Keywords

health care quality, heparin, medication safety

 

Authors

  1. Williams, Tanya D. RN, MSN, CCNS-BC
  2. Sullivan, Katherine PharmD
  3. Lacey, Christopher PharmD, BCPS
  4. Adoryan, Steve RPh, BCPS
  5. Watts, Brook MD, MS

ABSTRACT

Background: Safe use of intravenous heparin is an important safety goal.

 

Objective: To improve the quality of intravenous heparin use.

 

Methods: A pre-post intervention design assessed the number of patients who reached a therapeutic activated partial thromboplastin time (aPTT), time to aPTT goal, and complications. Fifty traditional care patients were compared with 50 nurse-driven intravenous heparin protocol patients. The data were used to assess the effectiveness of a developed intervention package to improve the quality of intravenous heparin use.

 

Results: Sixteen percent of the preintervention group never reached the therapeutic goal compared with 8% in the postintervention group (P < .05). Mean time to achieve first therapeutic aPTT was 18.6 hours in the preintervention group compared with 15.2 hours in the postintervention group (P = .33). Neither group noted complications.

 

Conclusions: The multidisciplinary team approach produced improved patient care outcomes and important lessons for improving the quality of intravenous heparin use.