Transcript No Slide Title

ACCU-CHEK® Inform Full Training
Sarasota Memorial Hospital
Roche ACCU-CHEK® Inform Blood Glucose Meter with the ACCU-CHEK®
Comfort Curve™Test Strip and the Roche Safe-T-Pro™ Lancets
V2.1 12/2004
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Copyright © 2004 Roche Diagnostics
ACCU-CHEK® Inform Full Training
Hospital Policy Requirements
• Required to run 2 levels (HI and LO) of quality control once per 24 hours.
• Regulatory requirements (Joint Commission and CAP) mandate an “audit trail” or
“tracer” for each test (including patient/operator ID, reagent lot, day/date/time). Most of
this information will be “scanned” in the meter.
• Draw a STAT lab draw for values outside SHM’s “Critical Values”.
• Required to write the open/discard dates on all control bottles (3 month expiration
after opened).
• Comments are required for QC that “fails” or patient results that are outside “critical
values”. The meter will remind you of this requirement.
System Features
• ANY sample can be used (capillary, venous, arterial, neonatal and cord) on the
ACCU-CHEK® Inform meter.
• The ACCU-CHEK® Inform is programmed with SMH’s “critical values” (below 40
mg/dl and greater than 400 mg/dl).
• Strips packaged in 50 test strip vials and expire the date on the vial.
• Bar code scanner for quickly scanning strip vials, control bottles, patient and
operator IDs.
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Other System Features
• Comments are easily added to each test result, are unlimited and customized by
nursing and the laboratory. There are separate comments for QC results and
Patient results.
• Communicate through touchscreen buttons, that in most cases, action will not
occur until after you release the button. Feel free to use any soft plastic point,
fingernail or your finger (do not use a ballpoint pen with the ballpoint exposed or
anything that may scratch/mark the screen).
• The ACCU-CHEK® Inform is automatically calibrated with the code key in each
vial of 50 strips (assures accuracy and should be replaced with each vial of strips).
• Touch-screen display that allows you also to manually input ALPHA characters
(A,B,C …).
• The meter uses a 5 YEAR rechargeable battery and a docking station for EACH
meter (where it should be stored when not in use).
• The ACCU-CHEK® Inform valid readable range is 10 to 600 mg/dl. Results below
10 mg/dl will report “LO”. Results above 600 mg/dl will report “HI” (see next slide).
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ACCU-CHEK® Inform Full Training
Test Ranges and Critical Values
(with messages displayed under each patient test result)
“Out of
“LO” Critical
Range”
<10
“Out of Normal
Range”
“Range”
<40
“Out of
Critical “HI”
Range”
“Out of Normal
Range”
>400
>600
RANGE: Normal “within” range values seen for healthy adult population.
OUT OF NORMAL RANGE: Values seen for outside healthy adult population.
OUT OF CRITICAL RANGE: Lab back-up must be drawn . SMH’s range selected is below
40 mg/dl and above 400 mg/dl. This message will be flashing at you to remind you that
this an “Out of Critical Range” patient test result.
ACCU-CHEK® Inform READABLE RANGE
Values that the ACCU-CHEK® Inform will report a result (10 mg/dl to 600 mg/dl). A result
below 10 mg/dl will report a “LO” and a result above 600 mg/dl will report a “HI”.
V2.1 12/2004
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Copyright © 2004 Roche Diagnostics
ACCU-CHEK® Inform Full Training
Roche Safe-T-Pro™ Lancets
“TWIST, PULL AND SHOOT ”
1. Hold the lancet and twist off
the protective lancet cap. (DO
NOT use if cap has previously
been removed.)
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2. Firmly place the lancet
against the fingertip and press
the blue button. AFTER USE,
PLEASE DISPOSE IN SHARPS
CONTAINER.
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ACCU-CHEK® Inform Full Training
How to Dose the ACCU-CHEK® Comfort Curve™
Test Strip
Lance the side of the finger,
wipe off the first drop of blood
with dry gauze. Then obtain
a small drop of blood.
With the strip is inserted into the meter,
touch and hold the edge of the yellow window
and blood should totally fill the yellow window
Acceptable
Not Acceptable
AFTER THE INFORM BEEPS THE REACTION HAS STARTED and you have up to 15
seconds to apply more blood to the strip, if the yellow window is not totally filled.
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ACCU-CHEK® Inform Full Training
How to Hold the ACCU-CHEK® Inform Meter While
Dosing a Strip
Always hold the meter in the middle, bottom or sides while dosing (see
above). It is not acceptable to hold the meter at the top (see below).
Not Acceptable
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ACCU-CHEK® Inform Full Training
How to Use the Barcode Scanner
• Do not stare directly into the laser.
• Aim the laser (end of meter) 4-6 inches away (about the distance of a pencil) from
the barcode you want to read.
