Accu-Chek Inform II

Accu-Chek Inform II
Accu-Chek Inform II: Training Powerpoint
ACCU CHEK Inform II
ACCU-CHEK
Operator Training
Provincial Health Services Authority
ACCU-CHEK, ACCU-CHEK INFORM, ACCU-CHEK PERFORMA and COBAS are trademarks of
Roche. All other trademarks are the property of their respective owners.
Accu-Chek Inform II
Preliminary Review for Hands On Training
Complete Quiz at the end of this session
1. AccuChek Inform II System Components
2. AccuChek Inform II Meter
3. AccuChek Inform II Test Strip & Quality Control Material
4. Key Points
5. Cleaning the meter
6 Operator ID & ongoing competency
6.
7. Perform a quality control test (QC) – Hands On
8. Perform a patient test – Hands On
9. AccuChek Inform II Meter ranges
10. PHSA Normal/Critical ranges
11. View results
12. Quiz
2
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
System Components
Base Unit (BU)
•Automatic data transfer and
battery charge.
•Connected
C
t d tto network
t
k & power
outlet
•Blue light – indicates data transfer.
Accu-Chek Inform II
Tote Box
•Green light - charging and properly
placed in BU
Meter, strips,
Meter
strips disinfectant
swabs, Control 1 & 2,
lancets, capillary pipettes.
g – BU is first p
plugged
gg into
•Red light
power outlet with no meter seated.
Quick Reference Guide
3
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Meter Components – meter front view
Test Strip
p Port
B
Barcode
d S
Scanner (L
(Laser))
TouchscreenMain menu
with 3 options
(finger touch
only )
•Operator ID
•Patient ID ((in future))
•Control Solution 1 & 2
•Inform II test strips
On/Off Button
4
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Meter Components – meter back view
• Meter re-set button
(for meter freeze situation, press gently with paper
clip a few seconds to re-boot)
•Re-Chargeable Battery Pack
•Charging Contacts
(To Base Unit)
•Infra-red contact to upload lot information
5
Accu-Chek Inform II Operator Training
Accu-Chek Inform II - Quality Control (QC)
Accu-Chek
Accu
Chek Performa Controls Levels 1 & 2
•Provided by Point of Care Testing - LAB
•All Lot #’s validated by Point of Care Testing
•Control 1 and Control 2
•One
One Lot # per year
ear
•Stored @ Room Temperature
•Expiry
p y date on vial is for “closed” vial expiry
p y
•Open vial Expiry is 3 months – Point of Care –
Lab will date the vials with open date
•Shake vial well before each use. Replace cap immediately.
Caution: Blue dye- will stain clothing
6
Accu-Chek Inform II Operator Training
AccuChek Inform II – Key Points









Operator ID as per current practice
practice. Barcode or Manual Entry
Entry.
Test Strip is inserted into the meter BEFORE blood is applied.
p Application:
pp
Apply
pp y to FRONT EDGE of test strip
p
Sample
Sample size:
0.6 microliters
Result time:
5 seconds
A l ti l Measuring
Analytical
M
i
Range:
R
0 6 mmol/L
0.6
l/L - 33.3
33 3 mmol/L
l/L
Hematocrit Range:
10 – 65 %
Clean meter after each patient use with CAVIWIPES.
Dock meter in BU after each use – Data exchange & Maintain
charge.
 Replace
R l
Meter
M t Tote
T t in
i appropriate
i t storage
t
area.
7
Accu-Chek Inform II Operator Training
AccuChek Inform II – Glucose Meter
Ongoing Operator Competency
Consistent with Current Protocol:
 Maintain with the use of your unique Operator ID #
 Enter with Barcode Scan or Manual Entry
 Not shared with other staff
Minimum Requirements:
 2 sets of Quality Control (Control 1 and Control 2) per year
 2 Patient Tests per year
 Operator Lock out if requirements are not met within the year
8
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Cleaning the Glucose Meter
Meter, Base Unit
Only use the Manufacturer approved Cleaning Wipe
Caviwipes @ PHSA – pre-moistened cleaning wipe
with Cavicide Surface Disinfectant/Decontaminant Cleaner
Glucose meters are cleaned & disinfected:
 After each patient use
 When visibly soiled
Base Unit & Supply totes are cleaned & disinfected:
 Weekly at a minimum
 When visibly soiled
9
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Cleaning the Glucose Meter - contd.
contd
D
Do nott allow
ll
pooling
li off th
the disinfectant
di i f t t solution
l ti from
f
the
th
towelette on the touch screen.
 Do not allow disinfectant solution to enter the test strip
port on the meter.
 Do not allow electrical contact points on the Glucose
Meter or Base Unit to become saturated with disinfectant
solution. Dry contact points well.
