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We recently released two new best practice protocols. 

The leading causes for readmission within 30 days of TAVR procedures in Michigan include arrhythmia, heart block, and heart failure. Frailty is also associated with heart failure readmissions. The “MISHC TAVR Readmission Prevention Best Practice Protocol,” identifies evidence-based indicators that identify patients at increased risk for readmission and actions to consider in managing that risk. Visit our website to find this document which outlines pre-procedure assessment and actions for cardiac conduction disturbances and arrhythmias, heart failure, and frailty testing as well as guidelines for management intra- and post-procedure and post-discharge follow-up.

Thank you to the protocol authors, Michelle C. Brogdon RN, MSN, ACNP-BC; Michelle Crean MSN, RN-BC, ACCNS-AG; Annette Frugé RN, BSN, CV; Kimberly Simons, RN, BSN; Michelle Walker, RN, MSN, AGNP-BC; and Janet Fredal Wyman DNP, ACNS-BC, RN-CS, FACC

TAVR carries some unavoidable bleeding and thrombotic events during the interventional period as well as in long-term follow-up. The Best Practice Protocol, “Antithrombotic Therapy Post-TAVR,” outlines risk factors and strategies for patients with and without concurrent indications for oral anticoagulants. The protocol includes a predictive model for bleed risk and questions and an illustration to help determine an antithrombotic regimen. You will find these best practice protocols, and others, on our website under “Quality Improvement.”

Thank you to lead author Dr. Mansoor Qureshi and support from the MISHC Best Practice Protocol Task Force.