Choix d'un protocole d'administration d'héparine sodique au pousse-seringue électrique par des infirmières et des prescripteurs

Abstract

ObjectivesSeveral protocols for administering heparin by electric syringe pump can coexist within the same hospital. This puts patients at risk of medication errors. In our hospital trust, two preparation protocols coexist (20000UI/48mL and 25000UI/50mL). The objective is to relate the work carried out with prescribers and nurses to retain only one protocol. MethodsWe questioned prescribers and nurses about the differences between the two protocols in terms of the simplicity of implementation and the risk of error to which nurses are exposed when preparing the syringe. Contextual information (heparin shortage, waste) was given in order to support the answers. ResultsAccording to the 96 nurses and 82 prescribers who responded, the protocol to use is 25000IU/50mL for 98% and 83% of them respectively. The 20000IU/48mL protocol was considered the riskiest due to the possibility of mistakenly collecting 5mL instead of the required 4mL. Given the heparin shortage, the waste inherent to the 20000IU/48mL protocol reinforced this choice. ConclusionsThe consultation of nurses and prescribers allowed the choice of a protocol with very strong agreement. This work also brought to light what appears to be a medical misconception, namely that the non-concerted choice by physicians of a mode of administration of a drug can put nurses in a situation to make preparation errors more frequently. This emphasizes that nurses must be stakeholders in the decision-making processes that affect their practice.