PROTIME MACHINE
Lisa Ritchey, RNSherrie Thomas, RN
Tracey McCaulley, RN
OBJECTIVES
• Define and describe trend• List and describe trend hardware and software• Identify, describe and review trend information system• Describe advantages/disadvantages of using trend• Examine legal and ethical issues related to use of trend• Describe technology-related competencies needed by the
professional nurse working with trend• Describe functions of the informatic nurse working with trend
TREND IN ANTICOAGULANT THERAPY MONITORING
Traditional
•Patient goes to lab
• Lab runs test; gets results
• Lab calls results to doctor
• Doctor adjusts coumadin dose
•Nurse informs patient of dosage change
New
• Patient runs test
• Patient gets results
• Patient adjusts coumadin
accordingly
Implementation of protime machine in home settings
WHY? In the new paradigm of patient-professional partnership patient self-management results in improved clinical outcomes with same quality of anticoagulation management.
GOAL: Implement best practice in managing coumadin dosages in patients on long-term anticoagulant therapy by performing PT/INR testing in the home.
.(Beyth, 2005)
Hardware
ProtimeMachine
(ITC, 2006)
Cuvette Tenderlett Plus
Software
Coagutrax
• Built in alerts• Built in patient dosing tool• Source of documentation• Interfaces with the EMR• Automated charge entry
(Medmatics, 2005-2009)
Coagutrax
ADVANTAGES
cost effective
Speed of results
convenient
Less invasive
DISADVANTAGES
dexterity
abilityRequired controls
Equipment cost
Cost Current Process Proposed Process
Mileage $10.80 $0
Travel time $30.72 $0
Increase staffing Costs
$49.00 $0
Cost of supplies $0 $5.00
(ITC, 2006)
Ethics Related To Home Monitoring Of PT/INR
• Responsibility shifts to the patient
•Patient’s are not skilled clinicians
•Impact on patient-professional relationship
(Martin, 1999)
Legal Issues
• Nurses competency• Corporate liability• Personal liability• Patient confidentiality
(Sullivan, 2005)
Technology-related competencies
Nurses must be proficient in:
• Use of hardware• Use of software• Conversion of data into information• Application of information into knowledge• Incorporation of knowledge into practice
(Sullivan, 2005)
Functions of the informatics nurse
• Critique the trend
• Evaluate hardware and software for usability
• Collect evidence to support best practice
(Sullivan, 2005)
Summary
• An example of new technology • No delay in treatment
• Support for best practice
References
• Beyth, R. J. (2005). Patient Self-Management of Anticoagulation: An Idea Whose Time Has Come.
• ITC (2006). ProTime Machine Microcoagulation System.
• Martin, P.A. (1999). Bioethics and the whole: Pluralism, Consensus of the Transmutation of Bioethical Methods into Gold, Journal of Law,Medicine, and Etjics, 27 (4), 316-327.
References Cont.
• McGonigle, D. and Mastrian, K. (2009). Nursing Informatics and the Foundation of Knowledge. Boston: Jones and Bartlet Publishers.
• Medmatics, LLC (2005-2009). Developers of Coagulax, Anticoagulation Management Software.
References Cont.
• Mendez-Jandula, B. M., Souto Juan Carlos, M.M., Oliver, A.M., Montserrat, M., Quimntana, M. R., Gich, I. M., et al. (2005). Comparing Self-Management of Oral Anticoagulant Therapy with Clinic Management. A Randomized Trial. Annals of Internal Medicine, pp. 142: 1-10.
References Cont.• ProTime PT-INR Testing Monitor-Process
Efficiency. (2008, January 31). Retrieved December 4, 2009, from Pro Time Test provided by QAS:http://www.protimetest.com
/homehealth efficiency.asp.• Sullivan, E.J. (2005). Effective Leadership
and Management in Nursing. Upper Saddle River, NJ: Pearson Education, Inc.
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