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  Poster Hall

Mon-24 - Evaluation of Nebraska Medicine’s Monitoring Protocol for Continuous Intravenous (IV) Heparin in Patients on Extracorporeal Membrane Oxygenation (ECMO), or Continuous Renal Replacement Therapy (CRRT)

Scientific Poster Session III - Students Research-in-Progress

Students Research in Progress
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Nebraska Medicine has a system for pharmacist management of continuous IV anticoagulation. Monitoring labs for all patients on continuous IV anticoagulation result in the pharmacist in-basket. Results are then reviewed, dose adjustments are made, documentation is completed, and a nursing order is placed via a pre-built order set. Standard heparin monitoring is every six hours (Q6H) until two consecutive results are within the therapeutic range, then monitoring changes to daily. Patients who are on mechanical circulatory support (ECMO or Impella) or CRRT are monitored Q6H indefinitely due to the increased risk of bleeding.

Research Question or Hypothesis: Evaluate if indefinite Q6H monitoring is necessary for patients receiving continuous IV heparin who are on ECMO, Impella or CRRT.

Study Design: Retrospective, single-center, observational chart review.

Methods: A retrospective chart review was conducted at a large academic medical center. Records were pulled from the electronic health record for adult patients who were on ECMO, Impella, or CRRT while receiving continuous IV heparin.

Data analysis will be completed to evaluate the impact on pharmacist workload by evaluating the number of in-basket monitoring labs that were in range compared with the number of dose changes made. Safety will also be assessed by evaluating the incidence of bleeding events that occurred using ICD-10 codes. These outcomes will be compared to the total ICU and non-ICU populations.

Results: In-progress

Conclusion: In-progress

Presenting Author

Emily Evans PharmD Candidate 2025
University of Nebraska Medical Center

Authors

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Rebecca Sedlak PharmD, BCCCP
Nebraska Medicine

Kaitlyn Squires PharmD
Nebraska Medicine