• Then press and release the “Scan” button on the upper right of the touchscreen to
turn it on (it will stay on for about 8 seconds).
• Move the meter up to LOOK FOR THE RED LASER LIGHT (usually appears a
couple of inches LOWER than where you are aiming).
• MAKE SURE THE LASER BEAM COVERS THE WHOLE BARCODE.
• Hold the bar-coded object still while you are positioning the laser beam to read it.
• MAKE SURE THE LASER BEAM COVERS THE WHOLE BARCODE, THE BARCODE
IS AS FLAT AS POSSIBLE AND THE BEAM IS NOT CURVED:
Not Acceptable
Acceptable
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ACCU-CHEK® Inform Full Training
The Tour of the ACCU-CHEK® Inform
Test Strip Port
Bar Code Scanner
(insert strip electrode
end first)
(for scanning strips,
control bottles and IDs)
Code Key
(automatically calibrates
the strip lot number)
Touchscreen Display
(showing the
“Main Menu” screen)
Forward Arrow Button
(acts like an “enter” key or
allows you to go forward)
Backlight Button
(backlights the screen
in a dark room condition)
Menu Button
(always gets you back
to the main menu)
Purple Power Button
(make sure you turn off
the meter after use)
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ACCU-CHEK® Inform Full Training
Power Up Screen
How many hours until
quality control is due
NICU
ICU 4
Location where the
meter is assigned
Battery gauge
(shown as FULL)
To turn the meter on, press and release the Purple Power Button. The meter will
perform self-checks after power-up for 7 seconds (will beep when done).
Press the Forward Arrow Button to get to the“Operator ID” screen
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ACCU-CHEK® Inform Full Training
Input Operator ID and Menu Screen
Your operator ID Number
will be displayed here
1234567890
Press and release the “Scan”
button to turn on bar code reader
Press the “ABC...” button to
display the alpha keyboard.
Press the “123…” button to return
to the numbers keyboard.
Back button (like
a backspace)
Position the Inform 4 to 6 inches away from your bar-coded ID badge and
scan it (scanner will stay on for 8 seconds), OR ...
Input your operator ID number manually, then press the Forward Arrow
Button to enter it and continue to the “Menu Screen” to run a control:
SMITH JOHN
Operator name should
be displayed here
Your operator ID is usually
your employee ID number
on your bar-coded badge.
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Press the “Control Test”
menu item
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Running Controls
REQUIRED label showing
that a Level is due now
REQUIRED label gone
when a Level has been
successfully run
Press the “Scan” button to
read the control bottle bar
code level and lot number
Required
If you press one of the “Level”
buttons (not recommended), you
will be asked to “Scan” the
Control Lot (see below left).
Required
You will“Scan” the control bottle and then the strip vial for each control test. The
ACCU-CHEK® Inform meter will automatically run that level control in any order. It is a
good practice to only remove the quality control bottle you are actually running.
Enter “Control
Lot” Screen
Enter “Strip
Lot” Screen
Use the“Scan”
button to scan
your “Control Lot”
on each control
bottle
Use the “Scan”
button to scan
your “Strip Lot”
on the strip vial
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ACCU-CHEK® Inform Full Training
Screens While Running Controls
Pass
Hold control
bottle horizontally
Squeeze small drop
at the end of the
control bottle
Apply to curved
BOTTOM edge of the
yellow reaction area
and fill window
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Press the “Forward
Arrow” button when
done to continue to
run the next control,
run a patient test or if
finished, TURN OFF
THE METER
Copyright © 2004 Roche Diagnostics
ACCU-CHEK® Inform Full Training
To Run a Patient
Press the “Patient Test”
menu item
Input the 7 digit “Patient Admission Number” by scanning their bar-coded
wristband, or ...
you may also manually input the 7 digit “Patient Admission Number” in the
“Patient ID” screen and when complete, press the Forward Arrow Button.
The Patient Admission Number
will be displayed here
as you type
1234567
Press the “ABC...” button to
input patient’s last name if
a “Patient Admission Number”
has not been generated yet.
Back button (like
a backspace)
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Press to “Scan” barcode
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ACCU-CHEK® Inform Full Training
Screens While Running a Patient Test
1234567
1234567
1234567
Use the “Scan”
button to scan
your “Strip Lot”
on the strip vial
The result for this test is
outside the hospital’s
normal range.
The “Range” button below the
result will remind you whether
the result is within “Range”
(normal), “Out of Normal Range”
or “Out of Critical Range”.
V2.1 12/2004
1234567
208
Out of Normal Range
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Comments are not required
for within “Range” (normal) or
“Out of Normal Range” results.
