Heparin Protocol

The Heparin is ordered via the Heparin Protocol PowerPlan.

 The PTT needs to be drawn 6 hours after the heparin drip has been started. The Heparin Protocol PowerPlan does NOT contain a PTT order.  A reminder task will appear on the PAL after the PowerPlan is initiated to remind the nurse to place the PTT order.

1. Scan the heparin IV bag to begin the bag. 2. Place the order for the initial 6 hour PTT as directed by the task.

3. Enter nurse, per protocol/policy/existing order.

4. Set Start Date/Time to the correct date/time (6 hours after heparin is started).

5. From the PAL tasks, right click on the Nurse to Order Lab Test Task, click Chart Done. 6. Based on the PTT results, adjust heparin.

7. Scan the infusing heparin IV bag, choose Rate Change. Enter new rate.

All further PTT orders must be entered using the Nursing Heparin Re-Order Protocol, even if the results are within normal limits.

1. To order a subsequent PTT, go to Orders, click ADD and type ‘Nursing’ in the Search field.

2. Click Nursing –Heparin Re-Order Protocol.

3. PTT result displays on the Careset. 4. Select for appropriate order.

5. Enter New Rate Units per Hour.

NOTE: If the PTT is therapeutic and no changes are needed, the subsequent PTT is ordered using this careset. New Rate Units per hour must still be completed although no rate change has been made. Document the current rate.

6. IView and I and O

7. Go to IView to chart your hourly titratable drip rate in the IV drips section, then go to I and O to chart the hourly volumes.

If a nurse shuts off Heparin prior to a procedure, the nurse must also discontinue to Heparin Protocol PowerPlan per Policy/Protocol/ Existing Order. If Heparin Protocol is desired post-procedure, it must be reordered using the Heparin Protocol PowerPlan.