CoaguChek Anti coagulation competencies FINALVersion Jan2009

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CoaguChek Anti coagulation competencies FINALVersion Jan2009 Powered By Docstoc
					    Competencies for Devon PCT employed staff that are monitoring
    patients blood levels using the Coaguchek INR analyser.

    Staff must demonstrate their competencies in these aspects.

    Staff Name:
    Job Role:
                                    Core Competency Achieved

                                              Signed      Date   Assessor   Date
1. All staff involved in the monitoring of
   blood levels using the Coaguchek
   INR analyser must be aware of
   relevant Trust Policy, Protocols and
   Standard Operating Procedures
   relevant to the care of the patient.

2. Staff must have access and read the
   patients;
    Medical/nursing notes including
       care plan.
    Patients Medication
       Administration Record if
       administration of medication is
       required:
    Patients anticoagulant record
       ‘Yellow book’

3. Greet, accurately identify patient by
name, and in community hospitals by
identification bracelet or other means of
identification if appropriate and
necessary. Introduce yourself and any
colleagues present to the patient and/or
carer.

4. If a carer is present, ensure that the
patient consents to their presence
throughout the assessment/intervention
and is willing for them to receive the same
information as that given to the patient.

5. Explain the procedure to the patient
and if present the carer.
Gain consent to undertake the procedure.




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6. Review the patient’s history/condition
since their last review of the anticoagulant
therapy.
Assess:
     Current health status with
        reference to acute illness.
     Introduction of any new
        medication, which has been
        prescribed, alternative therapy, or
        purchased over the counter.
     Changes to lifestyle such as
        diet/alcohol
     Date, time and dose of the last
        dose taken
     Any changes made to prescribed
        dose e.g. omission

7.Staff undertaking capillary blood
sampling for analysing International
Normalised Ratio (INR) just be able to
demonstrate:
     Precautions for staff when taking
         blood samples
    Identify the equipment required.
    Undertakes quality control checks
        required for the machine.
    Coaguchek machine should be
        located on a flat hard surface.
    Single use blood lancet.
    Test strip which has been
        removed from the refrigerator and
        allowed to reach room
        temperature (5mins)
    Ensure when machine is switched
        on the test strip is checked and
        code and chip numbers are
        identical
    Ensure if new batch of test strips
        is used is able to demonstrate
        how to insert a new code chip
    Is able to identify the sites for
        capillary collection.
    Can chose and clean the
        appropriate site.
    Using single use lancet obtain
        blood sample
    Ensure safe disposal of lancet.
    Is aware there is a 180 second
        time limit to obtain and get blood
        sample onto the strip.
    Ensures there is an adequate flow
        of blood without squeezing the
        site.



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      Ensures the blood is placed
       immediately onto the test strip
       without removing the first drop.
      Ensures the blood test result is
       written in the patient’s record
       including the ‘Yellow’ Book and
       nursing documentation.
      Ensure the blood test result is
       reported to the medical
       practitioner/prescriber.
      Ensure the patient is aware of how
       and when to obtain the dosing
       schedule.
      Ensure the patient is aware of the
       date for the next blood test.
      Ensure the safe disposal of all
       contaminated consumables.
      Is aware if required of how to
       contact trained staff member is
       any queries/concerns red to
       contact.

8. Staff must be aware of the need to
work in collaboration with the medical
practitioner to inform them of blood tests
and results.
Inform medical colleagues of any
contraindications to patient receiving
medication or changes in individual
patient circumstances.

9. Ensure care records are completed
legibly, ensuring your intention for
treatment and monitoring is clear,
accurate and complete and that there are
no ambiguities.

10. Update the patient-held record of
anticoagulant treatment.

11. Work in collaboration with the multi
disciplinary team, if they are involved with
the patient and the patient has given
consent to share any information
concerning anticoagulant therapy.

12. Record and report the findings,
recommendations, patient and/or carer’s
response and issues to be addressed
according to local guidelines.

13. Recognise when you need help and
seek advice and support from an
appropriate source when the needs of the



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individual and the complexity of
the case are beyond your competence
and capability.

14. When transferring the care of the
patient to another healthcare team,
ensure that the new team is sent
information concerning the plan of care.

                                  Knowledge and Understanding
You need to apply:

1. An in-depth understanding of national
and local anticoagulant guidelines and
their application.

2. A working understanding of local
guidelines for patient records, their
storage and confidentiality of information.

3. A working understanding of relevant
polices including:
Devon PCT Medicines Policy
Devon PCT Injectable Medicines Policy.
Nursing and Midwifery Council Standards
of Medicines Management.
Inoculation Injury
Consent Policy

4. A working understanding of risk
management, patient safety principles
and causes of medication errors.

5. A working understanding of the disease
progression and the potential impact on
physiological systems.

6. An understanding of the indications
and contraindications for the proposed
treatment.

7.A working pharmaceutical knowledge to
include dose range, side effects,
contraindications and interactions An
understanding of the side effects of the
proposed treatment, and their
assessment, monitoring, prevention and
management.

8. An understanding of relevant anatomy
and pathology.

9. An understanding of the normal
parameters for routine investigations.



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10. An understanding of the side effects
of anticoagulant drugs, how to recognise
them and the appropriate treatment
regimens.

11. An in-depth understanding of
diagnosis, care plans, protocols and
guidelines.

12. A working understanding of different
near patient testing devices and their care
and maintenance requirements.

13. A knowledge of the organisations that
offer support relevant to the patient’s
needs.

14. A factual knowledge of the roles and
responsibilities of other team members.

15. A working understanding of the limits
of one’s own knowledge and
experience and the importance of not
operating beyond these.

16. A working understanding of the
guidelines relevant to your own and
others’ roles and your own and others’
responsibilities, accountability and duties.




          References

              1. NHS National Patient Safety Agency (NPSA 18)
                 http://www.npsa.nhs.uk/nrls/alerts-and-directives/alerts/anticoagulant/

              2. Nursing and Midwifery Council (NMC), The Code, May 2008.
                 http://www.nmc-uk.org/

              3. Devon Primary Care Trust (DPCT), CLIN 07 Medicines Policy, March 08.
                 http://www.infopoint.devonpct.nhs.uk/

              4. Devon Primary Care Trust (DPCT), Records Management Policy, June 08.
                 http://www.infopoint.devonpct.nhs.uk/

              5. Nursing and Midwifery Council (NMC) 2007 Standards for medicines management
                 http://www.nmc-uk.org/




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