Development and implementation of a comprehensive heparin-induced thrombocytopenia recognition and management protocol.

Purpose: A quality initiative to improve the management of heparin-induced thrombocytopenia (HIT) at an academic medical center, including the development of guidelines on the use of direct thrombin inhibitors (DTIs), is described.

Summary: In keeping with the Joint Commission's National Patient Safety Goal (NPSG) for anticoagulant therapy (goal 03.05.

Evaluation of clinical practice guidelines on outcome of infection in patients in the surgical intensive care unit.

Objective: In this study, clinical practice guidelines were developed by a multidisciplinary team for patients with infections admitted to a surgical intensive care unit (ICU).

Design: A 51-day baseline audit period (Phase I) in a 20-bed (private rooms) surgical ICU was compared with a 34-day period in the same unit after implementation of the guidelines (Phase II).

Patients: Phase I included 182 patients (670 patient days), and Phase II included 139 patients (427 patient days).

An exploratory analysis of medication utilization in a medical intensive care unit.

Objectives: To evaluate patterns of medication use in a medical intensive care unit (ICU) and to explore relationships between drug use, patient age, admitting diagnosis, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, length of stay, and survival.

Design: Combination prospective and retrospective study.

Setting: Medical ICU in a large teaching institution.