title: Nurse-driven intravenous heparin protocol: quality improvement initiative.
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.
authors.affiliation: Department of Nursing, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 E Blvd 118 (W) Cleveland, OH 44106, USA. tanya.williams@va.gov
authors.forename: Tanya D
authors.initials: TD
authors.lastname: Williams
authors.forename: Katherine
authors.initials: K
authors.lastname: Sullivan
authors.forename: Christopher
authors.initials: C
authors.lastname: Lacey
authors.forename: Steve
authors.initials: S
authors.lastname: Adoryan
authors.forename: Brook
authors.initials: B
authors.lastname: Watts
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D009726:Nurses; D017749:Total Quality Management
chemical_list: D000925:Anticoagulants; D006493:Heparin