Transcript SURESTEP®FLEXX GLUCOSE MONITOR Nursing Orientation Ann E. Snyder MT(ASCP) Point-of Care Testing Coordinator OBJECTIVES Upon completion of this presentation the participant will be able to:  Describe use.

SURESTEP®FLEXX
GLUCOSE
MONITOR
Nursing Orientation
Ann E. Snyder MT(ASCP)
Point-of Care Testing Coordinator
OBJECTIVES
Upon completion of this presentation the
participant will be able to:
 Describe use and storage of glucose test strips.
 Describe use and storage of glucose control
solutions - High and Low
 Identify the function and location of key parts
of the SureStep Flexx Glucose Monitor.
 Describe the process for cleaning the Glucose
Monitor
OBJECTIVES
 Demonstrate use of the SureStepFlexx glucose
meter by:
 entering operator ID using the barcode scanner
 testing quality control
 Guiding Messages/QC Messages for FAILED
quality control
 entering Visit number (V00XXXXXXXXX)
 State critical ranges for adult/ pediatric and
neonatal patients.
OBJECTIVES
 Demonstrate how to review patient data stored
in the glucose meter.
 Explain the process for ordering necessary
equipment and supplies for glucose testing.
 Describe requirements for 6 month
competency/ Annual Certification.
 Location of the four (4) policy/procedures
pertaining to glucose testing at GBMC.
SureStep®ProTest Strips
(Reagents)
 Lot #, code # and expiration date are located
on the side of the reagent bottle.
 Document open date on vial when first
opened. SCOTCH TAPE IS OUR FRIEND
 Test strips can use capillary, venous or arterial
blood.
 Store tightly capped in original bottle
 Remove test strip and replace cap (twist
closed) immediately.
SureStep®ProTest Strips
(Reagents)
 Do not transfer test strips to a new bottle or
other container.
 Do not use if bent,torn,cut or damaged in any
way.
 Discard unused portion four (4) months after
opening bottle!
SureStep®Pro
Glucose Control Solutions
 LOW and HIGH levels of quality control tested
once every 24 hours when testing patients.
 Lot # and expiration date located on side of bottle.
 Solution expires in 3 months after opening Discard unused portion.
 Do not refrigerate, store at room temperature.
 CAUTION: Solution contains dye that stains
clothing.
 Always shake solution before testing.
SURESTEP FLEXX BLOOD
GLUCOSE MONITOR
Where is the:
• On/Off Button
• LCD Touch Screen
• Quick Keys
• Test strip holder
• Serial number
• Battery Replacement
• Barcode Scanner
Cleaning the Meter
DO:
DO NOT:
• Disinfect/Clean as
• Submerge in water.
warranted, tap water
• Use paper towels, alcohol,
ONLY.
glass or abrasive cleaners,
• Clean strip holder by
phenol or ammonia
popping out and placing
products.
under running water.
• Gently wipe lens area
with a damp cotton
swab.
• Document “Cleaned
Meter” in the QC Notes.
BARCODE SCANNER
Location - a low grade laser at the end of
the instrument.
Safety Issues
- do not look directly into the light
- do not shine the light into someone’s eyes
The beam does not transport the person to
another room.
METER OPERATION
Status Screen
Main Menu
- Patient Test
- QC Test
- Review Data
Quality Control Tests
 (Use Operator Certification Checklist)
QUALITY CONTROL
 ALWAYS confirm open/expiration dates
 ALWAYS confirm lot number of quality
control and test strips in the glucose meter
before proceeding with test!
 The highly absorbent application area removes
moisture away from the surface of the strip.
(Practice applying sample to test strip by
touching test strip with the control solution to
absorbent area of strip)
QUALITY CONTROL
All QC documentation and maintenance
will be done in the meter.
Operator will only see “Passed” or “Failed”.
Meter will “Lock out” if meter indicates
FAILED
every FAILED QC must have a QC
comment - “Enter Note” button
CORRECTIVE ACTIONS IF QUALITY
CONTROLS INDICATE “Failed”
•
•
•
•
Retest patient
Clean the meter
Use new control solutions
Shake control solutions before use
PATIENT TEST
 Visit # (V#) is printed on admit label or patient
ID bracelet.
 Unregistered Patients - Last Name, First
initial; use only until Visit # available.
(Alpha/numeric patient ID function is available
ONLY to NICU/NBN.
 Isolation Patient - set up instrument in the
CLEAN AREA OUTSIDE PATIENT”S
ROOM, and collect the blood.
 You may not add blood to the pink test area if
the first sample did not completely cover the
required test area
Hurrah!
Patient Barcoding is Here
Patient ID Bracelet
POSITIVE PATIENT IDENTIFICATION
Patient Last Name, First Name
Age
DOB XX/XX/XX
DOS XX/XX/XX
V00XXXXXXXXX MR:M000XXXXXX
Attn Dr. Doctor, Hello M.D. Svc. GOR
CRITICAL WARNING
MESSAGES
 Critical Range for Adult/Pediatric Patient
“Critical Low” “Critical High”
<50mg/dL or >450mg/dL.
“HIGH” = glucose > 500 mg/dL
 Critical Range for Neonate Patient
<45mg/dL or > 150 mg/dL.
 Hematocrit Limitations:
- Adult/Peds: 25-60%
- Neonates: 25-65%
 Patients with results beyond these percent limitations may have
inaccurate blood glucose meter results
CRITICAL WARNING
MESSAGES
 Critical values must be confirmed by repeat on the
SureStep Flexx glucose meter. Each critical value must
be accompanied by a patient message which is selected
from the glucose meter.
 “Critical glucose values that do not fit with the clinical
and physical presentation, as determined by the nurse,
will be repeated and notified directly to the physician.”
 It will be the responsibility of the physician to
determine whether a confirmatory stat serum glucose
(red top tube) is to be drawn and sent to the laboratory.
Patient Messages
1. Procedure Error
2. Repeated Test
3. MD Notified
4. RN Notified
5. Known DKA/HNK
6. SS Insulin
7. Treated Patient
8. Sent to Lab to Confirm
DATA REVIEW
Enter V# to review glucose tests performed
on the patient.
Meter stores 1500 data points of quality
control and patient data.
Stores patient data for one month.
DOWNLOADING DATA
Meter should not be stored in the cradle
when not in use.
Data Transfer begins when the meter is
placed in the cradle.
Download data after each series of patient
testing.
Meter is set to “lock out” operator if
downloading has not occurred.
ORDERING SUPPLIES
Use Laboratory Order Form. (See Handout)
Monitor stocking of order form supply.
Monitor Supplies include:
- SureStep®Pro Test Strips (50/box)
- SureStep®Pro High Control
- SureStep®Pro Low Control
Competency Assessment
 New Staff
- each operator must perform quality control once
within first 6 months of training to maintain
competency
- meter will indicate “Non-Certified Operator”
and prevent the operator from performing
patient testing
Annual Competency
Clinical P&Ps on GBMC Intranet
PPP updated 03/04/05
CONGRATULATIONS