SL145-Safe Management of Warfarin and Anticoagulant Therapy Policy

Registration Number: {{org_field_registration_no}}

Safe Management of Warfarin and Anticoagulant Therapy Policy

1. Purpose

The purpose of this policy is to ensure that {{org_field_name}} safely manages warfarin and other anticoagulant therapy for service users, maintaining compliance with the latest Care Quality Commission (CQC) regulations. Anticoagulant therapy is essential in preventing blood clots but carries a significant risk of bleeding complications if not managed correctly. This policy outlines safe prescribing, administration, monitoring, and review processes to minimise risks and optimise therapeutic outcomes for service users.

2. Scope

This policy applies to all staff, including care workers, nurses, and healthcare professionals responsible for the management of service users receiving warfarin or other anticoagulants within {{org_field_name}}. It also applies to the handling, storage, monitoring, and administration of these medications, ensuring service users receive person-centred, safe, and effective care.

3. Responsibilities of Staff and Healthcare Professionals

3.1 Designated Responsibilities

The Registered Manager is responsible for ensuring compliance with CQC regulations and overseeing anticoagulant therapy management.
Care Staff are responsible for following prescribed protocols, documenting medication administration, and reporting concerns.
Nurses or Healthcare Professionals liaise with General Practitioners (GPs) and anticoagulation clinics to ensure safe treatment plans and dose adjustments.
Service Users and Family Members are encouraged to engage in their treatment plan and report any concerns regarding side effects or adherence issues.

3.2 Training and Competency

All staff handling anticoagulant therapy must complete mandatory training on warfarin and anticoagulants, including risk management, side effects, and emergency procedures.
Regular competency assessments ensure staff remain updated on best practices.
Staff must understand the significance of INR (International Normalised Ratio) monitoring and how to respond to abnormal results.

4. Safe Prescribing and Documentation

4.1 Prescribing Procedures

Warfarin and other anticoagulants must only be prescribed by a qualified medical professional, such as a GP or specialist.
All prescriptions must be reviewed regularly, taking into account service user health status, potential drug interactions, and recent INR readings.

4.2 Accurate Record-Keeping

A Medication Administration Record (MAR) chart is maintained to ensure accurate documentation of dosage, frequency, and administration times.
Staff must log any missed doses, refused medication, or adverse reactions.
INR results and dose adjustments must be documented in both the service user’s records and communicated effectively to all relevant healthcare professionals.

5. Administration of Warfarin and Anticoagulant Therapy

5.1 Procedures for Safe Administration

Warfarin must be administered exactly as prescribed, ensuring that service users take their dose at the correct time each day.
Staff must cross-check INR test results before administering warfarin to confirm that the dose remains appropriate.
Any missed doses or errors must be reported immediately, and the GP or anticoagulation clinic must be notified.
Food and medication interactions should be considered, such as avoiding foods high in vitamin K (e.g., leafy greens) which can counteract warfarin’s effectiveness.

5.2 Self-Administration Support

Where appropriate, service users are supported to self-administer their anticoagulant therapy, following a risk assessment to ensure they can manage their medication safely.
Staff provide education on the importance of compliance, recognising side effects, and attending INR monitoring appointments.

6. Monitoring and Review

6.1 INR Monitoring and Dose Adjustments

Service users on warfarin require regular INR tests to ensure their blood remains within the therapeutic range.
Test results are reviewed by the GP or anticoagulation clinic, and any dose adjustments are communicated promptly to staff.
INR results must be recorded, and any extreme deviations from the prescribed range require urgent medical intervention.

6.2 Side Effects and Adverse Reactions

Staff must be aware of common anticoagulant side effects, including bruising, excessive bleeding, dizziness, and severe headaches.
Any suspected adverse reactions must be reported to the GP immediately.
Service users experiencing severe bleeding (e.g., nosebleeds lasting over 10 minutes, blood in urine or stools) must receive emergency medical attention.

7. Emergency Management of Anticoagulant Complications

7.1 Recognising and Responding to Over-Anticoagulation

Symptoms of over-anticoagulation (INR levels too high) include spontaneous bleeding, black stools, or severe bruising.
Immediate action includes withholding the next dose and seeking urgent medical advice.
Vitamin K administration may be required to reverse the effects of excessive anticoagulation, as directed by a healthcare professional.

7.2 Dealing with Missed or Extra Doses

If a dose is missed, it should not be doubled to compensate.
Any missed doses must be recorded, and medical advice should be sought to determine the best course of action.
If a service user takes an extra dose accidentally, staff must contact the GP or emergency services if symptoms of over-anticoagulation arise.

8. Quality Assurance and Compliance with CQC Standards

8.1 Adherence to CQC Regulations

This policy aligns with CQC Regulation 12 – Safe Care and Treatment, ensuring anticoagulant therapy is safely managed.
Medication safety audits are conducted regularly to ensure compliance with best practices and regulatory standards.
Staff training records are maintained to demonstrate competency and compliance with anticoagulant therapy management.

8.2 Incident Reporting and Continuous Improvement

Any incidents, errors, or near misses involving anticoagulants are recorded and reviewed to prevent recurrence.
Lessons learned from medication errors are used to improve training and procedures.
Service user feedback is actively sought to enhance the quality of care provided.

9. Related Policies

This policy should be read in conjunction with:

SL02 – Medication Administration and Management Policy
SL07 – Risk Management and Incident Reporting Policy
SL13 – Infection Control Policy
SL19 – Emergency First Aid Response Policy
SL21 – Nutrition and Hydration Policy
SL25 – Safeguarding and Protection of Vulnerable Adults Policy

10. Policy Review

This policy will be reviewed annually or sooner if changes in CQC regulations, anticoagulant therapy guidelines, or service needs arise.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.