cobas Accu-Chek Inform II User manual

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
Reference
The location of additional information or further reading material
Show
Recommendation to show or demonstrate an aspect of the current topic
Explain
Important/Key points that you should mention
Q&A
Suggested questions to trigger discussion during your training session
Notes
This area is for you to add any key learning points, relevant information or additional questions specific to your ward
or department
6452 AccuCheck Inform II linktrainer21.2.11.indd 2 24/02/2011 10:31

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
6452 AccuCheck Inform II linktrainer21.2.11.indd 3 24/02/2011 10:31

Tools needed for the training session
Meter
Strips
QC solutions
Lancing device
Local Blood Glucose testing policy
Attendance sheet
Notes
6452 AccuCheck Inform II linktrainer21.2.11.indd 4 24/02/2011 10:31

Training Guide Sections
1. Why Training?
2. Meter and Strips
3. Quality Control
4. Patient Preparation
5. Laboratory Involvement
6. Further Reading and References
6452 AccuCheck Inform II linktrainer21.2.11.indd 5 24/02/2011 10:31

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
6452 AccuCheck Inform II linktrainer21.2.11.indd 6 24/02/2011 10:31

Base Unit
Touch
Screen
On/Off
Button
Test Strip
Port
2. The Meter
Explain
Connected meter
Automatic data transfer
Operator ID: unique and never shared
Patient ID: audit trail and clear
identification of results
Barcode scanning of both
Show
On/Off button
Touchscreen
Press with fingertips only
What to do if damaged
Scanner
Dangers of laser in eyes
Strip port
Base Unit
Reference: Chapter 1 of Operator Manual
Notes
6452 AccuCheck Inform II linktrainer21.2.11.indd 7 24/02/2011 10:31

2. The Strips
Show pot of strips
Clean dry hands
Importance of closed lid
Information on the label
Explain
Calibration done centrally
Show single strip
Gold end in meter
Where and when to dose
Measurement 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
6452 AccuCheck Inform II linktrainer21.2.11.indd 8 24/02/2011 10:31

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 drop
Expiry dates (3 months from opening)
Content of solutions (Sugar water & dye)
What to do if the QC fails
Reference: Chapter 4 of Operator Manual
Q: When do you run a QC Test?
A: Hospital policy/pot change/
unexpected patient result/
dropped meter
Notes
6452 AccuCheck Inform II linktrainer21.2.11.indd 9 24/02/2011 10:31

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

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
Reference: Chapter 3 of Operator Manual
Notes
Q: What are the risks of
improper handwashing?
A: Erroneous results;
Inappropriate treatment;
Patient infection (show photo
if appropriate)
6452 AccuCheck Inform II linktrainer21.2.11.indd 11 24/02/2011 10:31

5. Laboratory Involvement
Explain
When to take a venous sample
Why a venous sample should be used
Where the venous sample should be sent
Show strip pack insert
Explain
Why pack insert must be read
Contra-indications and test limitations
Most 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
6452 AccuCheck Inform II linktrainer21.2.11.indd 12 24/02/2011 10:31

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 lled 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 nger 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
6452 AccuCheck Inform II linktrainer21.2.11.indd 13 24/02/2011 10:31

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 Disease
Practical Diabetes, 3: 100 (1986)
Further Reading:
www.roche-diagnostics.co.uk
www.cobas-roche.co.uk
www.mhra.gov.uk
www.imb.ie
www.diabetes.org.uk
6. Further reading and references
www.diabetes.ie
www.nmc-uk.org.uk
www.rcn.org.uk
www.nursingboard.ie
www.who.int/diabetes/fact
6452 AccuCheck Inform II linktrainer21.2.11.indd 14 24/02/2011 10:31

COBAS, ACCU-CHEK and LIFE NEEDS ANSWERS are trademarks of Roche © 2010 Roche
Information correct at time of going to print, 2010
Roche Diagnostic Limited, Charles Avenue, Burgess Hill, RH15 9RY
Head office 01444 256000
www.roche-diagnostics.co.uk
05519799001_0311
6452 AccuCheck Inform II linktrainer21.2.11.indd 15 24/02/2011 10:31