| Description |
Atrial Fibrillation (AF), Deep Venous Thrombus (DVT), and Pulmonary Embolus (PE) collectively affect millions, with AF alone impacting 3-5 million individuals (Polania et al., 2023). Annually, approximately 250,000 U.S. patients discontinue anticoagulation therapy for surgical procedures. Yet, Barnes et al. (2020) highlighted significant surgical complications associated with such treatment, including increased cancellations, heightened bleeding risk, compromised patient safety, and suboptimal outcomes. In interventional radiology (IR), the absence of standardized guidelines for managing anticoagulation therapy during elective image- guided interventions leads to preventable bleeding complications. Local Problem: Challenges persist in ensuring optimal patient outcomes due to the need for standardized guidelines for discontinuing anticoagulation therapy before surgery, exacerbating risks in perioperative therapy management, and adherence to evidence-based guidelines and testing protocols. This gap in awareness needs revised to ensure the precise assessment of a patient's anticoagulation status. At St. Marks Hospital's IR department, where standardized protocols and education are lacking, these challenges contribute to heightened cancellations and bleeding risks during the procedure. Methods: The author evaluated anticoagulation management practices in IR patients, assessing current policies and engaging with stakeholders. Pre-surveys gathered insights on the existing protocols, culminating in a detailed summary. The primary goal was to create an evidence-based anticoagulation protocol for IR, incorporating stakeholder collaboration. Post-implementation of this protocol included stakeholders' feedback that would be compiled into an executive report, offering a complete evaluation of the protocol's success. Interventions: A multidisciplinary team collaborated to develop an evidence-based anticoagulation protocol tailored explicitly to IR needs. The primary focus of this quality improvement project was to implement practice changes within the IR department aimed at enhancing patient safety. To support this initiative, a PowerPoint presentation detailing anticoagulation cessation times was developed to disseminate crucial information to relevant stakeholders effectively. Results: Of the 25 staff members in the IR department, 84% participated in the pre- questionnaires, and following the implementation of the protocol, 90.5% agreed on the protocol's effectiveness. The protocol significantly reduced cancellations (p=0.003) and improved staff confidence in managing anticoagulation therapy. Conclusion: Implementing of the evidence-based anticoagulation protocol improved patient safety and reduced cancellations in elective IR procedures. Ongoing education and monitoring are crucial for sustaining these improvements. |
