Anticoagulation management is a niche area of nursing. When I started 3 years ago managing a PT Clinic for a large cardiovscular group, I knew very little about INR's and the challenges that patients face while on this medication. Since then I have self-educated....in otherwords I've surfed the net endlessly for as much information as possible.
Generally, the nurse in charge of the PT clinic will test the patient's blood via finger-stick to obtain an [wiki]INR[/wiki]. Other patients have this done at an outside lab and the results are faxed into the clinic for management. You would assess the patient by asking them questions regarding bruising, bleeding, diet changes, medication changes, recent healthcare issues. You will adjust their [wiki]Coumadin[/wiki] (warfarin sodium) usually, according to a set protocol, chart the visit/call, and reschedule their next visit or test. Patient education is very important. As with diabetic patients, those on coumadin need advice and guidance on diet (vitamin K), drug to drug interactions, and risk factors.
My newest passion has become PST or Patient Self Testing at home with their own meter. The company (IDTF-Independent Diagnostic Testing Facility) uses the CoaguChek XS meter. According to surveys this meter is used by 4 out 5 clinics as their POC (point of care) device of choice. Your management of these patients is basically the same as management of "phone patients" that go to outside labs for their INR and faxed results. PSTers test INR at home and call the result either to their clinic or the IDTF. If the IDTF is contacted they in turn fax the physician's office with the result. Critical values are always called in addtionally.
Your role will most likely involve new diagnosis of patients, initiation of anticoagulation therapy, monitoring and management. You will spend time discussing treatment options with these patients. These could include medication or procedures to treat the patient. I spend time consulting the cardiologists in the practice regarding INR regulation.
A good resource is www.anticoagultionforum.com
as they have a national conference every other year. This year it was in San Diego and was fabulous. There were approximately 750 providers from across the US gather for this industry meeting. The next one will be in Boston in 2011.
I hope this has helped you undertand more about protime clinics. Obviously, the day to day management will vary clinic to clinic. I truly gained a passion for this niche of nursing and if you choose to folllow this path I think you will be very happy.
PS You can reach me at firstname.lastname@example.org
if you have further needs!