Precision ceedpro. Online Training for. Glucometer & Capillary Collection

Transcription

1 Online Training for Precision ceedpro Glucometer & Capillary Collection How long will it take? This module takes approximately 30 minutes to complete. What if I have to leave before I finish? Progress is saved so if you need to leave you can return and resume at the same spot you left. Do I have to go through every slide? Yes. To receive credit work through the entire module. Can I take notes? Yes! You are encouraged to write down any notes that will help you remember and do a great job after taking this module. Also, remember that this module is here for you to come back to if you want to at any time. What do I do at the end of this module? At the end of the module, you will need to confirm completion. Upon completion, you will receive credit in the LMS (Learning Management System). Revised April 2017

2 Overview This module has 6 sections: 1. Introduction 2. Analyzer Overview 3. Quality Control testing 4. Capillary Collection 5. Patient Testing 6. Results and Reporting

3 Precision Xceed Pro Front view LCD Screen Test Strip Port Frequently used keys: CLEAR, MENU, ENTER Barcode Scanner Alpha-Numeric Buttons Backlight On/Off Button

4 Precision Xceed Pro Alternate Views 1. Uses 2- AA batteries Serial number Needed for troubleshooting and techsupport when calling ATS 3. Data Port Place analyzer into docking station 3

5 Items in the Glucometer Tote Verify the tote is fully Stocked with: Instrument Lancets Controls Strips Alcohol wipes Gauze Quick Reference Guide Comment Code card *Isolation bags available to use in isolation rooms

6 How Do We Clean the Meter? Acceptable cleaning solutions Alcohol and ammonia based cleaners. Recommended solutions are Sani- Cloth HB, Sani-Cloth Plus, and Super Sani-Cloth. Must clean after each patient. 2 step cleaning process For C. Diff patients 1. Bleach must be used to clean meter after C. Diff patients. Bleach based cleaners will fade the monitor keypad. 2. Let bleach dry then follow up with Sani-Cloth to remove the bleach residue from meter.

7 Knowledge Check When the glucometer is docked, it will charge the batteries: a) True b) False

8 Overview This module has 6 sections: 1. Introduction 2. Analyzer Overview 3. Quality Control testing 4. Capillary Collection 5. Patient Testing 6. Results and Reporting

9 Quality Control Supplies Solutions All reagent Bottles must be labeled with modified expiration date AND open date Expires Whichever comes first: 90 days after Date Opened Manufacturer s Expiration Date Stored at room temperature Before use Mix by gentle inversion

10 Quality Control Supplies Test Strips When the barcode is scanned, the following information is collected by the glucometer. Strip lot number Control ranges Expiration date of the test strip Store at room temperature Test Strips are sensitive to light, temperature and humidity

11 When to Perform Quality Control Perform a High and Low QC test for the following: QC every 24 hours If the analyzer has been dropped To troubleshoot inconsistent patient results

12 Scanning with the glucometer If having trouble scanning, move analyzer closer to the item or further back Barcode Scanning Items to Scan Employee - Operator ID, barcode on the back of badge. Patient - CSN number is the barcode located on their patient ID armband or patient primary labels. QC bottles and test strips

13 Quality Control Test Procedure (1 of 3) 1. Press 2 - Control Test 2. Scan the barcode on the back of your badge.

14 Quality Control Test Procedure (2 of 3) 3. Scan the low level control solution barcode. 4. Scan the test strip barcode.

15 Control Test Procedure (3 of 3) 5. Open and insert test strip into the strip port, until Strip Inserted is displayed. (contact bars facing up) 6. Apply one drop of low solution to the end of the test strip. The Sample Accepted screen displays immediately followed by Analyzing Sample. Test 20 second countdown begins. Result will display as Pass or Fail. Press 1- Next Level If QC fails, enter comment code then press 2-Repeat Test.. Repeat steps 3-6 using the high control solution.

16 What if you get a QC Fail? You must enter the two digit code for reason for fail which is available on the lid of the tote. Reasons You may have a fail: Procedural error Damaged Strip Excess sample on end of strip while dosing Air bubbles in control bottle Old or contaminated control solution Incorrect test strip lot number scanned Unit malfunction / low battery Test strips or control solution outside degrees Celsius

17 Knowledge Check You need to enter a comment code if a QC test fails: a) True b) False

18 Overview This module has 6 sections: 1. Introduction 2. Analyzer Overview 3. Quality Control testing 4. Capillary Collection 5. Patient Testing 6. Results and Reporting

19 Collecting Specimen Finger Site Selection Adults and Children: Use middle or ring fingertips Palm side Off to the side of the pad Low Flow Needle Depth: 1.5 mm 30 G Medium Flow Needle Depth: 1.8 mm 21 G High Flow Blade Depth: 2.0 mm Width: 1.5 mm The blade is meant for filling microtainer blood tubes and is not appropriate for glucometer collections unless used in conjunction with a volume draw.

