The Joint Commission recently published a “Sentinel Event Alert” on managing the risks of direct oral anticoagulants. Remember the day when these new medications were introduced and everyone thought it was life changing? No PT/INR levels to worry about, short half life so the medications aren’t lingering in the system, etc.? Well, after years of use and some research, it is time for us to take a step back and evaluate what and why we are administering medications to our residents.

One of the risks associated with these medications is the risk that stopping bleeding events in patients on these medications is more complicated than those on warfarin and heparin. Reversal agents are lesser known and may not be available in every care setting. Attached is a link to guidance on the safe use and management of DOACs.

Take a few minutes to review the recommendations and:

• Share them with your medical director and other prescribing practitioners.
• Perform an audit of medications to identify those residents with current physician orders
• Ask the prescribing physician to review the orders and evaluate the risk/benefit of the medication
• Alert licensed staff to the risks associated with these medications
• Flag the MAR, care plan and caregiver guides to ensure staff are alert to signs of an adverse response related to the medication.

Remember, it is ultimately our responsibility to be aware of possible adverse effects related to medications we administer and publications like these will assist you and your team!