Policy Manual sample

MDT Home Health Care Agency, Inc. the procedure may call the patient’s physician with each result for instructions (known as patient testing) or may be given an algorithm to guide dosing adjustment with instructions to call if the result falls outside of the predetermined limits (known as patient management). B. Indications include patients on warfarin needing long-term ( > 6 months ) or life-long coagulation for any of the following: * Mechanical heart valves * Chronic atrial fibrillation * Venous thromboembolism inclusive of deep vein thrombosis (DVT) and pulmonary embolism (PE) AND With all of the following additional requirements: • The patient must have been anticoagulated for at least 3 months prior to the use of the home PT/INR device • The patient must undergo a face- to- face educational program on anticoagulation management • If applicable, the patient may continues to correctly use the device in the context of the management of the anticoagulation therapy following the initiation of home monitoring after full demonstration of ability to use/management the device. • Self-testing with the device should not occur more frequently than once a week C. Limitations include all of the following: (for patient self use) • Patients with poor eyesight with no caregiver • Patients with memory impairment • Patients with difficulty with motor coordination or manual dexterity • Patients with a history of noncompliance • Patients with porcine valves • The professional staff must following all guidelines from the ordering physician. Note: The device must be FDA approved Quality Audit: Quality Assurance Department may monitor policy compliance or billing accuracy at the request of the Nursing Department. Records Retention: Records Retention for documents, regardless of medium are provided within the Agency’s Policy Records Retention. Medicare beneficiaries meeting the following conditions: The beneficiary requires chronic oral anticoagulation with warfarin for a mechanical heart valve, chronic atrial fibrillation, or venous thromboembolism The beneficiary has been anticoagulated for at least three months prior to use of the home INR device. Panic value Parameters to report to physician: PT Less than 11 and greater than 20 INR Less than 1.5 and greater than 3 Home Health Agency Nursing Care & Procedures K-169