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Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Nurse-driven intravenous heparin protocol: quality improvement initiative
Tanya D Williams1, Katherine Sullivan, Christopher Lacey
1Department of Nursing, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 10701 E Blvd 118 (W) Cleveland, OH 44106, USA. tanya.williams@va.gov
AACN Advanced Critical Care
|May 1, 2010
Summary
Implementing a nurse-driven intravenous heparin protocol significantly improved patient outcomes by reducing the percentage of patients who never reached their therapeutic activated partial thromboplastin time (aPTT) goal.
Area of Science:
- Pharmacology
- Clinical Nursing
- Patient Safety
Background:
- Safe administration of intravenous heparin is a critical patient safety objective.
- Optimizing the use of intravenous heparin is essential for effective anticoagulation therapy.
- Achieving therapeutic activated partial thromboplastin time (aPTT) is a key indicator of heparin efficacy.
Purpose of the Study:
- To evaluate the effectiveness of a nurse-driven intravenous heparin protocol in improving the quality of heparin use.
- To compare patient outcomes between traditional heparin care and a nurse-driven protocol.
- To assess the impact of an intervention package on achieving therapeutic aPTT levels and reducing complications.
Main Methods:
- A pre-post intervention study design was employed.
- Fifty patients receiving traditional intravenous heparin care were compared with 50 patients managed under a nurse-driven protocol.
- Key outcome measures included the proportion of patients reaching therapeutic aPTT, time to achieve aPTT goal, and incidence of complications.
Main Results:
- The post-intervention group demonstrated a significant reduction in patients never reaching the therapeutic aPTT goal (8% vs. 16%; P < .05).
- Mean time to achieve the first therapeutic aPTT was shorter in the post-intervention group (15.2 hours) compared to the pre-intervention group (18.6 hours), though not statistically significant (P = .33).
- No significant difference in complications was observed between the two groups.
Conclusions:
- A multidisciplinary team approach, particularly through a nurse-driven protocol, can enhance patient care outcomes related to intravenous heparin administration.
- The study provides valuable insights for healthcare institutions aiming to improve the quality and safety of intravenous heparin therapy.
- Nurse-driven protocols represent a viable strategy for optimizing anticoagulation management and achieving therapeutic goals more efficiently.
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