It was recently brought up at our facility that we have guidance to use a PTT based heparin protocol when a patient has been on a DOAC but no guidance on when a patient is transitioning from Lovenox or other LMWH. I have seen couple examples of heparin protocols where if a patient has been on enoxaparin in the last 48 hours to use a PTT based protocol and other where they it just states to consider a PTT based protocol if recent enoxaparin administration.

If your facility is using anti-Xa protocol for heparin, do you have guidance on what do if recent enoxaparin or LMWH administration? DO you have hard stops or Logic built into your EMR to help catch this and guide use to the correct protocol? Thanks!