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KMID : 0869620150320010008
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Journal of Korean Society of Hospital Pharmacists
2015 Volume.32 No. 1 p.8 ~ p.20
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Improvements for Continuous Intravenous Heparin Management Practice through Application of HOAP (Heparin Order & Administration Program)
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Cheon Young-Ju
Ye Kyong-Nam
Kim Jeong-Ok
Yoon Ji-Eun
Park Mi-Hae
Jeong Kyung-Ju
Kim Jung-Tae
Lim Sung-Cil
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Abstract
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UFH (unfractionated heparin) has been classified as a high-alert medication by the Institute for Safe Medication Practices due to its narrow therapeutic range and the risk of serious adverse effects. To reduce medication errors, improve the patient safety, and simplify UFH related work processes, we developed a UFH computerized system, HOAP (heparin order & administration program). The aim of this study is to determine the safety and effectiveness of HOAP. The availability
ratio of HOAP went from 43% in Feb 2014 to 100% in June 2014. The HOAP reduced the number of steps required to order and administer heparin from 6 to 3 in physicians, and from 9 to 7 steps for nurses. A total of 167 patients were included in this study. Average run time of intervention decreased significantly from 3-10 minutes to 1-3 minutes in physicians and nurses, respectively (physician: p=0.018, nurse: p=0.014). HOAP reduced the subjective run time per intervention by more than 5 minutes. The HOAP reduced the prescription related errors from 5.7% to 0.1%, and reduced administration related errors from 13.5% to 1.0% (p < 0.0001). The HOAP also decreased the time interval of the control infusion rate from 9.2 hrs to 5.9 hrs (p = 0.001), but there was no statistically significant difference between the two groups in regards to reaching the target aPTT (42.1% vs 39.0%). The difference in the mean bleeding scores was not statistically significant between pre and
post group. We concluded that HOAP is helpful in improving UFH related work processes, preventing medication errors, and reducing the run time through standardization and automatization. Therefore, additional reserch is needed to demonstrate the clinical effectiveness of HOAP.
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KEYWORD
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HOAP, UFH computerized system, Medication errors
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