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NEW ORAL ANTICOAGULANTS – HOSPITAL PHARMACISTS IMPROVING THE SAFETY OF PATIENTS PRESCRIBED THESE AGENTS

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European Statement

Patient Safety and Quality Assurance

Author(s)

D. Lenehan, C. Meegan

Why was it done?

Due to the high risk nature of the NOACs, the PD has throughout 2014 and 2015 been committed to a comprehensive NOAC risk minimisation strategy, targeting all points of care to address the various safety concerns with these medicines.

What was done?

The following suite of activities were introduced in a drive to improve understanding, familiarity and awareness of new oral anticoagulant (NOAC) therapy.
1 – Medication Safety Alert – Outlines the relevant background information, risks and safety tips for prescribing and administering NOACs.
2 – Quiz – a novel and fun method to ascertain the level of knowledge staff had on NOACs by incentivising participation.
3 – Prescribing information sheet – summarises all the pertinent prescribing information on NOACs to aid selection and detail the relevant clinical cautions and risks.
4 – Point prevalence study (PPS) – captured data on all NOAC patients in the hospital to identify prescribing trends and appropriateness of prescribing.
5 – Clinical checklist algorithm – identifies the key prescribing decisions and risks when admitting a patient on a NOAC.
6 – Staff educational drive – a major innovative roll-out of education sessions to medical and nursing staff.
7 – Patient education – pharmacists now educate all patients newly started on NOAC therapy.

How was it done?

Introduction of this comprehensive suite of activities required collaboration and communication with our nursing and medical colleagues in the hospital.

What has been achieved?

Knowledge and awareness of NOAC therapy has improved significantly among clinical staff and this has been reflected in medication variance reporting. The safe use of this high risk group of medicines is of paramount importance in order to minimise patient risk with these agents.

What next?

The appropriateness of NOAC prescribing will continue to be assessed through the medication variance reporting process and a follow-up PPS will be completed. Rationalisation of NOAC therapies will be considered through the formulary process and the education of staff and patients will remain a priority.

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