Developing Anticoagulation Service Guidelines

All aspects of the running of an anticoagulation clinic should be documented and collated into a Practice Anticoagulation Protocol. Many Primary Care Organisations require a detailed protocol when agreeing to fund a practice for anticoagulation services.

The National Patient Safety Agency (NPSA), recommends that NHS and independent sector organisations "Review and, where necessary, update written procedures and clinical protocols for anticoagulant services to ensure they reflect safe practice, and that staff are trained in these procedures." (http://www.npsa.nhs.uk/nrls/alerts-and-directives/alerts/anticoagulant/)

When developing guidelines for an anticoagulation clinic areas to cover include:

• Aims of clinic
• Training
• Training Log
• Point of Care Testing (POCT)
• Clinical Decision Support Software (CDSS)
• Criteria for assessing existing risk factors for stroke or bleeding
  such as CHA₂DS₂-VASc and HAS-BLED
• INR testing protocol
• End of treatment
• Quality Control testing protocol
• Internal and External Quality Control log
• Health and safety