Point Of Care Testing - ProMedica
Point of CareTestingBedside GlucoseFreeStyle Precision Pro(FSPP)Meter
Regulatory Overview Bedside glucose is a point of care lab test andYOU are performing this lab test under the Lab’sCLIA license.All lab tests are regulated by the government.Point of care lab testing is inspected during thehospital inspection process.Lab Point of Care Staff monitors for complianceand serves as technical resources.Unit supervisors, educators and mangers areresources.Yearly re-certification is required for everyone.
FreeStyle Precision Pro (FSPP) MeterProvided by lab: FSPP Glucose Meter Glucose Meter Carrying Case Docking StationProvided by testing area: Testing supplies (gauze, test strips, lancets,etc.) AA Batteries
Meter Parts Display screen – prompts action and displaysinformation Has battery icon to indicate chargeTest Strip Port – where test strip is inserted fortesting.Connector Pins/Data Port – connects withdocking station, when wireless functionality isunavailable, to relay informationBattery compartment – holds 2 AA batteriesBarcode scannerSerial number – on the back of the meter
Meter KeypadON/OFF Press once to turn meter onPress and hold for 2 seconds to turn meteroffMeter turns off automatically after 4minutes to preserve battery power.
Meter KeypadMenu Key Willtoggle youback and forthbetween testingmenu and reviewresults menuEnter Key Use to enterinformation into themeter after typedinto the keypad
Meter KeypadClear KeyBacklight Key Will Pressback up onespace whileentering numbers Will delete abarcode Will return you to aprevious screen Used to delete infoentered incorrectlyand HOLD lowerleft key, A/a(under #7) for 2seconds to activatethe backlight thenrelease.
Digital camera scanner Hold the barcode scanner 2.5-7 inches from the barcode to bescanned, and at a 50-130 degree angle to the barcode.Press and hold down the Scan button until a visible green beamis emitted by the meter.Move the meter to align the green beam over the barcode.Hold the meter still while scanning, like taking a picture.Listen for beep which indicates scan is completed. If noinformation is scanned after 3 seconds, the scanner will turn off.Continuing to hold the scan button after beep will display whatwas scanned (CSN # for patient ID) until the button is released.
Troubleshooting Scanner Checkbattery power. Replace batteries ifnecessary Clean scanner window with soft cloth. Scanner works best if test strips andarmband barcode is flat. Meter will turn off scanner if scanner keydepressed too long.
Patient ID’s and GlucometersYou must verify the number after scanning Thereare two times during testing that youcan verify the patient ID – 1) When scanning the ID, hold the scanbutton down after scanning the barcode andreview the account number on the screen.2) Once the test is completed the result will bedisplayed with the patient ID.
METHOD ONE: hold downscan button and reviewaccount number on thescreen immediately afterscanning.If the scanned ID isincorrect, press clear todelete the ID and tryscanning again.METHOD TWO: Reviewthe account number at topof the screen when resultis viewed.If the ID is incorrectuse the POC CorrectedReport form to get thepatient ID corrected.
Battery Replacement Instructions Toooooremove the battery cover:Using both hands, press down firmly onthe cover.Position one thumb on rubber tab and other onraised lines .Push to slide the cover down, then lift upand away from the meter.Remove old batteries and position newbatteries in meter following ‘ ’ and ‘-’ guides.
Battery compartment cover replacement Toooreinsert the battery cover:Align battery cover with the slots on the meter, thenslide up and into place.Do not snap it down as it will break off the tab.
GLUCOSE CONTROL EXPIRATION DATEControls expire 90 days after opening1. Write Revised Expiration dateWrite 90 day expiration date with permanent marker. Ifmanufacturer’s expiration date is sooner than the 90day expiration date – use manufacturer’s date andcircle it. Do not write over bar codeDate it!Manufacturer’s expiration date2. Place Tape over the expiration dateTape it!The expiration dates get rubbed off even ifpermanent marker is used. Use tape to protectthe expiration date.
