Partners eCare will provide many tools to support evidenced-based practice. One example of an evidenced-based practice change is a nurse-driven protocol for the management of IV Heparin using a weight-based heparin nomogram. Literature has shown that body weight is the best predictor of individual heparin requirements. Studies have also demonstrated a decrease in time to therapeutic PTTs without an increase in risk of complications with the use of nurse-driven weight-based heparin nomograms.
This practice change will have implications for the way nurses manage heparin administration. Since all heparin dosing will be weight-based (Units/kg and/or Units/kg/hr) an accurate admission weight must be entered in PeC. The provider will order IV heparin using either a weight based heparin nomogram that will be managed by the patient’s nurse or a stand alone weight-based heparin infusion that will require a new order with each dose change.
If the nomogram is ordered, the nurse will be responsible to initiate the heparin infusion and titrate the dose/rate based on the nomogram and PTT results. This requires nursing to arrange for the collection of the PTT at the appropriate time, monitor the PTT results and make appropriate dose changes based on the nomogram.
Heparin nomogram education will be provided by a HealthStream course and your clinical nurse educator. You will learn how to titrate and document IV infusions in PeC during your application training.
For questions regarding this new practice, contact Anne Bane, MSN, RN, at email@example.com.