NPSG Anticoagulation

Anticoagulation therapy …

   1. Poses high risks to patients.

   2. Often leads to adverse drug events due to complex dosing, requisite follow-up monitoring, and inconsistent compliance.       

   3. Use of standardized practices including patient involvement, can reduce the risk of adverse drug events associated with the use of unfractionated heparin, low molecular weight heparin, and warfarin.                                                                                                  
   4. When  Aptt>100, INR>3.5 and/or unexplained bleeding in patient quick action is needed to prevent adverse drug events.

• 2010 Hospital National Patient Safety Goals
• 2010 National Patient Safety Goals | Joint Commission
• The Joint Commission
• Slide Show NPSG Anticoagulation
• The Weight-based Heparin Dosing Nomogram
• Heparin Dosing Review
• Using a Weight-based Heparin Dosing Protocol
• The Weight-based Heparin Dosing Nomogram Compared with a "Standard
• Weight-based Heparin Protocol using Antifactor Xa Monitoring
• The Use and Limitations of Unfractioned Heparin 
  
  
• AJHP Articles

• Brooke L. Griffin, Jill S. Burkiewicz, Laura R. Peppers, and Terri L. Warholak International Normalized Ratio values in group versus individual appointments in a pharmacist-managed anticoagulation clinic. Am. J. Health Syst. Pharm., Jul 2009; 66: 1218 - 1223.
• Deborah A. Cios, William L. Baker, Stephen D. Sander, Olivia J. Phung, and Craig I. Coleman. Evaluating the impact of study-level factors on warfarin control in U.S.-based primary studies: A meta-analysis. Am. J. Health Syst. Pharm., May 2009; 66: 916 - 925.
• MaryAnne Cronin, Timothy Hill, David A. Reich, Brian Pinard, and Eugene S. Krauss. Implementation of a multidisciplinary, pharmacy-led, thromboprophylaxis program in total-joint arthroplasty patients. Am. J. Health Syst. Pharm., Jan 2009; 66: 171 - 175.
• Jered B. Bauer, David S. Chun, and Todd A. Karpinski. Pharmacist-led program to improve venous thromboembolism prophylaxis in a community hospital. Am. J. Health Syst. Pharm., Sep 2008; 65: 1643 - 1647.
• James B. Groce. Initial management of deep venous thrombosis in the outpatient setting. Am. J. Health Syst. Pharm., May 2008; 65: 866 - 874.
• Tracy M. Meidl, Thomas W. Woller, Arlene M. Iglar, and Dennis G. Brierton. Implementation of pharmacy services in a telemedicine intensive care unit. Am. J. Health Syst. Pharm., Aug 2008; 65: 1464 - 1469.
• Nutescu EA. ASHP Therapeutic Position Statement on Antithrombotic Therapy in Chronic Atrial Fibrillation. Am J Health Syst Pharm. 2007;64(21):2281-91.
• Stephanie M. Cone, Michael C. Brown, and Richard L. Stambaugh. Characteristics of ambulatory care clinics and pharmacists in Veterans Affairs medical centers: An update. Am. J. Health Syst. Pharm., Apr 2008; 65: 631 - 635.
• Dager WE and Gulseth MP. Implementing anticoagulation management by pharmacists in the inpatient setting.  Am J Health Syst Pharm. 2007;64:1071-1079.
• Vats V, Nutescu EA, Theobald JC, et.al.  Survey of hospitals for guidelines, policies, and protocols for anticoagulants. Am J Health Syst Pharm.  2007;64:1203-1208.
• Challenges in managing venous thromboembolism and acute coronary syndrome: Case studies of the use of antithrombotic and antiplatelet therapies.   Am J Health Syst Pharm. 2008;65(Suppl 7):S1-S32.
• Improving the quality of care for venous thromboembolism and acute coronary syndrome: Using evidence-based guidelines and performance measures. Am J Health Syst Pharm. 2007;64(Suppl 7):S1-S32.