Limited impact of clinician education on reducing inappropriate PF4 testing for heparin-induced thrombocytopenia

Malalur, Pannaga; Greenberg, Charles S.; Lim, Ming Y.

doi:10.1007/s11239-018-01803-8

Cited by 7 publications

(2 citation statements)

References 29 publications

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“…This intervention increased appropriate heparin-PF4 test ordering from 40.4% to 79.1% ( P < .00001), a nearly 40% statistically significant improvement in appropriate testing. Although it is possible that some clinicians intentionally entered false values to game the system, a concern shared by others [ 6 ], there were no punitive actions taken if a heparin-PF4 test was ordered despite the alert. The percentage of inappropriate tests was similar across multiple large services—surgical intensive care unit (32.3%), oncology ward (25.6%), cardiac critical care unit (24.5%), and adult medicine (23.8%; Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

Electronic alerts to improve management of heparin-induced thrombocytopenia

Zon,

Sylvester,

Rubins

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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Section: Resultsmentioning

confidence: 99%

Electronic alerts to improve management of heparin-induced thrombocytopenia

Zon,

Sylvester,

Rubins

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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“…Based on this evidence, further efforts are required to improve compliance with the ASHs clinical practice guideline. Limited evidence shows that institutional educational interventions for healthcare providers can have a significant impact on reducing inappropriate HIT testing, although the data are conflicting 11 12 18. In one study, education alone improved appropriateness of HIT testing from 14% to 37%, but did not have a significant impact on documentation of the 4Ts score 11.…”

Section: Discussionmentioning

confidence: 99%

Improving compliance with appropriateness of testing for heparin-induced thrombocytopaenia: a quality improvement report

et al. 2022

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Heparin-induced thrombocytopaenia (HIT) is a serious complication of heparin therapy. Evidence-based guidelines recommend the use of the 4Ts scoring system to calculate pretest probability of HIT. However, this scoring system is often underused, and inappropriate testing can lead to increased morbidity, medical costs and length of hospital stay. We identified that inappropriate testing for HIT was common at our institution and implemented structured multicomponent educational interventions to evaluate the impact of education on the appropriateness of HIT testing. The educational interventions led to a significantly increased rate of appropriateness of HIT testing (69% vs 35%; p=0.001). In addition, the 4Ts score documentation rate significantly improved following the intervention (52% vs 17%; p=0.001). The rates of discontinuation of heparin products and initiation of alternative anticoagulation increased, although not statistically significantly. Educational interventions can improve compliance with evidence-based guidelines on appropriateness of testing for HIT.

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Heparin

2019

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Limited impact of clinician education on reducing inappropriate PF4 testing for heparin-induced thrombocytopenia

Cited by 7 publications

References 29 publications

Electronic alerts to improve management of heparin-induced thrombocytopenia

Electronic alerts to improve management of heparin-induced thrombocytopenia

Improving compliance with appropriateness of testing for heparin-induced thrombocytopaenia: a quality improvement report

Heparin

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