​​We have had some issues that have come up with Heparin dosing since we went to Smart Pump integration in August of last year. Some patient are started in our Emergency Department on Weight Based Heparin for chest pain that are capped at a dosage of 1000 units/hour to start. Thus, the pump gets started in non-weigh based programming however, 6 hours later, once the patient is on the floor and the first Anti-Xa result is dropped the nurse has to adjust the dosage based on a weigh-based nomogram. We have had some errors and some confusion around this when this change needs to be made. I am wanting to get feedback from others that are integrated on how they handle these orders and that transition from the initial infusion of 1000 units/hr to the weight based adjustments there on out.

Any advise or feedback would be greatly appreciated!