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- Title
Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage.
- Authors
Marrinan, Elizabeth; Chen, Lucia; Werring, David; Turner, David
- Abstract
Background/aims: Four-factor prothrombin complex concentrate is the first-line treatment in vitamin K antagonist-related intracerebral haemorrhage. Early administration is associated with improved patient outcomes. A quality improvement project investigated delays in prothrombin complex concentrate administration in vitamin K antagonist-related intracerebral haemorrhage in order to reduce the time from computed tomography scan confirming intracerebral haemorrhage to prothrombin complex concentrate administration (scan-to-needle time). Method: Twenty patients were identified by retrospective audit over a 3-year period. The median scan-to-needle time for prothrombin complex concentrate was 156 minutes. Several points of delay were identified, including contacting both haematology and transfusion departments for prothrombin complex concentrate dosing and dispensing. Following this audit, interventions were brought in which included the introduction of a protocol with a prothrombin complex concentrate dosing algorithm, negating the need to contact haematology before administration. A dedicated supply of prothrombin complex concentrate was given to the stroke unit avoiding the need to contact the transfusion service. Results: A re-audit showed a 68% reduction in median scan-to-needle time from 156 minutes to 49 minutes. Prospective data collection is ongoing.
- Subjects
ALGORITHMS; CEREBRAL hemorrhage; COMPUTED tomography; PROTHROMBIN; QUALITY assurance; STROKE; TIME; VITAMIN K; WARFARIN; TREATMENT effectiveness; RETROSPECTIVE studies
- Publication
British Journal of Hospital Medicine (17508460), 2020, Vol 81, Issue 2, p1
- ISSN
1750-8460
- Publication type
Article
- DOI
10.12968/hmed.2020.0007