The nurse-led anticoagulation clinic run by Provide at St Peter’s Community Hospital in Maldon, Essex, chose INRstar to support its clinic manage the therapeutic care of 470 patients.
The team at St Peter’s treats anticoagulation patients at around 10 surgeries in the area; including referrals from the acute sector. Jeanette Pratt manages the anticoagulation therapy unit and is the Lead Anticoagulation Nurse for the anticoagulation service. She uses the Roche CoaguChek XS Plus for its point-of-care-testing and INRstar’s interface to the TPP SystmOne clinical system. Moving to INRstar enabled Jeanette to leave manual dosing behind and since then, she has reported a number of benefits for both staff and patients.
“We chose to move to INRstar after our area carried out a review of anticoagulation services across the (then) PCT, with the aim of rolling out the same solution across every service provider. The PCT was keen to use dosing software and continue using point-of-care testing and, after an extensive review, INRstar was chosen as the most suitable system. We were really keen to provide the highest level of care, as we are a local service: some of the local GP practices are quite small and can’t justify the cost of an anticoagulation service, so we look after all of their patients.”
“We have found INRstar to be excellent, particularly for nurses who need assistance with dosing. I have a small team of nurses who carry out the clinics for me and, as I am a nurse prescriber, I am able to override and monitor patient doses if the dose needs to be titrated.”
“However, for those who are not prescribers, they no longer have to guess or estimate dosing. INRstar includes lots of helpful prompts and will bring up alerts specific to each patient, for example, prompting the nurse to look for bruising or reminding them to check that the patient is on the same dose. All these actions are acknowledged within the system, so there is a record of the fact that the right questions have been asked.”
“INRstar has helped to improve the efficiency of our anticoagulation service and is excellent at providing both patient safety benefits and a complete overview of our anticoagulation service. It has excellent audit facilities, enabling us to write easily to the patient’s GP and highlight that the patient is, for example, running at less than 25% Time in Therapeutic Range (TTR).”
“Equally, our audit parameters can show that we can run at between 75 – 80% TTR and we can demonstrate that the clinic has improved, which was not possible before,” says Jeanette. “INRstar gives us much better control of the patient and enables me to monitor the clinic in a way I could not before. We can audit on a yearly basis now and monitor how we do as a clinic and as individual staff members.”
“I would highly recommend INRstar to my peers; in fact I am carrying out some training with nurses in a different area in a few weeks and will recommend it to them. We really do like the software. There are many good things about INRstar – consistency with the patient being the best.”
*Provide is a community interest company that delivers community health and care services across Essex, Cambridge, Peterborough and north east London. To find out more visit their website: www.provide.org.uk.