Precision Xtra Training

Transcription

1 Precision Xtra Training

2 Objectives At the end of this module, the participant will be able to: List the steps to calibrate the machine Describe the steps for sample collection and blood glucose testing Describe steps to recall results Describe the quality control procedure Describe the actions to take when patient/resident results are outside of accepted ranges Verbalize actions to take when the error message appears on the screen

3 Calibrating the Meter Calibrate the meter when you open a new box of strips and whenever you get a new meter

4 Calibrating the Meter (cont.) Check the 5 digit lot number on the calibrator bar (metal bar found in each box of strips), the box of strips, the strips and the test strip package insert. They should all have the same lot number. With the machine off, insert the calibrator bar into the meter, number side up, until the lot number appears on the screen. Make sure that number matches the number on the bar, the strips and the package insert.

5 Calibrating the Meter (cont.) If the numbers do not match, recalibrate the meter. Make sure you are using the correct calibrator bar for that box of strips. The numbers should all match.

6 Calibrating the Meter (cont)

7 Positive Patient Identification If the patient/resident is able to communicate: Ask patient/resident to spell and/or state FIRST and LAST name and state birth date. Listen to response Compare verbal information and medical record number on wristband to chart All information must match EXACTLY Notify proper personnel of any discrepancy and DO NOT proceed until discrepancy is solved Identification must occur EVERY time a glucose test is performed

8 Positive Patient Identification If the patient/resident is unable to communicate: Compare information on patient chart (MAR) with information on the wrist (name) band, according to protocol Notify proper personnel of any discrepancy and DO NOT proceed until discrepancy is solved Identification must occur EVERY time a glucose test is performed

9 Before You Begin Testing

10 Opening the Strip Be careful not to bend or twist the strip or touch the end test area.

11 To Begin Testing

12 To Begin Testing (cont.)

13 To Begin Testing (cont.) If the numbers do not match, you must recalibrate the meter, using the bar from the box of strips Check the expiration date on the strip

14 When to apply blood This symbol appears as soon as you insert the strip.

15 Sample Collection Wash hands thoroughly and wear gloves Observe Universal Precautions!

16 Capillary Sample Collection from Finger Wash hands thoroughly and wear gloves Identify appropriate puncture site middle or ring finger preferred Avoid (if possible) Thumb (calloused) Index finger (sensitive) Fifth finger (insufficient tissue depth) Orange shaded area of finger in picture shows acceptable site for puncture Have the patient/resident hold hand in a downward position to allow gravity to help increase blood flow to the capillary bed of the hand

17 Capillary Puncture -Finger Grasp the finger to be used Cleanse the site according to site protocol: with soap and water or alcohol using a target (circular) motion Allow site to air dry completely to provide effective disinfection and to prevent hemolysis of specimen if using alcohol Grasp and steady the patient/resident s finger slightly below the first knuckle

18 Capillary Puncture Finger (cont.) Position (do not push) the device against the side of the finger so the blade will penetrate perpendicular to the patient/resident s fingerprint (cross cut) Prepare and activate the device causing a quick puncture to the finger do not remove until a click is heard Discard device into a sharps container

19 Capillary Puncture Finger (cont.) Squeeze and release the finger to initiate blood flow avoid milking which may cause hemolysis or tissue-fluid contamination Wipe away first drop of blood with a clean gauze Again, squeeze the finger until a drop of blood forms on the puncture Place next drop of blood on sample strip

20 Sample Collection and Testing

21 Sample Collection and Testing (cont.)

22 Sample Collection and Testing (cont.) Bars will appear after enough blood has been accepted by the meter Followed by the countdown of 10 seconds

23 Sample Collection and Testing (cont.) After blood is collected, wipe the site dry and apply direct pressure with gauze until bleeding has stopped. Bandage if appropriate. Dispose of used materials according to facility procedures.

24 Documentation of Results The result will then appear. Record the result on the correct documentation form, including: Date Time Identification of person performing test

25 Cleaning the Meter Wipe off the meter with a bleach wipe, alcohol wipe or approved disinfectant between patient/resident testing

26 Results The glucose meter can measure glucose levels between 20 mg/dl and 500 mg/dl

27 Results (cont.) If the screen does not display a number, but rather the word LO, repeat the test LO indicates that the glucose is below 20 mg/dl If the result is the same, assess the person and follow your facility protocol for low blood sugar and/or notify the physician

28 Results (cont.) If the screen displays the word HI, repeat the test The word HI means that the result is higher than 500 mg/dl If the result is the same, assess the person and follow insulin orders, and/or notify the physician

29 To Recall Results The meter may have turned itself off before you had a chance to see the results To recall that result, press and release the middle button. The most recent result will be displayed in the window

30 Quality Control Quality control is done: daily when you question the results when you get a new meter Document the QC results on the QC log sheet

31 Quality Control (cont.) Insert a test strip into the meter Choose either the high or low solution Check the date on the bottles, they should be dated when first opened and are good for 90 days Invert the bottle 3-4 times to mix the solution Apply the solution to the strip

32 Quality Control (cont.) Compare the reading to the range found on the insert in the box of strips Repeat for the other control solution If the result is not within range; check the expiration dates of the strips and solution if they are not expired, repeat the test using a new strip, be sure to invert the bottle 3-4 times to mix the solution if still not within range; replace the control solutions and repeat the test If still not within range, replace the meter

33 Error Messages Troubleshooting If you see an error message on the screen, repeat the test using a new strip If the message continues: Remove the batteries for a few seconds and then reinsert them Often error messages occur when someone turns the machine on and then inserts a strip, essentially asking the machine to turn on twice, which results in an error message.

34 Error Messages Troubleshooting (cont.) If the error message continues, try a new battery If the error message continues despite retesting with a new strip and a new battery: Contact your supervisor for a new meter Check with your facility protocols about what to do with the broken meter If the number bars are missing anywhere on the screen, stop using the meter. Results could be misread if the number bars are missing. This should be checked every time the meter is turned on and the 888 shows on the screen.

35 It is up to YOU Perform QC as required Do not hesitate to perform QC for review or meter operation verification Participate in mandatory annual competency

36 To complete this competency Review Policy Complete on line quiz Perform quality control levels, patient/resident test, calibrate the meter and recall a result with your preceptor/educator or designee