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Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the INR monitor, obtaining blood samp

CPT4 code

Name of the Procedure:

Patient/Caregiver Training for Home International Normalized Ratio (INR) Monitoring

Summary

This procedure involves face-to-face training for patients or their caregivers on how to monitor INR levels at home. It includes instructions on the use and care of the INR monitor, and how to properly obtain a blood sample. The training is conducted under the guidance of a physician or a qualified healthcare professional.

Purpose

The procedure addresses the need for regular INR monitoring in patients who are on anticoagulant therapy, such as warfarin. It aims to empower patients and caregivers to safely and accurately perform INR testing at home to ensure optimal management of blood thinning.

Indications

  • Patients on anticoagulants requiring regular INR monitoring
  • Individuals with conditions like atrial fibrillation, deep vein thrombosis (DVT), or mechanical heart valves
  • Patients demonstrating the capability and willingness to perform self-monitoring

Preparation

  • No specific fasting or medication adjustments are generally required.
  • Patients might need to have prior training sessions or initial testing done at a healthcare facility.
  • Ensure the prescribed INR monitor and test strips are available.

Procedure Description

  1. Introduction: Overview of the importance of INR monitoring and the training objectives.
  2. Device Demonstration: Demonstrating the INR monitor's components, functionality, and maintenance.
  3. Hands-On Practice: Guided practice on how to obtain a blood sample via a finger prick and how to use the monitor to read the INR levels.
  4. Record Keeping: Instructions on documenting results and understanding when to contact the healthcare provider based on the results.

Duration

The training session typically lasts 1-2 hours.

Setting

The procedure is usually performed in an outpatient clinic or the patient's home.

Personnel

  • Qualified healthcare professional (nurse, physician, or medical technician)
  • Patient and/or caregiver

Risks and Complications

  • Minor discomfort or bruising from the finger prick
  • Potential for inaccurate readings due to improper technique
  • Risk of infection if the lancet site is not properly cleaned

Benefits

  • Enables patient autonomy and convenience
  • Provides timely monitoring and management of anticoagulation therapy
  • Reduces the need for frequent clinic visits

Recovery

  • Post-training, no specific physical recovery is needed.
  • Continuous practice is recommended to enhance proficiency.

Alternatives

  • Regular INR testing at a healthcare facility
    • Pros: Professional administration, fewer chances of error
    • Cons: Less convenient, more frequent travel required

Patient Experience

During the training, patients may experience minor pain or discomfort from the finger prick. Anxiety regarding the use of the monitor is common initially, but typically decreases with practice. Pain management includes using a fresh lancet for each test and proper hand washing before the procedure. Comfort measures include a supportive and understanding trainer who answers all questions and concerns.

Medical Policies and Guidelines for Patient/caregiver training for initiation of home international normalized ratio (INR) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the INR monitor, obtaining blood samp

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