title: New Sentinel Event Alert addresses blood thinners.
abstract: Hospitals should be in pilot phase in preparation for implementation in accordance with NPSG 3E. Some of the most frequent problems with anticoagulants occur with failure to adminster a single dose or failure to resume therapy. There should always be physician verification when an unusual dose is ordered.
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D006761:Hospitals; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control; D018571:Sentinel Surveillance
chemical_list: D000925:Anticoagulants