Accreditation 2023 - Medication Use

Heparin Safety by Tina Davidson

Heparin is a high-alert medication with a heightened risk of significant patient harm when used in error. Heparin includes unfractionated heparin and low molecular weight heparin, both of which are anticoagulants used for prevention and treatment of blood clots. Ensuring safe and coordinated use of heparin is also a Required Organizational Practice of Accreditation Canada.  

Pembroke Regional Hospital promotes safety best practices when dispensing and administering unfractionated heparin and low molecular weight heparin through the implementation of safeguards that reduce the possibility of harm. Several PRH committees are involved in medication safety, including the Medication Management Committee which is responsible for identifying and mitigating risks associated with the medication system. Clinicians share this responsibility which includes reporting incidents through RIMS (RIMS). Safeguards are in place including audits of patient care areas conducted by Pharmacy at least annually. Click here for the ‘Quick Tip’.

Strategies that are employed for the safe use of heparin at PRH include:

• Avoiding high concentrations of unfractionated heparin at PRH  
• Unfractionated heparin (high dose): greater than or equal to 10,000 units is provided on a patient specific basis when required and is stocked in the pharmacy department
• Limiting the quantities of low molecular weight heparin stocked in patient care areas
• Restricting the patient care areas where low molecular weight heparins are stocked
• Standardizing medication options by having one low molecular weight heparin on our drug formulary – Enoxaparin  
• Labelling all low molecular weight heparin products in patient care areas with visible warning and auxiliary labels that identify it as a high-alert medication
• Using pre-filled syringes for low molecular weight heparin (i.e. Enoxaparin) instead of multi-dose vials
• Providing training about high-alert medications such as heparin
• Requiring an independent double check for unfractionated heparin prior to administration

More information on the safe use of heparin can be found in the “High Alert Medication List” and the “High-Alert Medication and Independent Double Check” policy document.