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CS82
Improving Safety For The Anti-Coagulated Patient: Falls And Medication Administration
By: Haldeman, S., Cierpial, C., Silva, J.; Massachusetts General Hospital, Boston, MA
For further information, please contact: SHaldeman@Partners.org
Purpose: Patients who are receiving anticoagulation sustain greater injury when they fall in the hospital than other patient populations. Nurse can best impact this patient problem by being well prepared to put interventions in place for anticoaglated patients. Cardiology patients require a ginger balance between clotting and bleeding. Our goals were to reduce the injury associated with falls for the anticoagulated patient and to enhance the quality of documentation for intravenous anticoagulants in the hospital.
Description: Clinical Nurse Specialists and the Nurse Manager of an Interventional Cardiology inpatient unit undertook a two-pronged effort to impact the safety for patient requiring anticoagulation. The first effort entailed a unit-based effort to closely examine patient falls during the previous 12 months and translate the themes into an educational effort. The second effort was the implementation of a new Medication Administration Record for patient requiring anticoagulation throughout the organization. Synergistically, the Cardiology and Cardiac Surgery CNS’s created a single patient problem list with interventions to facilitate intra-unit communication. Both Interventional Cardiology unit efforts used evidence, collaboration with expert nurses and other disciples, education and research. These efforts coincided with other hospital-wide initiatives to reduce falls for all patients that included an automated Safety Reporting system and several new products.
Evaluation/Outcomes: Through this project, staff nurses are better prepared to address the risk of patient falls while receiving anticoagulation. The incidence of patient falls remained the same. The incidence of injury was decrease based upon multiple patient and environmental factors. The quality of documentation for anticoagulation has improved in clarity and consistency. Administration results are still in review.
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