Education
Patient education
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Children's Mercy inpatients:
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Direct patient education on LMW heparin will be provided and documented by Children's Mercy pharmacists for Children's Mercy inpatients. Education will include potential for adverse drug reactions and interactions, as well as training for preparation of dose and administration.
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The injection aid device, Inject Ease, is often used when doses are dispensed or drawn up in non-Safety Glide insulin syringes. Training will be provided for this device if chosen by patient/caregiver. An education kit provided free-of-charge by manufacturer is available and will be provided when commercially prepared syringes will be used at discharge. These kits include either a DVD or VHS tape covering key points.
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Children's Mercy outpatients:
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Patient counseling and written materials on LMW heparin will be provided by the CMH Outpatient Pharmacy and/or Children's Mercy Homecare Pharmacy when LMW heparin is dispensed.
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Children's Mercy Med Cards and Lexicomp patient leaflets are available to outpatient clinics for patients who will obtain prescriptions from sources other than the Children's Mercy Outpatient or Homecare Pharmacy.
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References
David, M., et al. Heparin and LMWH in Children. Thrombosis Interest Group of Canada. January 2007. http://www.tigc.org/eguidelines/heparinchild07.htm. Accessed 11/15/08.
Lexi-Drugs Online/Pediatric Lexi-Drugs Online, Enoxaparin, http://online.lexi.com/crlsql/servlet/crlonline, Copyright © 1978-2008 Lexi-Comp, Inc, Hudson, OH 44236
Monagle P, Chan AKC, Goldenberg NA, Ichord RN, Journeycake JM, Nowak-Gottl U, Vesely SK. Antithrombotic therapy in neonates and children: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141: e737S –e801S.
Roach ES. Golomb MR. Adams R. Biller J. Daniels S. Deveber G. Ferriero D. Jones BV. Kirkham FJ. Scott RM. Smith ER. American Heart Association Stroke Council. Council on Cardiovascular Disease in the Young. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. [Journal Article] Stroke. 39(9):2644-91, 2008 Sep.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.