Design and Implementation of an Anti-Factor Xa Heparin Monitoring Protocol.

AACN Advanced Critical Care
Tanya Williams-NorwoodEvi X Stavrou

Abstract

The VA Northeast Ohio Healthcare System introduced a new nurse-driven anti-factor Xa (anti-Xa) protocol for monitoring unfractionated heparin to replace the previous activated partial thromboplastin time protocol. To design, implement, and evaluate the efficacy of the anti-Xa monitoring protocol. An interdisciplinary team of providers collaborated to develop and implement a nurse-driven, facility-wide anti-factor Xa protocol for monitoring unfractionated heparin therapy. The effectiveness of this protocol was evaluated by retrospective analysis. We reviewed 100 medical records for compliance with the new anti-Xa monitoring protocol. We then evaluated 178 patients whose anticoagulation was monitored with the anti-Xa assay to determine the time to therapeutic range. We found that 80% of patients receiving the anti-Xa protocol achieved therapeutic anticoagulation within 24 hours, as compared with 54% of patients receiving the activated partial thromboplastin time protocol (P < .001). Protocol conversion also yielded a decrease in blood draws, dose adjustments, and potential calculation errors. Monitoring intravenous heparin therapy with the anti-Xa assay rather than activated partial thromboplastin time resulted in a shorter time ...Continue Reading

References

Jan 1, 1989·Journal of Pharmaceutical and Biomedical Analysis·T W BarrowcliffeD P Thomas
Dec 21, 2000·British Journal of Haematology·S Kitchen
Mar 26, 2013·American Journal of Clinical Pathology·Clifford M TakemotoThomas Kickler
Aug 15, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Kristian S Frugé, Young R Lee

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