Objective: to describe the steps development for a software prototype that provides assistance with a safety view to orthopedic patient on anticoagulant therapy. Methods: was based on concept of prototyping life cycle in stages of planning and defining requirements for a software future construction. Results: using Microsoft Access® to build the instrument presented as partial result, 4 pages, initially, and proposed use of the nurse and medical professional therapeutic treatment with anticoagulant by an admitted patient in Orthopedic’s clinic. Conclusion: the evaluation of this resource as a basis for building a software will be studied later, in another opportunity.