Transcript HemoCue H201DM - Leeds Teaching Hospitals NHS Trust

Clinitek 50
POCT
Learning Objectives
Essential criteria for assessment:
Present for training session
Practical Assessment – 1 supervised test
Show knowledge and understanding of:
Urine dipping technique
Entering data
Changing the paper
Maintenance
Trouble shooting
Understand own continuous development responsibilities to
maintain competency.
What information about the body can we
obtain from urine ?
The parts of the body urinalysis can give us
information about include:
Kidney
Liver
Urinary Tract Infection
Blood
Carbohydrate metabolism
Nutrition
Muscles
Sample Collection
First voided morning urine is best for routine analysis as it is the most
concentrated.
If possible, void directly into a clean, dry container/bedpan.
It is best to test samples immediately. If this is not possible the test
must be completed within 4 hours providing the samples are stored in
clean plastic containers.
When disposable cardboard containers are used samples must be
analysed immediately as containers may leach contaminants into the
sample providing incorrect results.
Strip storage
All strips and cassettes should be ordered from pharmacy stores
and be stored on the ward based on the following criteria:
Multistix 10SG & 8SG
• Sensitive to moisture in atmosphere – ensure lid is replaced
securely after each test.
• Expiry date on side of vial and box.
• Store at room temperature.
•
The difference between the two sets of strips is that the 10SG also tests for
UBG and Billi.
Potential sources of error are:
Stale specimen, Poor technique, Improper recording, Unclean
containers, Incorrect storage, No routine Quality Control or Interfering
substances.
To combat these Biochemistry POCT ask that ward staff do not
do any of the following:
Touch the test pads.
Leave cap off the strips for prolonged periods of time.
Remove the desiccant packet from containers.
Take out more strips than required for each patient.
Use out of date strips.
How to analyse a sample
Patient Sample
All urine samples should be checked before being analysed
and the flow diagram on the following slide should be
followed.
Samples should be:
Labelled [3 unique identifiers/addressograph].
Freshly expelled from the body.
Room temperature [Do not refrigerate].
Samples should not be:
Very pale/dilute.
Heavily blood stained [<1g/dl Hb]
Multistix Technique
Set the test table up correctly, ensuring the table insert has the strip side is facing
upwards.
Completely immerse the reagent strip into the urine.
As you withdraw the sample run the edge against the rim of container to remove any
excess urine.
Holding strip horizontally blot the edge on a tissue. Do not draw the strip across the
tissue as this may damage the pads and give incorrect results.
Please try not to bend the strips whilst sampling. A bend in the strip may cause it
to get lodged inside the analyser and prevent it from working.
Place the strip along the centre of the table as far as possible and press either of the
green buttons on the front of the analyser.
Waste Disposal
Urine samples should be discarded in the sluice and any containers as
are to be disposed of as clinical waste following Trust guidelines.
Multistix strips should be disposed in a clinical waste bin.
Troubleshooting
&
Maintenance
Troubleshooting
The majority of the trouble shooting and
maintenance is carried out by Biochemistry
POCT, but there are a couple of things you
can do to help us out.
Maintenance - Cleaning the table
It is recommended that you clean the test table at least once a week by
putting it under a running tap, ensuring that the whole table is wet.
Using a tissue thoroughly dry the table ensuring that you don’t touch
the white section with your bare hands as this may affect calibrations.
The test table should be wiped with a dry tissue between each patient.
Check that the calibration strip on the instrument is clean EVERY day.
If the calibration strip is not clean then it should be cleaned using a soft
cloth ensuring that you do not scratch it.
Maintenance - Changing the paper roll
Lift the top [black section] of the analyser to reveal the location of the paper roll.
Remove the remains of the old roll by pulling it backwards through the printer.
To feed the new roll into the printer first cut the free end of the new roll into a point.
The ink is only on one side of the paper, not in the printer, and installing the paper incorrectly will result
in nothing being printed.
To check which side of the paper the ink is on scratch it with your fingernail. If grey marks are left
behind then you’ve scratched the side with the ink and this side needs to be facing the front of the
analyser.
Drop the new roll into the lid [black section] of the analyser and with the loose end locate the slot for
the paper to go through near the printer. Push the pointed end through the slot until it reappears at the
other side.
Feed the free end through lid and close everything back up.
Ordering details
Paper rolls for the urine machines are to be
ordered by individual wards and can be ordered by
ringing Protech Medical Ltd on 01457 852220.
The part number is PT 58/29.
The strips are ordered through Pharmacy.
Contacting Biochemistry POCT
For any other problems regarding the Clinitek
Status
please contact Biochemistry POCT on:
Ext
Rob Coleman
Andy Sheppard
Lindsey Riley
22338
80-2320
80-2310
80 -2311
Or e-mail us using “Point of Care” on GroupWise.
Quality Control
Biochemistry POCT will run all QC and EQA samples and
Ward staff are not expected to carry this out for
themselves.
QC is run on a 2 monthly basis, this consists of a Positive
And Negative solution being run through the analyser.
EQA is run on a 2 monthly basis and consists of a single
Sample being run through the analyser.
Auditing
Once every 2 months (at the same time as EQA) your analyser
will be audited for the following criteria:
Patient ID being correctly input
Strips being in date
Analysers settings being correct (time, date, strips etc)
General cleanliness
Associated paperwork present (SOP, Flowchart etc)
Training records kept up to date
A copy of the audit will be sent to matron and ward sister so
they are aware of how the ward is doing.
If there is cause for concern regarding the machines performance then POCT will let you
know.
An additional yearly audit will be carried out by Siemens.
Key Trainer Responsibilities
Your responsibilities as key trainers are to:
Ensure that every member of ward staff who needs to use the analyser
is trained to do so.
Send the details of all members of staff trained on your ward to the
email address “point of care” to be entered onto the database and the
electronic staff record (ESR) by POCT staff using the form provided.
Training records need to be kept locally and will be inspected during
auditing.
Teaching Resources
All the information you may need (including this presentation) to train
your colleagues can be found on the trust website alongside the
Standard Operating Procedure.
http://www.pathology.leedsth.nhs.uk
On the website highlight Point of Care in the blue bar along the top of
the screen and scroll down to the sections headed Urine Testing and
Training Resouces for Key Trainers – Urinanalysis.