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Heparin Weight Based Protocol - Patientsafetycouncil.org

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Anticoagulation Orders (Therapeutic)<br />

(<strong>Heparin</strong> <strong>Weight</strong> <strong>Based</strong> <strong>Protocol</strong>)<br />

Patient Information Required<br />

2. Warfarin (Coumadin):<br />

Daily warfarin orders to be written by physician or clinical pharmacist<br />

Obtain baseline INR, CBC, CMP before initiation. Daily morning PT / INR. CBC every 3 days.<br />

<br />

<br />

INR Goal 2-3 or ___________<br />

Nutrition consult<br />

Warfarin (COUMADIN ® )__________ mg PO today at 1700<br />

Physician Signature Date/Time Transcriber Signature Date/Time Nurse Signature Date/Time<br />

BLOCK Print BLOCK Print BLOCK Print<br />

M-ANTICOAG, C-ANTICOAG (October, 10) Page 2 of 4

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