Preventing Anticoagulation in Nursing Homes

Preventing Anticoagulation in Nursing Homes

Anticoagulation therapy is commonly used to reduce the risk of blood clot formation in nursing home residents who may be at an increased risk of suffering a stroke due to immobility, atrial fibrillation, and other comorbidities. While the positive effects of anticoagulation are well-documented, concern over the high risk of adverse events linked to hemorrhage and/or complex pharmacology has risen greatly over the past decade.

There are a number of other reasons why it may not be safe for a nursing home resident to receive anticoagulants. For example, when anticoagulants, such as Warfarin (also known as Coumadin), are taken at the same time as other medications, like aspirin, the risk of major bleeding episodes is vastly increased.

Unfortunately, too frequently, nursing home residents suffer harm, sometimes even death, due to the negligence of the facility nursing staff or attending physician.  Such errors commonly include inappropriate dosing of medication, failure to consider drug-to-drug interactions and a failure to  adequately monitor and supervise the effects of anticoagulation therapy through the appropriate lab testing.  These adverse events can lead to serious and potentially life-threatening side effects.

Risk Factors of Anticoagulation Therapy

Like other types of medically necessary treatment, administering anticoagulation therapy to patients must be carried out with extreme caution. Medical errors, such as administering the wrong prescription or over/under-dosing certain medications, can negate any positive effect these medications may have and ultimately cause more harm than good.

Nursing home residents are at particular risk when anticoagulants are administered improperly due to a variety of risk factors. These include age, diagnoses of cerebrovascular disease/hypertension, history of gastrointestinal bleeding, heightened risks of falling, and an extended length of use of oral anticoagulants. Knowing if these factors impact you or a loved one can be the key to recognizing symptoms of serious hemorrhaging and ultimately preventing fatal side effects.

How is Anticoagulation Medication Administered Improperly?

Common reasons anticoagulants and other medications are administered improperly include:

• Overworked and fatigued nurses;
• Miscommunication between a doctor and nurse;
• Poor or illegible prescription handwriting;
• Incorrect dosing (too much or too little);
• Failure to anticipate reactions with other prescriptions, over-the-counter medications and even foods;
• Failure to appropriately monitor a patient’s PT/INR lab values regularly to adjust dosages as each individual nursing home resident requires;
• Intentional error.

Preventing Medication Errors

Anticoagulation therapy has been observed to work best and most safely when a patient receives close and constant supervision from doctors, nurses and other medical practitioners. Attentive and frequent monitoring of patient health, as well as constant verification that a patient is receiving appropriate dosage(s) of all medication, are two ways to minimize the potential of negative side effects.

If you are concerned that you or your loved one may have been administered (or are currently being administered) oral anticoagulants inappropriately, there are some measures that can be taken to verify that a treatment plan is the best for a patient through a medical practitioner. These include:

• Reviewing comorbidities between anticoagulants and any other prescribed medication with a doctor, nurse or pharmacist;
• Ensuring that multiple anticoagulants are not prescribed to a patient at any point;
• Clarifying that all prescriptions written by a doctor have not been misinterpreted, misread or misunderstood by either a pharmacist, nurse or others responsible for patient care; and
• Verifying dosage and administration practice to ensure that too much (or too little) medication is not administered for extended periods of time to reduce the risk of negative side effects and/or internal hemorrhage.

Patient Protection in Nursing Homes

It is impossible to prevent all medication errors before they happen, but those under medical care can lean on Illinois’ Medical Patient Rights Act for some protection. In part, the act gives patients the right “to care consistent with sound nursing and medical practices” and “to receive information concerning his or her condition and proposed treatment.”

The penalties for violating this act are not especially stiff, but the act can embolden patients to advocate for themselves, ask pointed questions and expect answers before any medication is administered.

Additionally, the Illinois Nursing Home Care Act provides a vehicle for prosecuting civil actions when a nursing home fails to provide or willfully withholds adequate medical care that is necessary to avoid physical harm, mental anguish, or mental illness of a resident.

Contact an Experienced Nursing Home Lawyer

Administered properly, anticoagulation therapy can drastically improve the quality of life for nursing home residents who would otherwise face a high risk of heart attack or stroke. However, it is important that any resident in a nursing home or similar long-term care facility receives the care and attention they need, and that they are monitored properly while undergoing treatment.

When caregivers and medical practitioners cannot—or choose not to—properly care for their patients, there may be legal options for holding them accountable. If you or a loved one is concerned about the possible abuse or neglect of a patient while they are residing in a nursing home, contact us today for a free consultation.