Running Quality Controls Press ON/OFFPress 2 Control TestScan or enter Employee IDScan Control BarcodeScan Test Strip Barcode on wrapperInsert Test Strip from the wrapper you scannedMix controls by gently inverting prior to use. Do No shake.Apply drop of control solution – Keep meter flat! Do not allowliquid to enter strip port. It will damage the meter.Wipe off nozzle with clean cloth and recap control bottle5 second countdownPASS or FAILBoth levels (LO & HI) must be run each day of patient testingIf controls aren’t run, you WILL NOT be able to perform patienttesting
Reasons Controls Fail Controlsare expired – check date on vials Wrong level of control was run Controls not thoroughly mixed Air Bubbles in nozzle of vial Dried control material on nozzle Wipe the nozzle off with gauze
Prior to performing a patient test: You must have an order written by a physician.Verify that you have the correct patient using the patientarmband.Verify that the armband is for the correct facility withcurrent MRN and CSN.Verify the patient using two patient identifiers.If patient is transferred from another facility, the wristbandfrom previous facility must be removed. Test results will notbe transmitted if a CSN from another facility is used.Always scan the barcode when available to ensurecorrect visit number entry into meter. Scan if you can.You may not use hospital glucose meter on yourself,coworkers or visitors. See supervisor for proper procedurefor those situations.
Fingerstick collection Choosea spot that is on thebottom side of the tip of oneof the center fingers of eitherhand. Clean finger with alcoholprior to poking and allow to dry.
Fingerstick collection Gently squeeze across theentire finger at the last joint.Do not ‘milk’ finger.Always wipe off the firstdrop of blood after pokingfinger and apply seconddrop to test strip.
Applying sample to test strip Applysample to top or end of application areauntil you hear a ‘beep’ indicating enoughsample has been applied. If no beep, remove the test strip and depress the‘clear’ key to start over with new test strip. You may not add more sample to the test strip!
21Sample Application Ifusing a syringe, applyblood sample to the teststrip with the syringepointing away from themeter. Remember to keep the glucose meter flatwhen running controls or patient tests sosample does not flow into meter.
Patient Testing PressON/OFF Press 1 – Patient Test Scan or enter your employee ID Scan or enter patient CSN from armband Meterwill scan either 1D or 2D (QR code)barcode on armband Useall 9’s if no CSN available(do notmake-up numbers) Onlyuse all 9’s when patient is not yetadmitted so no CSN available eg: newbabies, ER urgent situation
Patient Testing Scanbarcode on test strip wrapper andinsert test strip into glucose meter Collect blood sample and apply to targetarea on test strip. Keep meter flat! “Sample Accepted” will display and 5second countdown Test results will be displayed with patientinformation/CSN# Review patient information and test resultfor accuracy.
Critical ValuesHigh Critical Values will have an arrow pointingup before the result.Low Critical Values will have an arrow pointingdown before the result.ACTION:Repeat if questionable and follow critical valuenotification process.Examples: 425 35
Out-of-Range Results Results that are too high for the meter to readwill appear as 500. (greater than 500)ACTION: Recheck if questionable and orderlab test to confirm result. Results that are too low for the meter to readwill appear as 20. (less than 20)ACTION: Recheck if questionable.
Comment Code #4 Ifyou made an entry or testing error, enter“4” while the patient result is on thescreen and the prompt say “Scan or EnterComment code”. Entering “4” will stop the results from goingto the patient record. If you do not enter a comment code, besure to press ENTER to complete the testcycle.Use code 4 to 4-get that result
Troubleshooting Patient results Ifthe blood glucose result appears to beinconsistent (lower or higher that expected),there may be a problem with the test strip,collection technique, or patient condition. Repeat the test using a new test strip. Results that are incorrect may have seriousmedical consequences. Order a lab performed glucose if bedsideglucose is questionable.
Reasons Glucose may be higher than expected HCTis less than 15% Line contaminationNeonatal glucose Asa matter of good clinical practice, cautionis advised in the interpretation of neonatalglucose values below 50 mg/dL.
Reasons Glucose may be lower than expected Capillary Specimen Severe dehydrationSevere hypotensionEdema of puncture siteShockHyperglycemic-hyperosmolar state (with or without ketosis)HCT is greater than 65%Alcohol remaining on the puncture siteVenous or Arterial Specimen Blood not tested within 30 minutes of collection
Repeating a patient test Ifyou question a test result, run the test again onthe same glucose meter. Run the second test within 5 minutes of the first test. Do not leave the patient test screen of the patientneeding repeat test. Do not turn the meter off ordock the glucose meter between tests. Only the second test will be sent to the patientrecord if the above points are followed.
