Delivery of Optimized Inpatient Anticoagulation Therapy

Consensus Statement From the Anticoagulation Forum

Edith A Nutescu PharmD FCCP; Ann K Wittkowsky PharmD CACP FASHP FCCP; Allison Burnett PharmD PhC; Geno J Merli MD FACP; Jack E Ansell; David A Garcia MD


The Annals of Pharmacotherapy. 2013;47(5):714-724. 

In This Article

5. Provider Education and Competency

The anticoagulation management system should provide an appropriate level of staff training, ongoing educational development, and documented competency assessment for all multidisciplinary personnel involved in anticoagulation management.

The multidisciplinary health care practitioners involved in the management of anticoagulation therapy should be educated and licensed in a patient-oriented clinical discipline (ie medicine, nursing, pharmacy) and trained in the assessment and care of the patient receiving anticoagulation therapy. Inadequate knowledge about the patient's medication or condition is one of the most frequently cited causes of medication prescribing errors.[38] Recognizing this risk, the Joint Commission National Patient Safety Goal 03.05.01 on anticoagulation therapy calls for the provision of focused anticoagulation education and training for prescribers and staff on a regular basis. Systems providing anticoagulation management should devise in-house staff educational programs and corresponding competency assessments. In addition to internal institutional-based training, formal external certification, didactic, experiential, and self-study programs can be pursued. Examples of formal anticoagulant therapy management training programs are listed in Table 5. A multidiscipline national certification credential in anticoagulation is administered by the National Certification Board of Anticoagulation Providers ( The credential CACP (Certified Anticoagulation Care Provider) is inclusive of inpatient and outpatient management needs. The core domains of competency for anticoagulation providers are outlined in Table 6.[39] Formal anticoagulant therapy management training programs should include the core domains of competency for anticoagulation providers required by the National Certification Board of Anticoagulation Providers.