Abstract
Many skilled nursing facility (SNF) residents require International Normalized Ratio (INR) monitoring. Nurses often report INRs after-hours, congesting phone lines with non-urgent calls, preventing urgent calls from being addressed expediently. This project was done in conjunction with Optum and Gonzaga University, and included 60 SNFs and 30 Nurse Practitioners (NPs). December 2014 call logs were used for baseline trends. 56% of SNFs used lab based monitoring despite evidence of more time spent at therapeutic INR with point-of-care (POC) monitoring. Labs create lag time as SNFs receive results late, leaving little time to communicate with NPs before the close of business. At baseline 15.34% of calls were for INRs, with disproportionate volumes on weekends. 25 SNFs called regarding INR results.
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