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Pharmacy and Pharmaceutical Sciences
Presentation Title: Education of heparin per pharmacy guidelines to increase compliance, safety, and pharmacists’ management of heparin infusions
Authors: Christopher Truong, PharmD and Braxton Mehl, PharmD, BCCCP
Facility: Providence Medford Medical Center
Background: Element of Performance 4 of The Joint Commission’s National Patient Safety Goal 03.05.01 requires that hospitals have a written policy that addresses the need for baseline and ongoing laboratory tests to monitor and adjust anticoagulant therapy. Our hospital has a written Anticoagulation Management General Operating Policy for heparin orders managed through nursing or pharmacy. Currently, most heparin orders are nurse-managed and have resulted in lab and dosing errors.
Purpose: The purpose of this project is to educate pharmacists on the Providence Oregon Region Heparin Guidelines as our hospital moves towards increasing pharmacists’ management of heparin infusions.
Methods: Pharmacists were trained in the Providence Oregon Region Heparin Guidelines through an education session and quiz that required application of the heparin guidelines. A post-education survey was administered to each pharmacist that received training. Scores from the survey were tallied to assess the effectiveness of the training. After the session, the heparin-per-pharmacy order was made available at our facility and pharmacists’ adherence to the guidelines were evaluated.
The primary outcome was the results from the post-education survey. Secondary outcomes include the number of heparin per pharmacy orders and adherence to the heparin guidelines by assessing the required baseline and follow-up labs and the appropriate loading, initial, and adjustment doses. Other secondary outcomes include time to therapeutic aPTT, signs or symptoms of bleeding or bruising, and the number of progress notes completed by pharmacists. Primary and secondary outcomes were analyzed with descriptive statistics. This project is IRB approved.
Results: Eight pharmacists completed post-education surveys. The average pre-education survey score was 2.9 out of 5 and the average post-education survey score was 4.4 out of 5, resulting in an average 1.5 score improvement after attending the education session. Pharmacists scored the practice quiz and education session’s helpfulness as 4.4 out of 5 and 4.8 out of 5 respectively.
Between February 20, 2020 and April 9, 2020, there were 11 heparin per pharmacy orders. Pharmacists managed 9 orders and 2 orders were not verified by pharmacy. Required baseline and follow-up labs were ordered in 100% of orders. Appropriate initial bolus and infusion doses were ordered in 100% of orders. Appropriate adjustment doses were ordered in 88.9% of orders. The average time to therapeutic aPTT was 12.68 hours. No signs or symptoms of bleeding were noted. A total of 68 heparin progress notes were completed by pharmacists.
An education session and quiz were effective methods in training pharmacists to a heparin per pharmacy system guideline.
Graduate Medical Education
Conference / Event Name
Academic Achievement Day, 2020
Providence Medford Medical Center, PGY-1 Pharmacy Residency Program
Truong, Christopher and Mehl, Braxton, "Education of heparin per pharmacy guidelines to increase compliance, safety, and pharmacists’ management of heparin infusions" (2020). Providence Pharmacy PGY1 Program at Providence Medford. 1.