Epic heparin calculator (or preventing wrong actions after holding heparin)

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Julie Kindsfater
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Joined: 11/04/2011 - 10:15
Epic heparin calculator (or preventing wrong actions after holding heparin)

How does your org prevent RNs from inadvertently increasing heparin dose after holding for critical PTT when post-hold PTT comes back therapeutic or subtherapeutic?

For example, my org's protocol is that if PTT is critical, hold heparin x 1 hr, recheck PTT, and if less than x secs, restart at 3 units/kg/h less than pre-hold dose. However, if post-hold PTT is subtherapeutic, for example, some RNs may misinterpret the protocol (which has been reviewed by human factors engineer) and increase dose, not as intended.

We're looking at Epic heparin calculator functionality, but this still seems to be a problem with this. I.e. if RN enters post hold PTT, calculator will tell him/her to increase dose.

Has anyone figured out a better way?

Thanks!

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