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Updated: Jun 13, 2026

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
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.
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Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
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