Nurse-Driven Intravenous Heparin Protocol

Abstract

Safe use of intravenous heparin is an important safety goal. To improve the quality of intravenous heparin use. 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. 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. The multidisciplinary team approach produced improved patient care outcomes and important lessons for improving the quality of intravenous heparin use.