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Quality improvement: Adherence to nurse-driven heparin protocols.

Chelsea Laughner1, Ryan Sentz, Alison Sabados

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Implementing process standard work did not improve adherence to nurse-driven unfractionated heparin (UFH) protocols in adult patients. This quality improvement initiative showed no significant change in following UFH guidelines.

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Area of Science:

  • Quality Improvement
  • Patient Safety
  • Clinical Protocols

Background:

  • Nurse-driven protocols are essential for safe medication management.
  • Unfractionated heparin (UFH) requires careful monitoring to prevent complications.
  • Standardized processes aim to improve adherence to clinical guidelines.

Purpose of the Study:

  • To evaluate the effectiveness of process standard work on adherence to nurse-driven unfractionated heparin (UFH) protocols.
  • To assess the impact of a quality improvement tool on clinical practice in a community teaching hospital.

Main Methods:

  • Retrospective quality improvement project design.
  • Analysis of 109 venous thromboembolism or cardiac UFH anticoagulant protocols.
  • Inclusion of 445 activated partial thromboplastin time results for adherence assessment.

Main Results:

  • No statistically significant change in staff adherence to the nurse-driven UFH protocol was observed post-implementation.
  • The quality improvement intervention did not alter the rate of adherence to UFH guidelines.

Conclusions:

  • Process standard work, as implemented, did not enhance adherence to nurse-driven UFH protocols.
  • Further strategies may be needed to improve adherence to UFH protocols in adult patient care.