What is the individualized Numeric Rating Scale (INRS)?
The Individualized Numeric Rating Scale (INRS) was developed by Martha A.Q. Curley, R.N., Ph.D. in collaboration with Jean C. Solodiuk, RN PhD (Pain Treatment Service, Children's Hospital Boston). You are free to reproduce and use the Individualized Numeric Rating Scale (INRS) for research or clinical practice.
What if INR 0.5 is below the therapeutic INR range?
In the event that we receive an INR value of ? 0.5 below the patient’s therapeutic INR range in a patient with a previously stable therapeutic INR, continuing current dose or a warfarin boost dose according to the pharmacist’s clinical judgement is recommended with subsequent INR check in 1-2 weeks.
What is good INR control?
Good INR control, defined empirically as a TTR >60%, may be best achieved by appropriately addressing both high and low INR values using a consistent approach (paper-based dosing nomogram or computerized decision support program). For each out-of-range INR value, attempt to identify the cause.
Can INR be elevated before a full anticoagulation effect of warfarin?
When initiating warfarin, INR may be elevated before fully anticoagulated? hypercoaguable due to protein C deficiency, t½ = 6hours. With these 2 things in mind: the higher the dose the higher the potential to overshoot the INR, possibly prompting early discontinuation of LMWH before true anticoagulation effect of warfarin has taken effect.