Meter Cleaning/Care Clean the meter after each patient useClean the supply case if blood is visibleWear gloves when cleaning the meterIf blood is visible on gloves, change thembefore cleaning the meterUse only hospital approved disinfectant wipesand allow meter to air dryFollow procedure for use of the cleaningwipesDo NOT write on the meters
To Review Patient Results: Press MENUChoose 1 –Data ReviewEnter Employee ID NumberChoose 1 – ‘Patient by Oper ID’ to reviewprevious patient results by current operatorChoose 2 – ‘Patient by Pat ID’ to reviewprevious patient results by patient ID #Choose 3 – ‘All Patient Data’ for all previouspatient recordsAfter selecting review option Press 1-PreviousPress 2-Next to review more recent results
Result Documentation Resultsare transmitted electronically into thepatient’s Electronic Medical Record by wirelesstransmission. If wireless signal is weak or notexistent, place the glucose meter onto thedocking station or docking cable. Transmit results after each patient test or group ofpatient tests as appropriate. Manually document results into ElectronicMedical Record during downtime. Results will usually populate into EMR within 2-5minutes.
Glucose data transmission:Docking stations Docking station Use docking station if wireless signal is weak ornonexistent. The rotating circling arrow indicates transmission. Do not remove meter from docking area while thearrows are actively circling. The glucose meter will automatically turn off whendocking is completed. If download is unsuccessful “Last UploadIncomplete Re-dock Meter” will display.
Docking station Placethe glucose meter gently into thedocking station sliding into place. Meter will turn on when properly positioned. Do not force it on.
Docking cable instructions Insert the cable connectorinto data port on thebottom of the glucosemeter. Guide it in gently,Do Not forceMeter will turn on.Lay on a flat surface whiledownloading.
Troubleshooting Docking StationDownloadingIf the circling arrows do not rotate, test results arenot transmitted. Check battery power by turning on meter andobserve battery icon. If low replace batteries. If problem continues, take meter to closestdocking station to download. Submit a Service Now ticket with IT to reportproblem with glucose meter uploading withdocking station, and to receive assistance.
Wireless result transmission Resultsaren’t “automatically” transmitted whentesting is complete Toengage wireless communication andtransmission, perform one of the following: Press “Menu” key. This should be done betweenpatients or group of patients. Turn meter on Turn meter off
Wireless result transmission (cont.) Afterpressing the ON/OFF key to turn the meteroff, you will see active arrows, , indicatingtransmission. There will also be a “1- Turn Off”prompt. If you press 1 to turn the meter offwhileis still displayed, result transmissionwill be stopped and patient results will nottransmit to the patient EMR. Active arrowswill disappear whenglucose data transmission is complete. Alwaysallow active transmission arrows to completeand disappear
Wireless transmission – New IconsUhOh!If you notice that results are not transmitting or the above iconsare missing, turn the meter off, then on again.If that doesn’t fix the meter, dock the meter using a dockingstation to transmit glucose data.Return the meter to lab to exchange it for a new one.
Reasons Results not in EMR after transmission initiated You may have scanned an old CSN Number or one fromanother facility. Check ID in meter and compare to wristband of patient.If you manually entered CSN Number you may haveentered it incorrectly. Check ID in meter and compare itpatient armband.The meter may have scanned the armband incorrectly.Review results in meter to check if CSN number scannedproperly. Compare scan to patient armband.***for any of the above errors,complete the POC Corrected Patient Report Formand send to lab, attention POC***
Reasons Results not in EMR after transmission initiated IfLab Information System or EMR is down, or if thereare network problems, results will not transmit. Followdowntime result documentation procedure. Resultswill populate when the computer system/interface isworking. Submit service now ticket to report problem andreceive assistance if needed.
Meter Replacement Clean meter with disinfectant wipeDo not return meter to biomed/TrimedxReturn meter to lab and state problemSome labs have a log to fill outLab will issue you replacementDO NOT send meters through the pneumatictube!
