38^th International Conference on Nursing & Healthcare Oct 16-18, 2017 New York, USA

Biography:

Low molecular weight and unfractionated heparin have long been effective interventions to prevent and treat clots. Potential complications of this therapy includes bleeding, clotting or heparin Induced thrombocytopenia.  Frequent monitoring of lab work is critical to maintain positive patient outcomes. When assessing therapeutic levels of unfractionated Heparin, two laboratory tests are available; the Activated Partial Thromboplastin Time (aPTT) and the Anti-Factor Xa Assay.

The aPTT has been the gold standard for monitoring IV heparin for more than 50 years.  It is cost-effective and familiar to most personnel.  However, it has no standard result.  Each hospital has their own therapeutic range based on equipment that is available.  It was determined that a “normal therapeutic” result was obtained when the patient’s a PTT was 1.5-2.5 times the control.  This is now considered to be an unsafe assumption because in many cases, as the patient is actually sub-therapeutic when within this range.

The Anti-Factor Xa Assay is recommended for monitoring unfractionated heparin by both the American College of Chest Physicians and the College of American Pathologists.  Advantages of this test include less blood needed for the test, shorter time to therapeutic goal, fewer dosage adjustments and laboratory tests,This may decrease hospital length of stay. Disadvantages include cost, initial errors form a learning curve and that after the blood has been obtained. The test must be completed within 1 hour

The presenters will conclude by discussing how a major health system converted from the aPTT to the Anti-Xa Assay.

Abstract:

Alice Jane Haines has obtained her BSN from West Virginia Wesleyan College and her Master of Science in Nursing Education and Doctor of Nursing Practice from the University of Pittsburgh. She is currently an Assistant Professor in the Department of Acute and Tertiary Care at the University of Pittsburgh. She has worked for 33 years in Nursing and has 25 years of Nursing Education experience. She has also worked as a Staff Nurse for more than 5 years on a Lung Transplant Step-down Unit. Caring for Lung Transplant recipients and their caregivers is truly her passion.

Biography:

Eitan Naveh is an Associate Professor at the Faculty of Industrial Engineering and Management, Technion–Israel Institute of Technology, where he received his DSc in Quality Assurance and Reliability. He acted as a Visitor Scholar in Harvard School of Public Health in 2016/17. His research interests include mainly two streams of organizational research: errors in organizations; and linkage between innovation and quality. His research has been published in the Academy of Management Journal, Journal of Applied Phycology, Journal of Management, Journal of Operations Management, Management Science, and other leading academic journals.

Abstract:

Errors are a recurring fact of organizational life and can potentially yield either adverse or positive consequences. Although we have learned much about errors in specific research areas across specific organizational contexts, we know little about how multifaceted forces in organizations, especially when they contradict each other, might affect the pathways of errors in organizations. In this seminar, I will present an integrative approach to errors by summarizing conceptual foundations and empirical findings of my studies. I will focus on three dimensions: namely (1) levels of analysis – the degree to which errors are attributed to the individual (e.g., individual employee) or collective actors (e.g., teams, units); (2) temporal dynamism – the degree to which organizational emphasis is put before, during, and after an error occurs; and (3) priority – the degree to which conflicting priorities are assigned to error coping strategies. I will present my research findings on how to reduce the underlying causes and negative consequences of errors while promoting positive outcomes and learning benefits in organizations and specifically in health care. I will discuss discrepancies, inconsistencies, and opportunities for research synthesis.