Super User training guidelines for the Nova StatStrip glucose meter

advertisement
University of Utah Hospitals and Clinics
Salt Lake City, Utah
Page 1 of 5
rev 11-8-13
StatStrip Super User training guidelines
Some things about the meter to be aware of:
The “power” button on the meter does not logoff the operator or turn the meter off.
It just puts the meter into standby.
The battery can drain on this meter if it is left off the charging dock.
The meter will go into standby (the screen will go dark, after 90 seconds of inactivity.
The meter will logoff the operator after 5 minutes of inactivity, or upon docking.
The scanner comes out the bottom of the meter.
The strips fill from the end and must be filled in a continuous dose.
If the strip is not filled the first time, you cannot add more.
Strips and Controls must be dated when opened. Upon opening, fill in the date fields on the labels.
(E.g. if the label has both “open” and “discard” fields, fill in both. If the container only has a “discard” field,
use that.)

Once opened,
o Strips are stable for up to six (6) months,
o Controls are stable for up to three (3) months,
o Or until the manufacturer expiration date listed on the container, whichever is first.
Note: If a container is found in use with the date(s) worn off or illegible, the container should be
treated as if it is undated. (See above). If only one date is used, it should be the discard date.
(This is because it is the expiration date that changes when reagents are opened.)
A marker writes best on the labels. If you use a separate sticker, then clearly mark the
date. (E.g. “discard”, “use by” or “expires”).
Be careful not to let the date(s) wear off. (E.g. cover the date with clear tape.)
The meter needs to be kept level during testing.
Excess blood or control solution can easily run down the strip and get into the strip port.
This can disable or completely ruin the meter and is the number one cause of disabled meters.
The linear range of the meter is 10-600 mg/dL.
This means that the meter will give you a number anywhere in this range but…
The reportable range for this meter is 60-500.
Any result displayed outside this range should be reported as <60 or >500.
Training:
Each trainee needs to know where the official copy of the procedure can be located, and should review it
before doing patient testing. They can be given a copy of the procedure during training.
Review the StatStrip Initial Training Module.
Use the script if needed.
Have the trainee do the hands-on.
Both controls should be run so that they can get comfortable with the meter.
Note that the meter defaults to patient testing at the welcome screen.
To run QC, touch “QC” on the screen.
University of Utah Hospitals and Clinics
Salt Lake City, Utah
Page 2 of 5
rev 11-8-13
StatStrip Super User training guidelines
Documentation:
Make sure the StatStrip initial training sheet is completely filled out.
Return the completed form to the educator to keep and file.
Forward a request to have the trainee’s badge access activated.
Trainer script:
Procedure binder:
Review procedure. Note limitations.
Each trainee should review the procedure before testing patients.
Note limitations.
Proper sample collection, reagent storage and patient conditions can all affect
the glucose result.
Refer to the procedure for factors that can affect the glucose result, when the
use of the meter is inappropriate and when a sample needs to be sent to the
lab.
Each unit has an official copy of the procedure
The trainee needs to know where the procedure can be located. Some units
keep a paper copy in a binder near the meter. Procedures can be found on
Intercomm>>Clinical>>Laboratory Services>>Point of Care.
Meter:
Touch screen, hard and soft buttons, On/Off/Sleep button
The “power” button does not logoff the operator, or turn the meter off.
The power button only puts the meter to sleep. So, the battery can drain on
this meter if it is left off the charging dock.
Operators should manually logoff when done. (The meters will also logoff an
operator after 5 minutes of inactivity or upon docking.)
The “soft” buttons on the touch screen that are above the “hard” buttons
(arrows and OK) are interchangeable.
Strip port and Scanner (avoid eyes)
Strip port in the top.
Scanner beam comes out the bottom.
Keep still and horizontal when testing
The meter needs to be kept level during testing. Blood or control solution can
easily run down the strip and get into the strip port. This can disable or
completely ruin the meter and is the number one cause of disabled meters.
Dock:
3 lights: left=networked, center=transmitting, right=charging
Spare battery
Reagents:
Strips:
Front fill
Touch the front edge of the strip to the drop. If the drop is applied to
the top of the strip, nothing will happen. The top is sealed.
Do not re-dose
University of Utah Hospitals and Clinics
Salt Lake City, Utah
Page 3 of 5
rev 11-8-13
StatStrip Super User training guidelines
The strips fill from the end and must be filled in a continuous dose. If
the strip is not filled on the first time, you cannot add more. Simply
get a new strip and dose again.
Date vials when opened, 6 month expiration
Vials are good for 6 months or until manufacturer expiry, whichever
comes first. Vials past expiry should be discarded.
Keep vials closed and at room temperature
Do not remove the strip from the vial until ready to use.
Controls:
2 levels
Date vials when opened, 3 month expiration
Vials are good for 3 months or until manufacturer expiry, whichever
comes first. Vials past expiry should be discarded.