Patient CSN/visit number not available You may enter all 9’s as PT ID when a STAT glucose isneeded on a patient that has not yet been given anadmission/CSN number.Example: ER patient, Newborn or Direct Admit patientnot given admission number yet.Only use when patient not yet admitted& no CSN available
POC Corrected Result Form You must fill out the POC Corrected Result form,available in mypromedica: My Work System andBusiness unit Policies Corporate policy manual Promedica Laboratories System Policies Point ofCare Lab Testing Procedures POC Request forCorrected Patient Report Form, and send it to theLaboratory whenever: You enter all 9’s as the patient ID Scanning error occurred Old CSN used as patient ID Manually entered incorrect CSN Wrong patient scanned You need patient results corrected for any reason
POC Corrected Results Form Complete all sections of theform. Include patientinformation once the CSNnumber has been assigned.Forward to laboratory whencompleted. This processmust be completed toensure patient glucoseresults are in the EMR.Form can be found inmypromedica – system andbusiness unit policies
Where is procedure located?My Work System and Business unit Policies Corporate policy manual PromedicaLaboratories System Policies Point of Care LabTesting Procedures Click on Freestyle Precision Pro Glucose meterProcedure in the list. The downloaded worddocument will appear in the lower left handcorner of the screen When document opens, press Ctrl key onkeyboard while clicking on the link in the worddocument, to open the procedure
QUESTIONS?
Regulatory Overview Bedside glucose is a point of care lab test and YOU are performing this lab test under the Lab’s CLIA license. All lab tests are regulated by the government. Point of care lab testing is inspected during the hospital inspection process. Lab Point of Care Staff monit
Jobst Vascular Institute, ProMedica Toledo Hospital from 2002-2015 and Executive Director of Research, ProMedica Health System and Jobst Vascular Institute from 2015- January 2017. Dr. Comerota has been a major contributor to the development of some of the newest forms of treatment for vascular disease. Dr. Comerota has a
Lenawee Health Network, comprised of multiple community organizations, collaborated to develop a community health improvement plan (CHIP) for Lenawee County. In 2019, ProMedica Bixby and Herrick Hospitals convened a CHNA committee to review the most recent Lenawee County CHA and CHIP, taking into account the gap and resource assessments.
EN 571-1, Non-destructive testing - Penetrant testing - Part 1: General principles. EN 10204, Metallic products - Types of inspection documents. prEN ISO 3059, Non-destructive testing - Penetrant testing and magnetic particle testing - Viewing conditions. EN ISO 3452-3, Non-destructive testing - Penetrant testing - Part 3: Reference test blocks.
Assessment, Penetration Testing, Vulnerability Assessment, and Which Option is Ideal to Practice? Types of Penetration Testing: Types of Pen Testing, Black Box Penetration Testing. White Box Penetration Testing, Grey Box Penetration Testing, Areas of Penetration Testing. Penetration Testing Tools, Limitations of Penetration Testing, Conclusion.
HOW A POERFUL E-COMMERCE TESTING STRATEGY 7 HITEPAPER 4.3 Obtaining Strong Non-Functional Testing Parameters Retailers also need to focus on end-user testing and compatibility testing along with other non-functional testing methods. Performance testing, security testing, and multi-load testing are some vital parameters that need to be checked.
One Point Perspective: City Drawing A Tutorial Engineering 1 Tatum. When completing this tutorial, you must use the following items: * White, unlined paper * A ruler or other straight-edge * A pencil. Begin by setting up your paper for a one-point perspective drawing. Draw a horizon line and a vanishing point. Draw two orthogonals (diagonal .File Size: 727KBPage Count: 41Explore furtherOne point perspective city: The step by step guide .pencildrawingschool.comHow to Draw One Point Perspective City Printable Drawing .www.drawingtutorials101.comOne Point Perspective Drawing Worksheets - Learny Kidslearnykids.comPerspective Drawing - An Easy Lesson in 1 Point .www.drawinghowtodraw.comThe Helpful Art Teacher: Draw a one point perspective city .thehelpfulartteacher.blogspot.comRecommended to you b
Applications - LHC collimation region Regions of high losses (e.g., Collimators, « ) ATLAS Regions with low losses (e.g., due to residual gas) The LHC Loss Regions Point 1 Point 2 Point 3.2 Point 3.3 Point 4 Point 5 Point 6 Point 7 Point 8 ALICE LHCb Momentun Cleaning RF CMS LHC Dump Betatron Cleaning FLUKA geometry visualized with SimpleGeo .
A student in the commerce stream studies various subjects which covers topics like business, commercial organisations, management of business, economics, financial accounting etc. Secretarial Practice is one of the subjects in commerce which deals exclusively with one of the largest and most popular forms of business organisation viz. the Joint Stock Company. In this subject, a student is .
