PT/INR instant results? Accurate?

[DutchgirlRN]

I have a PT/INR meter which I would liken to a glucometer. A drop of blood and it calibrates the PT/INR. I wonder does anyone know how accurate it is? The first patient I tested with it had a PT of 66.6 and a INR of 6.9. I called the doctor of course. He had the patient hold his coumadin for 3 days. I went back and retested and got an INR of 3.5. The doctor then told him to start back on the coumadin but at half the dose he had been on. Three days later I tested him and his INR was 4.9. Some patients I draw blood on for the PT/INR and some I'm told to just check with the meter. I wondering how accurate it is? I'm thinking the next time I draw blood for a PT/INR I ought to also check it with the meter and then see if the results turn out to be the same. Just wondering if any of you have experience with the PT/INR meter? Thanks

[RubyRN,CHPN]

It is my understanding that Levonox does not impact PT/INR results as it works on intrinsic factors (probably bettered answered by your dispensing pharmacist.) It is my understanding traditional medicare programs pay for 52 meter strips a year (one a week) with certificate of medical necessity provided by your MD. As a trainer, my goal is training a patient to best practice with their meter and encouraging complicance with their physcian perscribed medication and monitoring program. With proper training and compliance, I have seen many people be very successful at home with monitoring and have improved control with their INR readings. Like I have said, coumadin is a drug that if not used correctly and monitored appropriately, can be dangerous. Best of luck.

[Eddie_T]

With our continuing interest in home testing my wife's cardiologist and INR nurses are going to move her to the [/url]CoaguChek XS sysrem to see if it works best for her.

[RubyRN,CHPN]

That's a very nice, easy to use system as well. Drop of blood goes to the side of the strip vs. the top of the strip. Has a few extra steps to it's use but steps to obtain the sample are pretty much the same. Manufacturer recommends washing your hands with warm soapy water prior to obtaining sample vs. using alcohol prep. Best of luck.

[Katme65]

Our agency has tested our machines for accuracy multiple times. Seems when we get bad readings, it's generally user error. Blood drops for our machines are to be obtained via a hanging drop, and no milking is allowed. A gentle steady pressure on dangling finger is okay supposedly. I've gotten the best results by warming the fingers with a moist compress, swab w/alcohol, wipe w/2x2, then obtain hanging drop via pipette which is then applied to the strip.

[indbletrble]

Our agency uses the Protime 3. It is approved by the FDA and has literature to support its accuracy. I am one who does not always take things at face value and have compared venipuncture results with the Protime results and found them to be right on target.

This machine uses a slide called a curvette.....and the blood is gathered from a fingerstick with a tenderlet. The curvettes can remain stored in a cool, dry place for up to 6 months. They do not need to be refrigerated......although I do advise the staff to not leave the machine in their cars overnight with the winter temperatures.

This machine cannot be used for patients on Lovenox. It is primarily used for those patients who have poor venous access.....although many of the MDs are requesting the machine be used so they can get immediate results.

The agency absorbs the cost for the procedure....which is about $6.00 a draw......but have found it to be worthwhile. We get accurate results, our homebound patients are not incurring costs for a lab to draw the specimen and those that are difficult sticks are not traumatized.