Keep vials closed and at room temperature
QC testing:
QC lockout every 24 hours, requires that both levels pass
Other times to run QC (new strips, “drop”, as a check)
In addition to the daily QC, you should also run QC:
If you open a new vial of strips.
Each new vial of strips should be checked with both levels of QC before
using them for patient testing.
If the meter is ever “dropped”.
There may be no visible damage, but the meter should be checked
with QC.
If you are questioning the result, you can check the meter’s performance by
running QC.
Failed QC follow-up, do not just rerun until the QC passes, see procedure
The procedure lists steps to resolve failed QC and minimize the number of
repeats attempted. Failed QC results require a comment on the meter.
Mix vial and waste first drop
Running the wrong vial
Common sources of failed QC are:
Running a vial other than the one scanned.
Not mixing the vial before testing.
Discarding the first drop when repeating QC can help.
Patient testing:
Hospital Patient ID policy
Patient ID# from wristband. MRN vs CSN barcode.
The linear barcode on the wristband is the CSN, which can be scanned.
The MRN can also be entered on the meter manually.
Wear Gloves
Proper finger-stick technique
See procedure. All new trainees should perform this under observation during
the hands-on. They can perform it on themselves. Emphasize the need for a
clean dry finger and wiping away the first drop of blood and that if it is
difficult to get a drop of blood, the result could be inaccurate.
Venous and Arterial line draws, result documentation: training done by unit.
Procedure also has some guidelines for line draws.
Documentation may be a unit specific form, such as MediTape, or manual
entry into the EMR.
Results:
Normal range is 64-128 mg/dL, results displayed in blue
University of Utah Hospitals and Clinics
Salt Lake City, Utah
Page 4 of 5
rev 11-8-13
StatStrip Super User training guidelines
Results outside this range are red and have 1 arrow
Critical range is <60 or >450 mg/dL, results outside this range have 2 arrows
Critical results must be communicated to the clinician
Critical results require a comment in the meter
Linear range is 10-600 mg/dL, Reportable range is 60-500 mg/dL
Results outside this range display as HI or LO, must use lab
Lab recommends that unexpected and critical results be confirmed by lab
Linear range means that the meter will give you a result anywhere in the
range of 10-600 but…
The reportable range for this meter is only 60-500.
Any result displayed outside the reportable range should be reported
as <60 or >500.
The laboratory also recommends confirmatory testing for results outside the
reportable range or anytime you question the meter result.
Cleaning:
Clean after each patient with a disinfectant wipe
Such as Sani-Wipes or Clorox wipes.
Note the wipe’s manufacturer recommended contact time.
Avoid liquid pooling on meter or getting into any ports
Wipes should be damp, not dripping.
Do not spray the meter with disinfectant.
Also avoid the electrical connectors for docking and charging.
Meter should be dry before docking
To avoid electrical shock, damage to the meter and risk of fire.
Quiz:
1. Once opened, controls are good for up to 3 months,
strips are good for up to 6 months
2.
Besides daily, list two other times to run controls?
New strips, Dropped meter
3.
If you under-fill the strip, can you re-dose?
Yes
4.
What patient IDs are entered into the meter?
5.
What two things must be done with critical results?
No
MRN or CSN
Notify Clinician, Comment on the meter
6.
What is the range in which the meter will display a result?
10-600 mg/dL
7.
What is the result range that can be reported?
10-600 mg/dL
8.
60-500 mg/dL
60-500 mg/dL
What is the acceptable hematocrit range for this meter? 20-65%
Review the Quiz and correct any wrong answers with the trainee.
University of Utah Hospitals and Clinics
Salt Lake City, Utah
Page 5 of 5
rev 11-8-13
StatStrip Super User training guidelines
Hands-on competency:
Under the observation of the trainer
Run both levels of control
Perform a patient test
Enter “training” comment (optional)
Review past results (optional)
Logoff
Clean the meter
Have the trainee do the hands-on. At a minimum, both controls should be run so that they
can get comfortable with the meter. Also, all new operators should be observed doing a
fingerstick.
Note that the meter defaults to patient testing at the welcome screen. To run QC, touch
“QC” on the screen.
The most common problem people have is not realizing when the strips have been scanned
while doing QC. The screens that prompt you to “enter strip lot” and “enter QC lot” only
differ by the text at the top of the screen. If you are getting an “invalid lot” error, you may
be scanning the strip container when the meter is asking you to scan the QC bottle.
Any questions?...When you feel that you have been adequately trained and are
ready to perform this procedure, please sign below.
The trainee should not sign this if they have any questions.
Trainee signature:
Trainer signature:
Date:
Date:
Sign if the trainee demonstrates a good grasp of the procedure.
If the trainee displays a poor grasp of the procedure, a retraining will have to be scheduled.
Trainer Comments:
Make sure the StatStrip initial training sheet is completely filled out.
Return the completed form to the educator to keep and file.
Request to have the trainee’s badge access activated.
Download