10
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Cleaning the Glucose Meter - contd.
contd
To Clean Visible Soil:
 Wear
W
gloves
l
 Use one Caviwipe towelette
 Completely clean the surface of all gross debris.
debris
 Discard the towellete & remove gloves
 Follow by
y disinfecting
g the surface
To Disinfect / Decontaminate:
 Wear a second pair of gloves
 Obtain a second Caviwipe towelette
 Thoroughly wet the surface
 Allow
All
the
th surface
f
to
t remain
i wett for
f 3 minutes.
i t
11
 Wipe Dry with soft cloth or tissue
11
Accu-Chek Inform II Operator Training
Performing a Quality Control Test
Glucose Meters, Base Units & Supply Totes are labeled
Obtain corresponding Supply Tote
Remove meter from base unit.
1. Press and release the On/Off button
2. Meter performs a Self Check
3. ‘Power Up’ screen appears
4. Confirm date and time
5. View battery “life” symbol in bottom right corner
6 Proceed
6.
P
d to
t the
th nextt screen
•
Manually - touch the arrow symbol
•
Automatically - after 5 seconds
12
Accu-Chek Inform II Operator Training
Entering an Operator ID M
Manual
l Entry
E t
Picture
with
operator
ID
screennot QC
• Touch the
symbol to backspace and
delete a character entered incorrectly
• Touch
symbol to confirm
Once entry is complete, the main menu appears
13
Accu-Chek Inform II Operator Training
Entering an Operator ID –
Barcode Scanner
To SCAN the Operator ID using the barcode reader:
1. Touch and release the ‘Scan’ symbol
in
top right corner of screen (black background=scan
mode)
2. Hold meter so window of scanner is 4-8 inches
above barcode you wish to read.
Meter beeps once the barcode has been read
successfully and info scanned appears on screen.
Scanner turns off after 5 seconds
seconds.
14
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Quality Control (QC)
1 Touch ‘Control
1.
Control Test
Test’
2. Touch Level 1 (Lo) or Level 2 (Hi) to
select the level for the test desired.
Note:
QC testing is required every 24 hours –
both Level 1 and Level 2.
Glucose Meter will be locked out until QC
testing is completed
Screen will display the level of control
required
15
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Quality Control (QC) contd.
contd
Lot number entry – QC solution & Test Strip
3. Touch the barcode symbol at top right corner of screen to
enter the lot number of the Quality Control Solution
Scan the lot number on the control solution vial - hold meter so
scanner is 4-8 inches in front of vial barcode
T
Touch
h
to
t confirm
fi the
th scanned
d lot
l t number.
b
Repeat procedure to scan the test strip vial.
4. Touch the barcode symbol at top right corner of screen to
enter the lot number of the Test Strip Vial.
NOTE L
b
ll entered
t
d
NOTE:
Lott numbers
cannott b
be manually
16
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Quality
y Control ((QC)) contd.
5.“Flashing Arrow” symbol appears.
Insert test strip into test strip port.
Test Strip Port at the top of meter.
meter
6.“Flashing Drop” symbol appears.
Meter is ready for QC sample.
Mix the control vial by gently inverting 5 times
Remove cap and wipe vial with tissue
Discard first drop and apply 2nd drop to the FRONT EDGE
off the
th test
t t strip.
ti
Note:
Test strip is ALWAYS inserted in the meter BEFORE application of QC solution.
Position the meter on a flat surface or downwards – DO NOT allow liquid in test strip port.
17
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Quality Control (QC) contd.
contd
Numeric QC Result will appear in 5 seconds
“RANGE” symbol
b l will
ill appear when
h QC value
l iis within
ithi th
the QC range.
“Out of Range” symbol will flash when QC value is not within the QC range.
g symbol
y
7. Touch “RANGE” or “Out of Range”
to view the QC range.
Note: A comment is required if result is out of range or there is
an error code.
Touch
to return if QC is in Range.
For “Out of Range” QC:
Touch
symbol in lower left corner of screen
Pre-programmed comments will appear.
Up to 3 comments can be selected.
T
h
i lower
l
i ht tto confirm
fi selection.
l ti
Touch
in
right
Then
again to return.
Accu-Chek Inform II Operator Training
Note: Comments cannot be edited once Control Result Screen is exited.
Accu-Chek Inform II
Perform a Patient Test
1 Touch ‘Patient
1.
Patient Test
Test’
2 Next
2.
Ne t Screen displa
displayed
ed will
ill ask for Patient ID
ID.
Pass through this page.
Note: Use of Patient ID is not activated @ PHSA
3. Confirm selection of Patient Test
Touch
in lower right corner of screen.
19
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Patient Test contd.
contd
To Enter the test strip lot:
4. Touch the barcode symbol
4
the lot number of the Test Strip Vial.
at top right corner of screen to enter
Scan the lot number on the test strip vial – hold the meter so
scanner is 4-8 inches in front of vial barcode
Touch
to confirm the scanned lot number.
5. “Flashing Arrow” symbol appears.
