Abstract:
BACKGROUND:Asymptomatic blood pressure elevation is common in the inpatient setting. National guidelines recommend treating with oral agents to slowly decrease blood pressure; however, many clinicians use intravenous antihypertensive medications, which can lead to unpredictable changes in blood pressure. OBJECTIVE:To decrease the number of inappropriate orders (without symptoms of hypertensive emergency or order for NPO) of intravenous antihypertensives and adverse events associated with intravenous orders. DESIGN:Quasi-experimental study with multidisciplinary intervention. PARTICIPANTS:Inpatients with a one-time order for an intravenous antihypertensive agent from January 2016 to February 2018. MAIN MEASURES:The main outcomes were the total numbers of orders and inappropriate orders, adverse events, and alternate etiologies per 1,000 patient-days. As a balancing measure, patients were monitored for adverse events when blood pressure was elevated and not treated. KEY RESULTS:There were a total of 260 one-time orders of intravenous antihypertensives on two medical units. Inappropriate orders decreased from 8.3 to 3.3 per 1,000 patient days (P = .0099). Adverse events associated with intravenous antihypertensives decreased from 3.7 to 0.8 per 1,000 patient days (P = .0072). CONCLUSION:This initiative demonstrated a significant reduction in inappropriate use of IV antihypertensives and an associated reduction in adverse events.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Pasik SD,Chiu S,Yang J,Sinfield C,Zubizarreta N,Ramkeesoon R,Cho HJ,Krouss Mdoi
10.12788/jhm.3190subject
Has Abstractpub_date
2019-03-01 00:00:00pages
151-156issue
3eissn
1553-5592issn
1553-5606pii
jhm.3190journal_volume
14pub_type
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