Redesign of a weight-based heparin protocol for improved outcomes in a community hospital.
Heparin has long been used to minimize complications of a variety of disorders and reaching a therapeutic level within 24 hours has been shown to improve patient outcomes. However, the dosing of heparin to reach a therapeutic level has been controversial. At our institution a weight based heparin nomogram was in place, however an initial data analysis revealed a large percent of the initial aPTT levels were above therapeutic range. This article will describe the performance improvement process and the overall goal to decrease the percentage of patients exceeding the initial therapeutic aPTT levels without compromising daily therapeutic aPTT levels.
Stahl
Kathy L
KL
Wheeling Hospital, 1 Medical Park, Wheeling, WV 26003, USA. kstahl@wheelinghospital.com
Pollard
Deborah L
DL
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001835:Body Weight; D002985:Clinical Protocols / Q000592:standards*; D016903:Drug Monitoring / Q000379:methods / Q000592:standards*; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D008485:Medical Audit; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010314:Partial Thromboplastin Time; D011367:Professional Staff Committees / Q000458:organization & administration; D012189:Retrospective Studies; D017749:Total Quality Management / Q000458:organization & administration*; D014903:West Virginia
D000925:Anticoagulants; D006493:Heparin