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14.04.2015, admin  
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I have to tell you that when you live with the kind of constant, debilitating pain that someone like me with Rheumatoid Arthritis and Lupus experiences every day, you are willing to try anything and everything to bring some relief. An anticoagulation medication chart has been available for use in Western Australian hospitals since mid-2007. In 2012 a process of chart revision was undertaken by the Quality Improvement and Change Management Unit (previously known as the Office of Safety and Quality in Healthcare), Performance, Activity and Quality Division, in consultation with the WA Anticoagulation Steering Committee.
Separate regular dose anticoagulant order prescription sections for venous thromboembolism prophylaxis and treatment dose to highlight the different dosing requirements.
Additional information on fixed dose oral anticoagulants (NOACs - dabigatran, rixaroxaban and apixaban) which are to be prescribed on this chart in the regular dose order section of the WA AMC (in VTE prophylaxis or treatment sections depending on indication).
Warfarin reversal guidelines have been formatted to provide clearer instructions in response to high INR and bleeding risk. Clarification of rows indicating approximate patient weight on the intravenous heparin nomograms. This operational directive specifies the use of the WA AMC for the prescribing and administration of all anticoagulants in all WA Public hospitals excluding PMH.
The WAAMC is to be used in conjunction with the adult (non-paediatric settings) National Inpatient Medication Chart (NIMC).


The WA AMC caters for the prescription and administration of anticoagulant medications, including low molecular and unfractionated heparins, warfarin and new oral anticoagulant agents. The WA AMC is not to be used for the prescribing and administration of antiplatelet or other antithrombotic agents.
The WA AMC is not to be used for prescribing or monitoring the use of mechanical prophylaxis.
While use of the chart for prescribing and administering anticoagulant medications is mandated, dosing guidelines contained within the chart are recommendations only. The WA AMC Version 7 should be in use all WA public hospitals as early as practical, no later than 31 July, 2014. Artwork for the chart (HP 10744) is available through the Quality Improvement and Change Management Unit and with the printing company tendered to print medication charts for WA Health through the Health Corporate Network.
Most important is the need for each Health Service to insert the aPTT therapeutic ranges and the aPTT nomogram range cut-offs. If an individual Health Service needs to modify the hospital specific aPTT ranges in response to changes in equipment or processes at individual laboratories.
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. The WA Anticoagulation Medication Chart (WA AMC) was originally developed by a multidisciplinary working group of the WA Medication Safety Group (WAMSG) and was designed to standardise and replace the anticoagulation charts in use across WA hospitals. The WAAMC is mandated for use to prescribe and administer all anticoagulant medications in all non-critical care areas.
Concomitant use of these agents must be clearly documented by the medical team on the WAAMC in the PRE-PRESCRIPTION SCREEN on the front page of the WAAMC. These do not cover all clinical scenarios and do not replace the need for clinical judgement. A number of resources are available to assist with implementation of this version of the WAAMC and these are available on the Office of Safety and Quality in Healthcare website. Dosing and monitoring recommendations are to be applied at the discretion of the medical staff and do not replace clinical judgement.



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