Anticoagulation in long-term care

Although anticoagulants have been a part of the medical armamentarium for more than 50 years, their use is complex, and new agents and regimens are being added. It is critically important that each facility consider the issues surrounding the use of anticoagulants in LTC settings, as these agents have significant risks and benefits, and are in frequent use. Monitoring of anticoagulants is a frequent area of error and adverse outcomes in the LTC setting. Policies and procedures should address drug administration; bedside monitoring for bleeding by nurses and aides; policy recommendations for the minimum frequency of laboratory monitoring, if required; and administrative systems for obtaining laboratory monitoring in a timely fashion, including obtaining and reporting of laboratory testing results to the facility and to the physicians in a timely manner.