Insert test strip into test strip port.
T t Strip
Test
St i Port
P t att the
th top
t off meter.
t
Note: Test strip is ALWAYS inserted into the meter BEFORE application of patient
blood sample!!
20
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Patient Test – contd.
contd
6.“Flashing Drop” symbol appears.
(up to 10 minutes to apply sample before meter times out)
C simulate
Can
i l t with
ith a Li
Linearity
it sample
l d
during
i ttraining.
i i
Meter is ready for Patient sample.
Follow institutional guidelines for the capillary puncture.
Select puncture site
Choose appropriate capillary puncture device
Puncture site is clean. If required, clean site with soap & water.
Disinfect with 2% chlorhexidine in 70% isopropyl alcohol
Perform skin puncture
Allow puncture site to Air Dry.
Remove first drop of blood. (removes contaminants/residual disinfectants & any possible dilution effect).
Apply 2nd drop to the FRONT EDGE of the test strip.
Note: Arterial or line samples may be used.
Touch the first drop to a gauze/tissue before application to the front edge of the test strip
strip.
Result appears after 5 seconds
21
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
Perform a Patient Test – contd.
contd
Neonate Collections – Incubators & Cribside
Neonate Samples may be collected in micro tubes prior to test strip application-see educator.
T
Touch
h the
th fifirstt d
drop tto a gauze/tissue
/ti
b
before
f
application
li ti to
t the
th front
f t edge
d off the
th test
t t strip.
ti
Application with micro-collection rod
Application with micro-collection pipette
22
Application directly from neonate heel
Accu-Chek Inform II Operator Training
Accu-Chek Inform II –
Patient Testing contd.
contd
Common Screen Shots Seen after Patient Testing
Numerical Glucose value will display @ PHSA if within 0.6-33.3 mmol/L
Touch “Range” Field to view the Normal, Out of Normal, or Critical Ranges
Normal Range
Neonates:
2.6 – 5.5 mmol/L
Action Ranges
Neonates:
2.0 - 2.5 & 5.6 – 10.0 mmol/L
Critical Results
Neonates:
< 2.0 & > 10.0 mmol/L
Pediatrics & Adults:
4.0 – 11.0 mmol/L
Pediatrics & Adults:
2.0 – 3.9 & 11.1-30.0 mmol/L
Pediatrics & Adults:
< 2.0 & > 30.0 mmol/L
23
Accu-Chek Inform II Operator Training
Reportable Range:
0.6 - 33.3 mmol/L
Out of Range Low:
< 0.6 mmol/L
Out of Range High
> 33.3 mmol/L
Accu-Chek Inform II
Perform a Patient Test contd.
contd
7. Touch “Range”
g Field to view the Reference,, Action,, or Critical Results
Ranges.
Note: A comment is required if result is out of range or there is an error code.
Touch
to return to the Main Menu and accept the patient test result.
OR Touch
symbol in lower left corner of screen if Comment required.
Pre-programmed comments will appear
appear.
Up to 3 comments can be selected.
Touch
in lower right to confirm selection. Then
Note: Comments cannot be edited once Control Result Screen is exited.
24
Accu-Chek Inform II Operator Training
again to return.
Accu-Chek Inform II Results Review
Patient or Quality Control
From main menu screen touch ‘Review Results’.
Stored test results are displayed in a sequential list
list.
Touch
or
to scroll up or down in the list. Results are grouped by date.
25
Accu-Chek Inform II Operator Training
Accu-Chek Inform II Results Review
Patient or Quality Control contd.
contd
•Touch an entry in list to display related details.
•Touch ‘Patient’ symbol to display results for a specific patient only.
26
Accu-Chek Inform II Operator Training
Accu-Chek Inform II
T t Strip
Test
St i Limitations
Li it ti
• Galactose
Elevated Galactose can occur in neonates with inherited
galactosemia (1 per 40,000 in BC).
The first glucose value for neonates > 5
5.5
5 mmol/L is checked
simultaneously with a lab glucose during the first 5 days of life.
Collect a lab draw prior to next scheduled feed.
•Triglycerides – Interference of meter is > 20 mmol/L far beyond
average values.
•Ascorbic Acid – Interference of meter is > 0.17 mmol/L ICU
patients receiving high dose IV ascorbic acid as support
support.
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Accu-Chek Inform II Operator Training
Accu-Chek Inform II –
On line educational material review, quiz, hands on training
with a competency checklist will complete training
requirements.
q
Once the requirements are met your Operator ID’s are validated
Hands on Training – Nursing Educators or Leaders will provide
a schedule of classes or roaming edu-quick times.
•Print name and ward on Sign in sheet.
•Complete and sign the Competency Check List
•Include
Include Operator ID
•Include PHSA location – ward or clinic area.
•Include work email
Return Check List to Trainer for POCT records 
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Accu-Chek Inform II Operator Training
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