Stahl Kathy L, Pollard Deborah L
Wheeling Hospital, 1 Medical Park, Wheeling, WV 26003, USA.
J Nurs Care Qual. 2003 Jul-Sep;18(3):193-201. doi: 10.1097/00001786-200307000-00005.
Heparin has long been used to minimize complications of a variety of disorders and reaching a therapeutic level within 24 hours has been shown to improve patient outcomes. However, the dosing of heparin to reach a therapeutic level has been controversial. At our institution a weight based heparin nomogram was in place, however an initial data analysis revealed a large percent of the initial aPTT levels were above therapeutic range. This article will describe the performance improvement process and the overall goal to decrease the percentage of patients exceeding the initial therapeutic aPTT levels without compromising daily therapeutic aPTT levels.
肝素长期以来一直用于将各种疾病的并发症降至最低，并且已证明在24小时内达到治疗水平可改善患者预后。然而，肝素达到治疗水平的给药剂量一直存在争议。在我们机构，有一个基于体重的肝素剂量表，但初步数据分析显示，很大比例的初始活化部分凝血活酶时间（aPTT）水平高于治疗范围。本文将描述性能改进过程以及总体目标，即在不影响每日治疗性aPTT水平的情况下，降低超过初始治疗性aPTT水平的患者百分比。
