.AC_BLEED

Bleeding screen: skin {bruising/petechiae}, gums {y/n}, epistaxis {y/n}, hematuria {y/n}, GI {melena/hematochezia y/n}, hemoptysis {y/n}; falls / head injury {y/n}.

.AC_INR

Anticoagulant {drug/dose}; INR {#.#} (ordered range {#.#–#.#}) on {date}; trend {in/above/below}; action {continue / hold / MD per order}; renal {CrCl #} if DOAC.

.AC_TEACH

Reviewed bleeding precautions, adherence / no abrupt stop, interaction avoidance {NSAID/abx/supplements}, vitamin-K consistency (warfarin), and the INR schedule with {pt/cg}; method {teach-back}; mastery {##}%.

.AC_SAFETY

Call for any unusual or persistent bleeding or an out-of-range INR; 911 for GI bleeding, severe epistaxis, a head injury or fall with head strike, or stroke / PE / limb-ischemia symptoms.

.AC_NECESSITY

Skilled nursing required today to {action} for {bleeding / thromboembolic risk} given anticoagulation, resulting in {measurable effect}.