Background Our hospital has 100 beds available for short-term stays and 200 available for long-term stays. There is a contract between the hospital and the Regional Health Agency which requires a yearly evaluation of medical practices. This audit is part from this evaluation.
Purpose To assess whether the prescription of prothrombin complex concentrate (PCC) matches with official recommendations, with or without anti-vitamin K overdose.
Materials and methods As guidelines we used the Summary of Product Characteristics of the 2 PCC products that we use in our hospital, Kanokad and Octaplex. We also used a guideline provided by the French National Authority for Health (HAS) in 2008. We included in the audit each patient who received PCC from 15 October 2012 till 30 September 2013. Then we created a data collection form to assess if the indication and the dosage regimen were correct in each situation.
Results 14 patient files were included in the audit. Of these 13 were correct regarding the indication and 9 regarding the dosage regimen. The incorrect indication was the case of a man with an unexplained fever for whom a neurological infection was suspected. He was given PCC because a lumbar puncture was needed. It was not indicated because he had an International Normalised Ratio (INR) of 1.32 before the injection whereas the target for such an injection is an INR under 1.5. It was already reached before administration.
Conclusions Regarding the results, the INR is not always taken into account before injecting PCC perhaps because it is not always available when the physician decides to prescribe. We could improve our provision of INR results and sensitise physicians to take account of the INR before injection to calculate the right dose.
No conflict of interest.
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