Key result
Checking ACT levels 3 hours after the last heparin dose in post-PCI patients showed only 7% met the criteria of ACT < 150 seconds for sheath removal, and 21% had an ACT < 160 seconds.
Why the study?
What is the most appropriate time to begin analyzing ACT levels for femoral sheath removal in post-PCI patients?
Observational (n=44)
What is the most appropriate time to begin analyzing ACT levels for femoral sheath removal in post-PCI patients?
Initiating ACT level checks at 3 hours post-heparin and using a threshold of < 160 seconds for sheath removal can optimize nursing workflow and reduce costs.
ACT checks at 3 hours post-heparin rarely meet sheath removal thresholds post-PCI; hypothesis-generating for timing protocols and needs prospective validation.
Guidelines currently exist that describe the medical management of patients undergoing percutaneous coronary interventions (PCI), but these guidelines do not include nursing management of the patient post procedure. The nursing staff on an intermediate care unit believed there were numerous and unnecessary activated clotting time (ACT) levels obtained on post PCI patients. The purpose of this study was to identify the most appropriate time to begin analyzing ACT levels. Results from a retrospective chart audit of 44 patients indicated that 3 hours after the last dose of heparin, only 7% of the patients met the criteria of ACT < 150 seconds in order to have their femoral sheaths removed, and 21% of patients had an ACT of < 160 seconds. It is recommended that current standard orders be changed to begin drawing ACT levels at 3 hours post last heparin dose and removing sheaths when ACT is < 160 seconds. This change would save the hospital nearly dollars 5000 in nursing time alone.
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Jennifer A. Niederstadt (2004) conducted an observational in Post percutaneous coronary intervention (PCI) (n=44). ACT level analysis at 3 hours post last heparin dose was evaluated on ACT < 150 seconds at 3 hours after the last dose of heparin. Checking ACT levels 3 hours after the last heparin dose in post-PCI patients showed only 7% met the criteria of ACT < 150 seconds for sheath removal, and 21% had an ACT < 160 seconds.
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