A system commonly called the INR (International Normalized Ratio) was established by the World Health Organization and the International Committee on Thrombosis and Hemostasis for reporting the results of anticoagulant  (blood clotting) tests.  A common test is called prothrombin time. The prothrombin time (PT) is the time it takes plasma to clot after addition of tissue factor.  All results are standardized so that no matter what laboratory checks the prothrombin time, the result should be the same even if different testing reagents are used.  

Anticoagulants such as Coumadin are administered to patients after mechanical valve replacement surgery, repair of atrial septal defect closure (Patent Foramen Ovale) and atrial fibrillation, to keep the blood thin and less likely to clot. The INR Clinic at Cardiovascular Consultants regularly checks Coumadin levels in patients and monitors dosage.

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 halted.

Patients are assessed by the registered nurses in the INR Clinic at least once a week for the first month after surgery. Future frequency of visits is determined by stability.

During each visit, a finger stick is used to draw blood for a PT test. That blood is measured for the INR. Results are received immediately. Dosages of Coumadin are adjusted before patients leave and the next appointments are set up based upon the test results.

The registered nurse in the INR Clinic performs a one-to-one nursing assessment, discusses patient concerns, and addresses any patient issues. Visits may require a few minutes or an hour and a half, depending upon each individual situation.