Joint Commission Revises National Patient Safety Goal Addressing Anticoagulation Medications

PUBLISHED: Dec 5, 2018
Relevant to: Ambulatory Care, Critical Access Hospitals, Home Health, Hospitals, Long Term Care, Medical Office

The Joint Commission (TJC) recently announced revisions to National Patient Safety Goal (NPSG) 03.05.01, effective July 1, 2019. NPSG.03.05.01 is applicable to ambulatory health care (medical centers only), critical access hospital, hospital, and nursing care center accreditation programs and addresses the initiation, management and dosage adjustment for anticoagulant medication. (Note: this NPSG does not it apply to organizations limited to the mechanical treatment of bleeding.)

NPSG.03.05.01 requires organizations to reduce the potential for patient harm associated with the use of anticoagulant therapy.

TJC has added new and also revised certain elements of performance (EPs) to address areas such as use of evidence-based guidelines, ongoing patient monitoring, education and safety practice evaluation.

Highlights of the revisions include:

  • A requirement that organization use approved protocols and evidence-based practice guidelines for:
  • Reversal of anticoagulation and management of bleeding events that are related to anticoagulant medications.
  • Perioperative management of patients on oral anticoagulants (this management might include use of bridging medications, timing dosing around stopping/restarting of an oral anticoagulant.)
  • Initiation and maintenance of anticoagulant therapy taking into consideration type of medication, dosing, patient age, renal and liver function, drug-drug and drug-food interaction and other risk factors as applicable.
  • A requirement that organizations have policies addressing baseline and ongoing laboratory tests to monitor and adjust anticoagulant therapy (warafin therapy should use INR, direct oral anticoagulant (DOAC) should use evidence-based practice guidelines).

Follow the link below to review the new and revised NPSG. Included with today’s notice are example policies related to initiation, management and prevention of adverse events related to anticoagulant therapy.

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