Heparin-associated thrombocytopenia: nursing implications

Because of the potential severity of the associated complications, nurses have an essential role in the care of patients with HAT. Bedside nurses have the opportunity to report information that may indicate a change in a patient's condition after administration of heparin. This information could lead to diagnosis of heparin sensitivity and prompt treatment to decrease the associated thrombotic complications. Once HAT is diagnosed, a variety of resources are available as the patient's condition evolves. Primary concerns include determining effective strategies to provide appropriate skin care, educating the patient and the patient's family members, and providing effective continuity of care. Continuity of care is essential to maintain the patient's physical and emotional status and should be provided by a multidisciplinary team that includes physical and occupational therapists, skin care specialists, and clinical nurse specialists. Future topics for nursing research on HAT include the education of nurses, patients, and families about HAT; the most effective nursing interventions; and appropriate treatment for ischemic extremities. By knowing how to respond safely and effectively to a patient's sensitivity to heparin, critical care nurses can have a beneficial impact on the patient's care.