What is Warfarin
Warfarin is a type of medicine known as an anticoagulant. This medicine makes the blood flow trough veins more easily which means the blood will be less likely to make dangerous blood cloth. Too much or too less warfarin can cause serious harm to the resident using this therapy.
Pharmaceutical form
Warfarin tablets come in 4 different strengths: 0.5mg, 1mg, 3mg and 5mg.
The dose may be made up of a combination of different strength of the tablets.
Warfarin liquid comes with a plastic syringe to help with the measurement of the correct amount.
Warfarin dose
The usual warfarin dose is once a day in the evening. This is so that if the dose needs to be changed after a routine blood test, this can be done on the same day rather waiting until the following day.
Regular blood test
The aim of warfarin treatment is to make the blood clot more slowly, not to stop it from clotting completely. Getting this balance right means that warfarin dose MUST be carefully monitored.
Patients on warfarin will have a regular blood test called the international normalised ratio (INR). The warfarin dose depends on the INR test results. This blood test is done every 1-2 days at the beginning of the therapy then once or twice a week until the INR is stable at the target level. If the blood test results are stable, then the blood test can be performed once every 12 weeks.
How to manage warfarin dose into Atlas
When using Atlas system the recommended dose instructions for warfarin administration is “Take daily according to INR”. This will allow the user to provide the therapy daily and use any strength combinations. This dose can be added by the pharmacy user when entering prescription or by the Care Home user via Atlas eMAR or Atlas Central. The different strength and formulation of warfarin can be added by the user into system like any other drug. Please ref. to How to add item into CAPA/ Atlas.
Witness requirement when administer warfarin
Atlas has in place a safety functionality for warfarin. Witness requirement can be set up for this item as preferred by the CH via Atlas Manager.
Conclusions
Nationwide there is a high number of incidents in regards anticoagulants administration therapy. Most of the time prescriptions are issued with the dose “Use as directed”, “Take as directed” or just “ As directed” . This will be entered into the system by the pharmacy user accordingly. This will not make the item to prompt into eMAR device for administration and the dose can be missed. For safety reasons we are highly recommend the CH to contact the prescribers and change dosages when needed.