|Title:||Implementation of the WA Anticoagulation Medication Chart (WAAMC)|
|Document ID:||Operational Directive OD 0270/10|
|Date of issue:||Wednesday, 17 February 2010|
|Status:||NO LONGER APPLICABLE|
|Description:||This operational directive specifies the use of the WA Anticoagulation Medication Chart (WAAMC) for the prescribing and administration of all anticoagulants (excludes paediatric setting and KEMH)|
|Applicable to:||Clinical staff|
|Period of effect:||from 1 January 2010 to 31 December 2015|
|Authorised by:||Mr Kim Snowball, A/Director General, Department of Health, 31-Jan-2010|
|Print version:||View print version|
Implementation of the WA Anticoagulation Medication Chart (WAAMC)
An anticoagulation medication chart has been available for use in Western Australian hospitals since mid-2007. The chart was developed by a multidisciplinary working group of the WA Medication Safety Group (WAMSG) and was designed to replace the anticoagulation charts in use in various WA hospitals. This chart has been evaluated and revised. The revised chart was piloted at Royal Perth Hospital (RPH) and is currently in use at RPH, Fremantle and Armadale.
This operational directive specifies the use of the WA Anticoagulation Medication Chart (WAAMC) for the prescribing and administration of all anticoagulants in all WA Public hospitals excluding KEMH and PMH. The WAAMC is to be used in conjunction with the adult (non-paediatric settings) NIMC.
The WAAMC is mandated for use to prescribe and administer all anticoagulant medications in all non-critical care areas. Use of the WAAMC is recommended within critical care areas, where this is practicable.
The WA Anticoagulation Medication Chart (WAAMC) is to be for the prescribing and administration of all anticoagulant medications. This includes but is not restricted to low molecular and unfractionated heparin and oral anticoagulants. The WAAMC is not used for the prescribing and administration of antiplatelet or other antithrombotic agents. Concomitant use of these agents must be clearly documented on the WAAMC in the PRE-PRESCRIPTION SCREEN on the front page of the WAAMC.
While use of the chart for prescribing and administering anticoagulant medications is mandated, dosing guidelines contained within the chart are recommendations only. These do not cover all clinical scenarios and do not replace the need for clinical judgement.
The WAAMC Version 3 should be in use all WA public hospitals as early as practicable and no later than 1 April, 2010. A number of resources are available to assist with implementation of this version of the WAAMC.
Use of ancillary charts
It is recognised that missed doses may be an unintended consequence of the use of ancillary charts. For this reason it is important that the main medication chart (NIMC) is appropriately annotated to indicate the use of the ancillary chart.
Artwork for the chart (HP 10744) is available through the Marketing Office of the Department of Health. Anything modifiable at the Health Service level is shown in blue. Most important is the need for each Health Service to insert the aPTT therapeutic ranges and the aPTT nomogram range cut-offs. All other changes in layout and content must be made at the state level. It is recommended that the following system be used to indicate the version.
VERSION NUMBER 000_AAA###_MMYY where,
If an individual Health Service needs to modify the hospital specific aPTT ranges in response to changes in equipment or processes at individual laboratories. These changes should be reflected locally in the version number of chart.
While the Australian Standards (AS-2828-1999) recommends white paper be used for medication charts it does allow pastel alternatives. It is the practice at a number of hospitals to use pale pink anticoagulation chart. The decision regarding the colour of the WAAMC, either white or pale pink, is left with the Medical Records Committees at individual jurisdictions.
Recommending a change in the WAAMCRecommendations for change of the WAAMC can be made via email to firstname.lastname@example.org. Recommendations for change must be evidence based, with the primary objective of improving patient safety.
Health Services should monitor compliance against the features of the chart in terms of completion of appropriate sections.
Dosing and monitoring recommendations are to be applied at the discretion of the medical staff and do not replace clinical judgement.
Mr Kim Snowball
This circular last updated: Wednesday, 17 February 2010 at 12:33pm