patients started on warfarin, a baseline international normalized ratio (INR) should be available, and for all patients receiving warfarin therapy, a current INR should be available and used to monitor and adjust therapy.
• When dietary services are provided, the service should be notified of all patients receiving warfarin and respond according to an established food/drug interaction program.
• When heparin is administered intravenously and continuously, the organization should use programmable infusion pumps.
• The organization should have a policy that addresses baseline and ongoing laboratories tests that are required for heparin and low molecular weight heparin therapies.
• The organization should provide education regarding anticoagulation therapy to prescribers, staff, patients, and families.
• Patient/family education should include the importance of follow-up monitoring, compliance issues, dietary restrictions, and potential for adverse drug reactions and interactions.
• The organization should evaluate anticoagulation safety practices.