20 Collecting Specimen Heel Site Selection Patients under 1 year and not yet walking, heel site should be: Warm (warming of the heel of infants is mandatory) Normal color Free from scars, cuts, bruises, or rashes On the side of the heel

21 Collecting Specimen Do Not Puncture Do Not Puncture: The tip of the finger (close to bone) The side of the finger (close to bone) The pad of the finger (annoying) The index finger The little finger No thumbs! Careful with fingers of infants or very young children

22 Blood Collection Wipe away 1 st drop: Avoid tissue fluid contamination A small amount of contamination can greatly impact the glucose result. Apply gentle intermittent pressure to site, touch end of test strip to site of blood. Position the site downward to enhance blood flow. Hold analyzer at a level or downward angle.

23 Blood Collection Filltrigger helps prevent shortsampling. Each strip is equipped with a trigger to auto-start the test. Test starts only when enough blood is obtained; an audible beep alerts the operator and the testing countdown begins. If there is not enough blood to initiate the automatic start, then the procedure must be performed anew with a new strip and a continuous flow of sample into the testing strip must be ensured until the audible beep signaling the start of analysis is heard BEEP!

24 Knowledge Check How should you hold the glucometer as you apply the sample? a) Level b) At a downward angle c) At an upward angle d) Both A & B are correct

25 Overview This module has 6 sections: 1. Introduction 2. Analyzer Overview 3. Quality Control testing 4. Capillary Collection 5. Patient Testing 6. Results and Reporting

26 Patient Identification Compare TWO Patient Identifiers to the Laboratory Barcode Label, Epic Order or Requisition 1. Patient s Full Name 2. Medical Record Number, Contact Serial Number or Date of Birth

27 Patient Test Procedure (1 of 3) Step 1 Press 1- Patient Test 1 2 Step 2 Scan the barcode on the back of your badge. 3 Step 3 Scan patient armband or patient primary label (outpatient setting).

28 Patient Test Procedure (2 of 3) 4 Step 4 Enter last two digits of birth year. 5 Step 5 Scan Strip Lot 6 Step 6 Insert Strip

29 Patient Test Procedure (3 of 3) 7 Step 7 Apply Sample 8 Step 8 Device will analyze sample Step 9 After countdown result will be displayed 9

30 Contact Serial Number (CSN) Override Form The POCT Override Test Sheet is to be scanned when Point of Care testing is needed for a patient not yet admitted to the hospital and who DOES NOT have a CSN available. Directions: 1. Scan the OT-barcode on the override sheet as the temporary patient ID number 2. Once patient has registered, place the patient label in the Patient Identification box on the override form. 3. FAX completed sheet to Ancillary Testing Services at Patient results will be posted to the EMR upon receipt of the form. Do Not Copy the Override Sheets as additional ones are needed! Each form is for one time use only and numbered accordingly. These are to be ordered through MultiCare s Printshop (Printshop form # is ). Questions? Contact Ancillary Testing or poctadmin@multicare.org

31 Glucometer Patient Comment Codes Comments are required on ALL critical values posted in the EMR Comments must be placed by the operator performing the test at the time the result displays on the screen Manually enter the two digit comment code available on the lid of tote, then press enter. Then press 1- Next Patient 2- Patient History Or press Menu to return to menu mode.

32 Knowledge Check When are you required to enter a comment code on a patient test result? a) For all critical results b) When a test is repeated within 10 minutes c) After every patient test d) Both A & B

33 Overview This module has 6 sections: 1. Introduction 2. Analyzer Overview 3. Quality Control testing 4. Capillary Collection 5. Patient Testing 6. Results and Reporting

34 Troubleshooting Patient Test Results Reasons Glucose Results may be Higher or Lower than Expected Please refer to the Precision Xceed Pro quick reference guide pgs HIGHER THAN EXPECTED GLUCOSE RESULT: Hematocrit lower than 20%. Serum or plasma samples were used instead of whole blood. Hyperosmolar State (HHS) LOWER THAN EXPECTED GLUCOSE RESULT: Hematocrit higher than 70%. Severe dehydration. Hypotension or shock. Hyperglycemic Water or alcohol remaining on the puncture site.

35 Troubleshooting Patient Test Results Procedures for Abnormal Adult and Pediatric Results Adult Record and report results per site protocol. If patient values are less than 50 mg/dl or greater than 400 mg/dl perform the following: Repeat the test on the Abbott Precision Xceed Pro glucose monitor. The second result must be close enough (~10%) in value to confirm the first result. Notify the provider as needed or required by the unit. If results are a significant change from recent patient glucose history, a STAT glucose should be sent to the laboratory for confirmation. Results above 400 mg/dl should be verified by a laboratory confirmation. Pediatric When monitoring neonatal samples, laboratory confirmation is recommended for all results less than 50 mg/dl. Blood glucose values on neonates less than 40 mg/dl or greater than 200 mg/dl must be confirmed with at least one of the following: Repeat the test Notify the RN or Doctor Refer to hypoglycemia protocol for results less than 40 mg/dl Verify with laboratory confirmation

36 Reviewing Patient Data Step 1: At the test menu screen, press the Menu button once. Press 1 Data Review Step 2: At the operator ID screen scan or enter operator ID number. Step 3: Press option: 1 - Patient by Operator ID 2 - Patient by Patient ID 3 - All Patient Data Patient test result history can also be reviewed upon completion of a patient test. Select 2 Patient History

37 Knowledge Check What are the critical result ranges for adult patients that require a comment code? a) Less than 40 greater than 300 b) Less than 50 greater than 400 c) Less than 50 greater than 300 d) Less than 60 greater than 400