Anticoagulation Management: A Case Study
Present the Evidence: Anticoagulation Management Anticoagulants are considered to be among the most commonly implicated medications to cause adverse drug events in hospitalized patients (Piazza et al., 2011). As a result, there has been an increased focus on preventing medication errors in relation to anticoagulant therapy. The purpose of this paper is to demonstrate how the current Anticoagulation Management policy, used at Advocate Medical Centers, is supported by or needs revision according to the evidence-based clinical guidelines. In addition, this paper will also discuss ways to implement change to the policy and a means to evaluate change as a result of the proposed policy revision.
The Policy The current four-paged policy in place at Advocate Health Care (2014), describes recommendations for the formulary management, procurement, prescribing, storage, dispensing, administration and monitoring of anticoagulant medications.
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One change that was recommended by Holbrook et al. (2012) is an INR therapeutic range of 2.0 to 3.0 and targeted INR of 2.5 for those patients receiving Vitamin K antagonists (VKA). The current policy by Advocate Health Care (2014) fails to specify a preferred therapeutic and targeted INR value that healthcare professionals should monitor and strive to achieve as an outcome for their patient. This range provides a basis for the subsequent steps to be taken during the continuation of anticoagulation management. Due to the risk of anticoagulant-associated bleeding, it is recommended that Vitamin K antagonist therapy be stopped five days prior to a procedure in non-urgent situations. Again, this is a section where the current Anticoagulation Management policy by Advocate Health Care (2014) should be developed to include the steps that should be taken in situations where the therapy is to be
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