PT INR

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Specializes in ER, L&D, ICU, LTC, HH.

When do you all call the doctor on a PT INR level done in the home?

Thanks!

~Willow

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I used to use a coag monitor, if the physician allowed, that gave the results in seconds. Then I would call the physician before I left the home. If its a lab draw, I used to collect them before 2pm, take the right to the lab to be ran A.S.A.P with call results. I would still call the lab at 4pm, see if it was done, give them my fax and call the physician with the results also, this way I could obtain follow up orders. Then I would call the patient. If by chance it was not done, they would call our aswereing service with it, then that nurse would have to contact the physician. Of course I would pass this on to her/him, and what to do, as its my responsibilty to make sure its done right since I collected it.

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Specializes in ER, L&D, ICU, LTC, HH.

I had to do one this weekend and all the offices are closed. I usually just call them on Monday through Friday. Then let the MD deal with it. This lady had a 2.2 and 26.1 on the machine. She has stents in and DVT history.

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If a pt inr was ordered to be done on a sat or sunday, I would page the dr's office with the result. The dr on call would have to call me. If he chose not to give me any follow up orders, I would ask him "should they stay on the same dose over the weekend"? Keep in mind, this is C.Y.O.A stuff. Then I would contact the office monday to find out any futher orders( like when it need repeated ). Then all of this would be written on a order for the chart.

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Specializes in ER, L&D, ICU, LTC, HH.

Thanks! so much. I rely on you guys experience a lot and I really appreciate everyone that post here.

~Willow

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Specializes in COS-C, Risk Management.

I've rarely done them over the weekend, although I have a pt on dailies right now. Call to the doc, follow up with a fax to the office on Monday.

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Specializes in CTICU.

I don't work in home health, but I look after patients that often have INRs drawn at home on weekends. They are critical results and should be called to the on call person at our office because even a day or two at the wrong level can have devastating results.. but of course it depends on the patient.

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Specializes in ER, L&D, ICU, LTC, HH.

Thanks I tried but I am in rural area no answering service just voice mail grr

~Willow

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Specializes in ER, L&D, ICU, LTC, HH.

According to this website she is within normal ranges. It explains it pretty well.

http://packageinserts.bms.com/pi/pi_coumadin.pdf

This is another new area I will need to learn more about. That is why I think the ANA should bring back the certification for HH. It is a different world of nursing with a lot of critical thinking.

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Specializes in Med/Surg, Home Health.

Well, if it was 2.2, isnt that WNL? I mean, here, the docs want the INR between 2 and 3 with DVT's, but not sure what this doc has ordered.

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I have found that when taking orders for weekend PT/INR's, when I ask "And whom shall I page with the results?", Suddenly that weekend PT/INR can wait until Monday to be drawn, lol.

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Specializes in Hemodialysis, Home Health.
I have found that when taking orders for weekend PT/INR's, when I ask "And whom shall I page with the results?", Suddenly that weekend PT/INR can wait until Monday to be drawn, lol.

:up::up::up:

Go figure.

We do ALL our labs M-F.. we never draw on a weekend. Well.. RARELY. VERY rarely. But if we do, the PCP will be available for the results and following orders.. they don't leave us hanging on these special cases.

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