Date of Award

Spring 5-5-2023

Document Type

DNP Project

Project Team Faculty Member

Dr. Rebecca Collier

Project Team Faculty Member

Dr. Jenna Tebbenkamp


Tranexamic acid, TXA, antifibrinolytic, transfusion, joint arthroplasty



Bleeding is a risk associated with surgery, and complications, such as hypotension, anemia, and decreased oxygen-carrying capacity, can occur. Blood transfusions have been the mainstay treatment for excessive surgical blood loss; however, transfusion has associated risks including infection, volume overload, immunological reactions, and increased morbidity and mortality (Sahu et al., 2014). Interventions to decrease surgical blood loss are essential components to improving surgical outcomes. The antithrombolytic, tranexamic acid (TXA), decreases surgical blood loss and blood transfusion requirements, thereby decreasing transfusion-related complications (Gausden et al., 2017). Despite frequent use, variance exists surrounding the administration of TXA. Current evidence and guidelines regarding TXA administration were examined to decrease provider variance and optimize utilization. This quality improvement project aimed to improve outcomes for patients undergoing lower extremity total joint arthroplasty in a tertiary care facility in central Illinois by developing a TXA administration protocol. The protocol addressed contraindications and dosing guidelines. The results of the project indicated anesthesia providers at the host facility supported implementation of the evidenced-based TXA protocol into practice.

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