Copyright © 2004 Roche Diagnostics
ACCU-CHEK® Inform Full Training
Patient Test Results that are “Out of Critical Range”
1234567
Customized “pop-up” message
appears to remind you to run a
STAT lab draw for this result.
The result for this test is
outside the hospital’s
“Critical Range” (greater
than 400 mg/dl)
The “Range” button
will be flashing “Out of
Critical Range” (to
alert you)
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Exceeded Critical Range - 129
Out
of Critical Range
Order STAT Lab Glucose
Press “OK” to continue.
Comments
OK
1234567
505
Out of Critical Range
The “Comments” button
will also be flashing to
alert you a comment is
required for this result.
Press the “Comments”
button to add a comment.
Comments
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ACCU-CHEK® Inform Full Training
Screens While Adding Comments
Run STAT lab
Press the
comment(s)
you want
to add
Run STAT lab
Custom button
to add a “custom”
comment
Down button
for the next
4 comments
• use the down arrow button to scroll to the next 4
comments if needed
1234567
• to de-select a comment, just press it again
Your comment
or comments
• you may add up to three (3) comments per test
• you may also add a custom comment by pressing the
“Custom” button
• when you are complete, press the “Forward Arrow
Button” to get to the summary screen (see right)
505
Out of Critical Range
Run STAT Lab
Comments
Summary Screen
• press the “Forward Arrow Button” when done
V2.1 12/2004
It will turn dark
to let you know
the comment
is selected
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ACCU-CHEK® Inform Full Training
Miscellaneous Information
• The Accu-Chek INFORM® has been programmed by SMH to warn you (and eventually
lock you out) if the meter has not been downloaded after a certain time period (you may
use any download station within the hospital).
• Only valid (certified) operators will be allowed to use the meter (all others will be
locked out). You must be certified annually.
• If cleaning is required, you may either use alcohol, a damp cloth with a soapy
solution or a 10% bleach wipe (to disinfect). Dry off the meter with a soft towel after
cleaning. Do not saturate the meter or place a damp meter into a docking station.
• If a replacement meter is needed, a replacement meter should be available in the
laboratory.
• Keep the lid tightly on the strip vial (strips expire the date on the vial). Do not use
strips that have been left out of the strip vial. Write the date on each new bottle of
glucose controls (the discard date on control bottles is 3 months after opened).
V2.1 12/2004
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Copyright © 2004 Roche Diagnostics
ACCU-CHEK® Inform Full Training
Troubleshooting Tips
Tips regarding docking and un-docking the meter:




Always wait 3-5 seconds after taking meter off base unit before pressing the Purple Power
Button to turn the meter on.
NEVER place a wet meter (from cleaning or a spill) into the electric docking station.
Make sure the ACCU-CHEK® Inform meter is OFF before docking in base unit.
Whenever you dock the meter, you should see a box around “Transmitting” for 15 to 45
seconds (after that you will see a box around either “Connecting” or “Idle”).
If you have any issues with the meter not responding, you may reset the
meter. TO RESET THE ACCU-CHEK® INFORM METER:



Turn the meter over. Locate small hole on the bottom right side of the ACCU-CHEK® Inform
meter (on battery cover).
Insert a large paperclip or the blue pin from a Roche Safe-T-Pro™ lancet and push the
“recessed reset button” for about 1 second.
The “Palm Computing Platform” will appear on the screen and the meter will restart. Re-dock
the meter and allow it to “Transmit”. You will not lose any patient data by resetting the meter.
Recessed Reset Button
•
V2.1 12/2004
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ACCU-CHEK® Inform Full Training
Fingerstick Glucose versus a Venous Puncture Glucose
Performed in the Laboratory
• In the non-fasting state, capillary (finger stick) blood glucose levels can
be up to 70 mg/dL higher than venous (lab draw) blood glucose levels¹.
• Glycolysis (the breakdown of glucose) can be another cause for a higher
meter-to-lab analyzer comparison². One of the main benefits of using a
bedside meter is the elimination of the issue of glycolysis, especially in
neonate samples². Be sure to send the blood sample immediately to the lab
for processing within 30 minutes.
• In situations of decreased peripheral blood flow, fingerstick blood testing
may not be appropriate (i.e. severe dehydration - increased plasma sodium in
the critical range, hypotension, shock or peripheral vascular disease).
• Underdosing the Accu-Chek® Comfort Curve™ strip can lead to erroneous
readings. All users should be aware that the yellow window of the strip must
be completely filled during the entire process.
¹ Tietz Textbook of Clinical Chemistry, 2nd Edition; Carl A. Burtis and Edward R. Ashwood, Editors; 1994; Page 959.
² Tietz Textbook of Clinical Chemistry, 2nd Edition; Carl A. Burtis and Edward R. Ashwood, Editors; 1994; Page 959 and 1975.
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