Health and social care staff often manage medicines on behalf of people using their services. Providers must promote the safe and effective use of medicines in care homes. This includes prescribing, handling and administering medicines. Failing to do this poses real risks to people who may be vulnerable, including:

  • older people
  • people with reduced mental capacity, reduced mobility, a sensory impairment
  • people who rely on help to take their medicines

Monitoring of high risk medicines comes under key line of enquiry S4 in the CQC’s healthcare assessment framework. The CQC may identify patients prescribed high risk medicines in the previous 12 months and review a sample of notes.

Anticoagulants are medicines used to prevent the blood from clotting as normal. They treat and prevent blood clots and are considered by the CQC to be high risk medicines.

Examples of anticoagulants include:

  • warfarin
  • non-vitamin K antagonist oral anticoagulants – also known as direct oral anticoagulants (DOACs) or novel oral anticoagulants (NOACs). These include apixaban, rivaroxaban, edoxaban and dabigatran
  • injectable anticoagulants – also known as low molecular weight heparins (These are often prescribed for prevention of blood clots in patients after surgery.)

The most common side effects of all anticoagulants are bleeding and bruising. They are considered critical medicines and must be given at the prescribed times to make sure they are effective.

People taking anticoagulants should have accessible information to use them safely and effectively. The NICE guideline on venous thromboembolic diseases says that people should know:

  • how to use anticoagulants
  • how long to take anticoagulation treatment
  • possible side effects of anticoagulant treatment and what to do if these occur
  • the effects of other medications, foods and alcohol on oral anticoagulation treatment
  • how to monitor their anticoagulant treatment
  • how anticoagulants may affect their dental treatment
  • what to do if they are planning pregnancy or become pregnant
  • how anticoagulants may affect activities such as sports and travel
  • when and how to seek medical help

This information should be included in a care plan to support the use of anticoagulants and all anticoagulants should have an accompanying risk assessment when in use.

With this in mind Care 4 Quality has created a risk assessment for anticoagulants which we are supplying free of charge.