inform ii - barnsley hospital

Guide for Trainers

Inform II

6452 AccuCheck Inform II linktrainer21.2.11.indd 1 24/02/2011 10:31

How to use

Thank you for being a Link Trainer for Point of Care Testing (Blood Glucose).

This document is to be used as a guide to enable a progressive learning experience during blood glucose training sessions that you deliver.

The information and instructions contained in this document are for guidance only and do not supersede the information and instructions contained in the Operator Manual, Package Inserts, Hospital Standard Operating Procedures (SOP) or Product Bulletins.

Please make any changes to the guide that are appropriate based upon your hospital/department SOP’s. Roche has made all reasonable efforts to ensure that the information contained in this guide is correct at the time of printing. However, Roche reserves the right to make any changes necessary without notice as part of ongoing product development.

Any updates will be sent to the nominated Point of Care Testing Training Co-ordinator in your hospital/department.

Explanation of the document layout

ReferenceThe location of additional information or further reading materialShowRecommendation to show or demonstrate an aspect of the current topic ExplainImportant/Key points that you should mentionQ&ASuggested questions to trigger discussion during your training sessionNotesThis area is for you to add any key learning points, relevant information or additional questions specific to your ward or department


Link Trainer for Inform II

The Roles And Responsibilities

To casacade training and updates to all staff that perform Point of Care Testing on the Ward/Department at agreed intervals. The training must include reference to Hospital Policies, Contra-Indications and Test Interferences.

To maintain a record of all staff trained or updated and to give a copy of this record to the relevant person/authority within the Trust.

To inform the relevant training co-ordinator of any people that decline mandatory update training.

To ensure that the Point of Care equipment is maintained in accordance with departmental or hospital policies.

To attend regular Link Trainer sessions provided by the department or hospital.

To feedback any queries that arise from the sessions you run to the relevant training co-ordinator.

Notes


Tools needed for the training session

Meter

Strips

QC solutions

Lancing device

Local Blood Glucose testing policy

Attendance sheet

Notes


Training Guide Sections

1. Why Training?

2. Meter and Strips

3. Quality Control

4. Patient Preparation

5. Laboratory Involvement

6. Further Reading and References


1. Why Training?

All nursing staff are responsible and accountable for ensuring that they keep up to date with their personal training needs.

Reference: Section 6 of this document

Q: Who says it is important?

A: Department of Health MHRA NMC ABA RCN Local Policy

Notes


Base Unit

TouchScreen

On/Off Button

Test StripPort

2. The Meter

ExplainConnected meterAutomatic data transferOperator ID: unique and never sharedPatient ID: audit trail and clear identification of resultsBarcode scanning of both

Show On/Off buttonTouchscreen Press with fingertips only What to do if damaged Scanner Dangers of laser in eyesStrip portBase Unit

Reference: Chapter 1 of Operator Manual

Notes


2. The Strips

Show pot of strips

Clean dry handsImportance of closed lid Information on the label

Explain

Calibration done centrally

Show single strip Gold end in meterWhere and when to doseMeasurement range of meter (0.6 – 33.3 mmol/L)

Explain

Use of arterial/venous blood

Reference: page 35 – 37 of Operator Manual

Q: Why must the lid be kept closed?

A: Accurate results; patient safety

Notes

Golden End(Electrodes)

Yellow Window


3. Quality Control

QC is run to test the accuracy of Meter Strips QC Solution Operator

Show Running a QC

Explain Getting rid of the first dropExpiry dates (3 months from opening)Content of solutions (Sugar water & dye)What to do if the QC fails


Q: When do you run a QC Test?

A: Hospital policy/pot change/unexpected patient result/ dropped meter

Notes


3. Quality Control: Maintenance

Explain Cleaning meter What to use daily What to use for blood contamination

Where to obtain New strips New solution New meter New workstation

Troubleshooting

Reference: Chapter 10 and 11 of Operator manual

Notes


4. Patient Preparation

Explain Gain consent

Handwashing Water and non-lint gauze Dry thoroughly

Infection Control

Suitable sites for lancing Importance of finger choice Where to avoid Neonatal choices What lancing device

Obtaining a blood sample

Health and safety Disposing of strip and lancing device


Notes

Q: What are the risks of improper handwashing?

A: Erroneous results; Inappropriate treatment; Patient infection (show photo if appropriate)


5. Laboratory Involvement

Explain

When to take a venous sampleWhy a venous sample should be usedWhere the venous sample should be sent

Show strip pack insert

ExplainWhy pack insert must be readContra-indications and test limitationsMost up to date reference

Q: When should you not use a capillary sample?

A: Dehydration; Diabetic Keto-Acidosis (DKA); Shock; Hyperosmolar non-ketotic coma (HONK); Peripheral occlusive disease; hypotension; decompensated heart failure NYHA Class IV ; impaired peripheral circulation

Reference: MDA Safety Notice 9616 (June 1996)

Notes


Training Key Points

• Always check for contra-indications & test interferences, details of which are found in the strip pack insert and the Operator Manual.• The code chip in each pot of test strips is for calibrating unconnected meters.• Ensure the yellow test pad is completely filled with blood/QC solution.• Never touch the LCD screen with sharp/pointed objects.• Never share your Operator ID with anyone else.• The quality control solutions only last 3 months from the date of opening. Remember to write this date onto the quality control solution bottles.• Other times to perform quality control: Every new pot of test strips If the meter is dropped If you get an unexpected result New meter• If the quality control test fails, remember to add a comment, then exclude user error, solutions & test strips before contacting the laboratory.• Maintain good hand washing techniques, yours and the patient.• Remember to always wear gloves.• Maintain good finger lancing technique & use the correct procedure for obtaining a capillary blood sample.• Ensure all blood glucose results are recorded according to local policy.

6. Further reading and references


References:

Blood Glucose Measurements: Reliability of Results Produced in Extra-Laboratory Areas.DoH(HN(Hazard) (87) 13)Extra Laboratory use of Blood Glucose Meters & Test Strips: Contra-Indications, Training & Advice to the Users. MDA Safety Notice. MDA SN 9616 (June 1996)NMC: Code of Professional Conduct (2008)NMC: Records & Record Keeping (2007)NMC: Accountability (2008)An Bord Altranais: The Code of Professional Conduct for each Nurse and Midwife (2000)DoH: NHS Knowledge & Skills Framework (2008)Atkin, S. H et al. Fingerstick Glucose Determination in Shock. Annals of Internal Medicine, 114: 1020-1024 (1991)Sandler, M. et al. Misleading Capillary Glucose Measurements. Practical Diabetes, 7: 210 (1990)Wickham, N.W.R et al. Unreliability of Capillary Blood Glucose in Peripheral Vascular DiseasePractical Diabetes, 3: 100 (1986)

Further Reading:

www.roche-diagnostics.co.ukwww.cobas-roche.co.ukwww.mhra.gov.ukwww.imb.iewww.diabetes.org.uk

6. Further reading and references

www.diabetes.iewww.nmc-uk.org.ukwww.rcn.org.ukwww.nursingboard.iewww.who.int/diabetes/fact


COBAS, ACCU-CHEK and LIFE NEEDS ANSWERS are trademarks of Roche © 2010 RocheInformation correct at time of going to print, 2010Roche Diagnostic Limited, Charles Avenue, Burgess Hill, RH15 9RYHead office 01444 256000www.roche-diagnostics.co.uk

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