Discontinuation of Proton Pump Inhibitors in Patients With Chronic Kidney Disease.

Proton pump inhibitors (PPIs) are commonly used medications and are historically well tolerated. Recent studies have linked PPI use to the development of chronic kidney disease (CKD) and end-stage renal disease. This study investigated the impact of discontinuing PPIs on renal function in patients with CKD.

Design and Implementation of an Anti-Factor Xa Heparin Monitoring Protocol.

Background: The VA Northeast Ohio Healthcare System introduced a new nurse-driven anti-factor Xa (anti-Xa) protocol for monitoring unfractionated heparin to replace the previous activated partial thromboplastin time protocol.

Objective: To design, implement, and evaluate the efficacy of the anti-Xa monitoring protocol.

Methods: An interdisciplinary team of providers collaborated to develop and implement a nurse-driven, facility-wide anti-factor Xa protocol for monitoring unfractionated heparin therapy.

Nurse-driven intravenous heparin protocol: quality improvement initiative.

Background: Safe use of intravenous heparin is an important safety goal.

Objective: To improve the quality of intravenous heparin use.

Methods: A pre-post intervention design assessed the number of patients who reached a therapeutic activated partial thromboplastin time (aPTT), time to aPTT goal, and complications.