Quality improvement approaches to heparin-induced thrombocytopenia: a scoping review.
Res Pract Thromb Haemost
; 7(7): 102219, 2023 Oct.
Article
em En
| MEDLINE
| ID: mdl-38077807
ABSTRACT
Background:
Heparin-induced thrombocytopenia (HIT) is a relatively uncommon condition characterized by 2 exceedingly common phenomena in hospitalized patients thrombocytopenia and heparin exposure. Consequently, HIT is frequently overdiagnosed and inappropriately treated. These issues are the focus of many quality improvement (QI) initiatives.Objectives:
In this scoping review, we identified and characterized all published QI studies on improving the diagnosis and management of HIT.Methods:
We conducted a systematic literature search through April 2022 for studies reporting on QI interventions regarding the diagnosis, treatment, and/or prevention of HIT.Results:
Thirty studies were included in the final review. Studies were separated into 5 groups based on the focus of theinterventions:
increasing HIT recognition, reducing HIT incidence, reducing HIT overdiagnosis, promoting safer HIT management, and creating HIT task forces. Nine studies focused on the implementation of 4Ts score calculator into electronic medical record orders for HIT testing, while only 1 evaluated the impact of reducing unfractionated heparin use in favor of low-molecular-weight heparin. Six studies focused on the implementation of direct thrombin inhibitor management protocols, while none evaluated the use of alternative anticoagulants in HIT management.Conclusion:
The bulk of published HIT QI research focused on reducing overdiagnosis and promoting safer direct thrombin inhibitor therapy, while minimal attention has been devoted to HIT prevention and the use of evidence-based alternative HIT therapies.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Systematic_reviews
Idioma:
En
Revista:
Res Pract Thromb Haemost
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos