Fraser Health Authority Accu-chek Inform II: Training Script

Transcription

1 1. Introduction Ensure that each participant Signs the attendance Sheet (please PRINT first & last name, and middle initial legibly) Refer to; For Reference Only: o Quick Reference Guide o What s new document QUIZ & Competency Checklist Form: Complete at end of session. o Competency Checklist goes to site lab or designated lab in your area. 2. Physical Aspects of the Accu-chek Inform II Details: Tote box Contains meter, test strip vial, QC, Lancets, Alcohol swabs and Quick Reference guides (Quick sheet and picture sheet). Tote boxes are to be stored upright or flat Tote must be cleaned regularly using FH approved low level disinfection wipes (e.g. Caviwipes, Oxivir Tb). o After each use if taken in to patient room o Daily if NOT taken in to patient room Front of Meter Details Power Button: Turn meter off after use and before returning to base. Touch Screen: Only use the pad of a finger (No pens or sharp objects) Test Strip Port o Ensure meter is used on a level surface. ANY liquid entering the test strip port could disable the meter. Laser Bar Code Scanner (care to be taken not to flash in eyes) o Scan Test Strip and control solution lot # s Back of Meter Meter re-set button (for meter freeze situation, press gently with paper clip a few seconds to re-boot) Re-Chargeable Battery Pack Charging Station Base Unit for recharging batteries without downloading data Base Unit light shows Green when charging and Red when you first plug in base unit to power outlet until meter is placed in it Place meter facing upright and forward Recharge Battery Pack (3 hours for full charge can be ready to test after charging 20 minutes from a fully dead battery) Base Unit requires cleaning weekly using FH approved low level disinfection wipes (e.g. Caviwipes, Oxivir Tb)

2 Downloading Station Base label will be clearly identified with a LABEL stating Downloading and Recharging Place meter facing upright and forward QC and Operator ID Info are downloaded automatically after placed on base unit Base Unit light shows Blue when downloading Can be used as a charging station as well (light will show green when charging) Base Unit requires cleaning weekly 3. Accu-Chek Inform II Glucose Meter Requires 6 digit User ID for nurses (others require Operator ID as per lab protocol) Age appropriate critical ranges for FHA are programmed into each meter along with choices of Action Steps performed. Three types of samples may be used with the Accu-chek Inform II: o Capillary (adult and neonate) o Arterial o Venous The meter reportable range is mmol/l Adult Critical Glucose Range: o CRITICAL HIGH: will show with any results over 28.0 mmol/l o CRITICAL LOW will show with any results below 2 mmol/l o Follow hospital protocol on Mosby s Procedures Pediatric Critical Glucose Range: o CRITICAL HIGH: any results over 11.0 mmol/l will show o CRITICAL LOW any results below 2 mmol/l o Follow hospital protocol on Mosby s Procedures Cleaning and Maintenance: Remove the meter from the base unit. Clean meter using FH approved low level disinfection wipes (e.g. Caviwipes, Oxivir Tb): o between each patient use, o If visibly soiled wipe to remove soil then wipe again for disinfection Always allow meter and base unit to thoroughly air dry before putting back into use 4. Test Strips The test Strips must be stored at room temperature and away from windows or heaters. The cap must be replaced as soon as possible after opening. Observe area on bottle where barcode is located this is what you will be using when you scan the test strip vial Opened bottle expiry Strips can be used until the manufacturer s expiry date on the vial (open or un-opened) Lab will enter the lot numbers of the test strips that will be available for use

3 Using the test strip: o Hold the test strip so the lettering Accu-chek is facing upwards. Push strip in to meter till meter beeps and wait until the flashing drop appears on the display before applying blood. o You will need a 0.6ul sample of blood. An insufficient sample will give an error code. o Apply the drop of blood to the front edge of the strip (Do not apply the blood on top of the strip). Fill the yellow target window completely. Once a sufficient blood sample has been detected, the meter beeps and the measurement begins. o The Glucose Meter must be kept level during sample application (especially QC testing) to avoid damaging internal components of meter with liquid Once the strip is insert in the meter, you have up to 5 minutes to apply the blood sample/control solution 4. Quality Control Solutions The Accu-chek Inform II has a Quality control lock-out. Both levels of QC must be performed once every 24 hours. If you go beyond the 24 hours, the meter will not allow you to perform patient testing until both levels of QC are successfully completed. There are 2 Quality control Solutions: Levels of QC, o Level 1 (LO - on meter only) (on vial control 1) o Level 2 (HI - on meter only) (on vial control 2) You should be aware that there are may other times when QC should be performed such as: o If the meter has been dropped o If the QC was done on a different lot number of test strips o If for any reasons you question the results the meter has given o If still in doubt about accuracy, contact the laboratory for a confirmatory result. Expiry date: Opened bottles are good for 3 months after opening and kept at room temperature. Write opening date on vial. Lab will enter the lot numbers of the QC solution that will be available for use. The most common cause of Failure of QC solutions is reversal of solutions. Barcode scanning of the QC vial will help eliminate this error. If you have failed and then repeated your QC and it still failed. DO NOT USE THE METER FOR PATIENT TESTING-Contact the Laboratory for a replacement 5. Hands On Practice Performing the QC Test: Have class perform BOTH levels of QC Utilize Mosby s Procedure to walk staff through the steps. Ensure they complete their competency checklist as they do this

4 MOSBY S PROCEDURE (awaiting Upload) 1. Turn on the meter. Press and release the ON/OFF button Power Up screen appears after meter performs self-checks Note Quality Control Status on Power Up screen Battery life symbol appears in bottom right corner Manually proceed to the next screen by touching arrow symbol (happens automatically after 5 seconds) 2. Enter 6 digit Employee Number or assigned Operator ID. Main Menu screen now appears. Touch the left arrow symbol to backspace and delete a character entered incorrectly Touch Checkmark symbol to confirm Once entry is complete, the main menu appears 3. Have the entire class select one level (i.e. all select LOW).Touch Control Test button. 4. Scan Barcodes: QC Level 1 or Level 2 vial, then Test strip vial. Scan the lot number on the control vial - hold meter so scanner is 4-8 inches in front of vial barcode Touch Check Mark to confirm the scanned lot number Repeat Procedure above to scan test strip vial. 5. When Flashing Arrow symbol appears, insert test strip in top of meter. (Strip must be in meter before dosing). When the meter is ready for control solution application, a flashing drop will appear on screen. 6. Apply Control Watch me first a. Invert the control vial 5 times. b. Remove cap and wipe tip of vial. c. Discard first drop into the cotton gauze, then apply second drop to front EDGE of strip (not on top) 7. Quality Control result will appear after 5 seconds. 8. The meter screen will display the QC value along with a PASS or FAIL message. Touch Check Mark to accept QC result and return to Main Menu 9. Touch Comments button if QC Fails (Mandatory step), choose most likely cause. IF THEN Passed Touch Check Mark to continue to next level or Return to Main Menu. Failed Repeated QC Fails 1. Touch Comments button and select applicable comments. Touch Check Mark to confirm selection. Touch Check Mark again to exit from screen. Repeat the QC test. 2. Contact Laboratory Medicine and Pathology Program 10. Discard supplies. 11. Return meter tote to storage area and return meter to the base unit for charging.

5 12. Download data once every 24 hours by placing the meter at the designated computer terminal. Performing Patient Test 1. Touch Patient Test. 2. Touch barcode symbol top right corner of screen 3. Scan barcode on strip vial holding scanner 4-8 inches in front of vial barcode 4. When Flashing Arrow symbol appears, insert test strip 5. Clean site with antiseptic swab (i.e. alcohol swabs), and allow it to dry completely. 6. When Flashing Drop symbol appears, pierce site - for hospital patient testing. 7. Wipe first drop and apply second drop to front edge of test strip (not top) 8. Result appears after 5 seconds COMMON ERROR MESSAGES & TROUBLESHOOTING: In most scenarios, meter screen will display error and how to resolve IF Meter Display or Symptom is Strip Defect Error Type Bad Dose THEN Test strip defective or result is extremely low and below meter range Insufficient amount of blood on strip ACTION Repeat the test using a new strip. If error persists, contact POC/Lab staff. Repeat the test using a new strip. Ensure sample is applied to strip FRONT edge. If error persists, contact Lab staff Diagnostic Accreditation Driven Competency Requirements Competency on the blood glucose meters is your professional responsibility Annually each operator MUST successfully complete: QUIZ (located on Mosby s Procedures) and sent to your site lab. ONE HI and ONE LO Quality Control Test FIVE patient tests If the above is not successfully completed: Complete the following: e-learning module on CCRS (starting summer of 2013) Competency Training Checklist (on Mosby s Procedure until summer of 2013) o E-learning module and Training Checklist must be completed and sent to your site Lab.