PMID- 27698506
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20191120
IS  - 0018-5787 (Print)
IS  - 1945-1253 (Electronic)
IS  - 0018-5787 (Linking)
VI  - 51
IP  - 8
DP  - 2016 Sep
TI  - Comparison of Time to Therapeutic aPTT in Patients Who Received Continuous 
      Unfractionated Heparin After Implementation of Pharmacy-wide Intervention Alerts.
PG  - 656-661
AB  - Background: For patients on continuous IV unfractionated heparin (UFH), failing 
      to achieve a therapeutic aPTT by 24 hours can be associated with increased 
      morbidity. A pharmacy clinical surveillance system (PCSS) subtherapeutic aPTT 
      alert was implemented at our institution to improve achievement of therapeutic 
      aPTT goals by 24 hours. Objective: The primary objective was the time to achieve 
      the minimum goal aPTT before and after the alert implementation. The secondary 
      objectives were to examine the percentage of patients who achieved the minimum 
      goal aPTT by 24 hours and the number of dose changes to achieve the minimum goal 
      aPTT. Methods: A single-center retrospective study was conducted to include all 
      adult inpatients receiving a continuous UFH infusion during a 3-month period 
      prior to the implementation of a subtherapeutic aPTT alert and a 3-month period 
      after implementation. Results: 317 patients were included in the analysis. The 
      average time to achieve the minimum goal aPTT was 21.8 hours prior to alert 
      implementation and 15.4 hours after implementation (p = .002). The percent of 
      patients who achieved the minimum goal aPTT by 24 hours was 65.7% prior to alert 
      implementation and 82.4% after implementation (p = .035). The average number of 
      dose changes necessary to achieve aPTT value to the minimum goal aPTT prior to 
      alert implementation was 1.67 and 1. 98 after implementation (p = .68). 
      Conclusion: This analysis showed that implementation of a PCSS subtherapeutic 
      aPTT alert for patients on continuous UFH infusions may ensure patients reach 
      goal aPTT faster and facilitate a higher percent of patients who achieve the 
      minimum goal aPTT by 24 hours.
FAU - Alsulaiman, Duaa
AU  - Alsulaiman D
FAU - Sylvester, Katelyn
AU  - Sylvester K
FAU - Stevens, Craig
AU  - Stevens C
FAU - Carter, Danielle
AU  - Carter D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hosp Pharm
JT  - Hospital pharmacy
JID - 0043175
PMC - PMC5030878
OTO - NOTNLM
OT  - aPTT
OT  - alert
OT  - heparin
OT  - monitoring
OT  - pharmacy clinical surveillance system
EDAT- 2016/10/05 06:00
MHDA- 2016/10/05 06:01
PMCR- 2017/09/01
CRDT- 2016/10/05 06:00
PHST- 2016/10/05 06:00 [entrez]
PHST- 2016/10/05 06:00 [pubmed]
PHST- 2016/10/05 06:01 [medline]
PHST- 2017/09/01 00:00 [pmc-release]
AID - 10.1310/hpj5108-656 [doi]
PST - ppublish
SO  - Hosp Pharm. 2016 Sep;51(8):656-661. doi: 10.1310/hpj5108-656.