What is an Anticoagulation Clinic?
The Clinic, commonly called the INR (International Normalized Ratio), is a service established to monitor and manage the medication(s) that you take to prevent blood clots. Nurses, working in conjunction with your physician, will check your blood test and adjust your dose of warfarin (Coumadin) as well as other medicines that may be needed.
Why is a special clinic needed to manage my medicine?
Warfarin can be a dangerous medicine if not closely monitored. While on warfarin, your blood clotting time or INR must be checked every 4-5 weeks. However, you may be checked more often if: you are initally starting your Coumadin therapy; when changes are made to other medications; or if INR results are not within the designated therapeutic range.
Anticoagulants such as Coumadin may be administered to patients after mechanical valve replacement surgery, diagnosis of clotting disorder, stroke, deep vein thrombosis, pulmonary embolism, and atrial fibrillation. Regular blood tests, called the INR, are done to determine whether you're getting the right amount of Coumadin.
Patients generally begin treatment immediately after surgery or diagnosis. In the case of surgical procedures, subcutaneous Lovenox is given immediately following the operation so that the blood is thinned. Coumadin is given at the same time and once the Coumadin reaches the appropriate level, the Lovenox is stopped.
Patients are assessed by the nurses in the INR Clinic at least once a week for the first month after initiation of Coumadin therapy. Future frequency of visits is determined by stability of INR.
What is the procedure for follow-up in the Anticoagulation Clinic?
After your physician sends in the referral form, you will be contacted by the Anticoagulation Clinic to discuss your therapy and to arrange your first appointment. At the appointment, a nurse will check your INR by using a finger stick blood test (the result will be available immediately). You will be asked some questions about your health and medications, determine if your warfarin dose should be adjusted, and schedule your next appointment. At your first visit, you will be given additional education regarding warfarin.
The INR Clinic will provide patient education which includes the purpose of the patients therapy, duration of therapy, dosing and administration of prescription(s), what to do if you miss a dose, compliance, monitoring, signs and symptoms to watch for (bleeding and clotting), drug interations, preferred nutritional diet as well as alcohol intake, informing the patients other healthcare providers, follow-up appointment information, medical alert bracelet or card.
To schedule an appointment, contact the INR Clinic at (402) 328-3702. |
INR Care Goals:
Determine care needs
Manage anticoagulation dosing
Provide systematic monitoring &
patient evaluation
Provide ongoing education
Communicate with other providers
involved in the patient's care
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