StatStrip Glucose Meter Self-Learning Module

Legacy Laboratory Services StatStrip Glucose Meter Self-Learning Module Patient Care Services Clinical Practice Support 2020 Page 1 of 10

Legacy Laboratory Services StatStrip Glucose Meter Self-Learning Module Overview The StatStrip Glucose Meter self-learning module has been designed to provide you with a fundamental understanding of the StatStrip glucose meter, its features, and the basic principles of operation. Objectives With the completion of this SLM, you should be able to: Identify: the functions/components of the StatStrip glucose meter important points to remember when performing a test criteria for performing a quality control test methods for applying a sample to the test strip result flags and their significance Perform: StatStrip glucose meter power on operator ID (employee number) entry patient ID entry by barcode scanning test strip lot number entry proper application of blood sample to test strip quality control testing meter cleaning Directions 1. Read Legacy specific information. 2. Complete the post-test with a score of 100% 3. Print the checklist and perform the QC test at an in-service or with a super user. 4. Submit completed checklist to your manager for completion of this module and inclusion in your education record. Page 2 of 10

Legacy Laboratory Services StatStrip Glucose Meter Self-Learning Module Introduction Physician order or protocol will determine the blood glucose (BG) monitoring regime. Please refer to the standards of care for your patient population for information on blood glucose management. Note: 1. Obtain a breakfast BG no earlier than 30 minutes prior to breakfast 2. Obtain BGs no earlier than 30 minutes prior to meals (or at least 2 hours following prior meal or snack unless ordered otherwise) or when tray arrives on unit 3. Obtain HS BG at least 3 hours after evening meal (before HS snack) 4. Obtain BG at least every 6 hours when patient NPO or not tolerating diet 5. Obtain BG every 2 hours if patient receiving insulin infusion or as per MD orders. Responsibilities RN only: Interprets and plans BG monitoring schedule for patient according to physician order or protocol. RN or LPN performs all BG testing for patients receiving mealtime insulin. RN or LPN: Assures tests are completed as ordered. Acts on the results as necessary. RN, LPN or CNA/CHT: Performs BG test with StatStrip glucose meter as directed by RN/LPN. Reports results, observations and patient comments about patient condition to RN/LPN. Enters notes in StatStrip for critical values and as needed for other test results. May do quality control checks as per unit routine. Critical High/ Critical Low Critical value flags on the meter are set to prompt additional actions by the clinical staff. Staff must add critical value comment before accepting the result. These are set differently for the adult, neonatal or pediatric populations. The actual age related critical values will attach to the result after download and posting to the Electronic Health Record (EHR). Equipment needed to perform BG Soap, water and towel Lancet StatStrip glucose meter Test strips Control solutions #1 and #3 (if QC needs to be done prior to patient test) Kleenex or cotton ball swab KEY POINT: Patient ID must be scanned into the glucose meter using patient ID band. Reprint wristband if it fails to scan or use the 911 Emergency Patient ID Page 3 of 10

Legacy Laboratory Services Form specific to hospital facility, located on Intranet via Clinical Resources/Patient Care Forms/Point of Care forms. Procedure for Obtaining Blood Glucose Specimen or getting a drop of blood KEY POINT: Getting an adequate drop of blood is one of the most important steps in getting an accurate result. Patients with decreased peripheral blood flow, or capillary refill greater than 3 seconds may not be acceptable candidates for capillary blood collection. This may include conditions such as hypotension, peripheral circulatory disorders, and dehydration. Use a new lancet every time you do a test. Do not use the lancet if the cap covering the sharp end of the lancet has been removed or damaged. Never use a lancet more than once. Wash your hands and don gloves. Wash the patient’s hands with soap and water. Dry thoroughly. KEY POINT: Warm water stimulates blood flow to the fingers. Alcohol foam may be used as an alternative if water is not available. Choose a site on the side of the fingertip. The side of the thumb may also be used. KEY POINT: The sides of the fingertips are less likely to get sore after repeated punctures. Remove the covering on the lancet; hold it firmly against the side of the finger. KEY POINT: The harder you press, the deeper the puncture. Page 4 of 10

Legacy Laboratory Services Hold the hand down for 10 15 seconds before and after the puncture. Knead the palm to promote blood flow. Squeeze the finger gently if needed, avoid squeezing too hard. Note: “Hanging” drop is just the right amount of blood for test. Discard used lancet in sharps container. Figure 1. StatStrip Glucose Meter 1.75 QC Testing QC testing is to be performed at least daily when patients are tested. Gather supplies to perform QC: meter, test strips, StatStrip Glucose Control Solution #1 and #3. Gently mix the glucose control solution before beginning test. From the Patient Test screen press the QC soft key. “Enter Strip Lot” appears on screen. Press the Scan soft key (Figure 2) and scan strip lot number. Press Accept soft key if lot number is valid. Insert test strip as indicated. When “Apply Sample” appears on screen, open the glucose control Page 5 of 10

Legacy Laboratory Services solution and waste the first drop of solution to avoid contaminating the test strip. Place a drop of control solution on the end of the test strip until solution is drawn into the well of test strip (Figure 3). When enough solution has been drawn in there will be an audible beep. Recap the control solution. The Testing Sample screen display a clock showing seconds remaining for test. When the meter completes the test, the QC Result screen displays the result in mg/dL. Make any needed comments and Press Accept then repeat the process with the second bottle of control solution. Note: result is displayed with either PASS of FAIL (Figure 4). Remove the test strip manually or by using the ejector button on the back of the meter. Place used strip into biohazard container. CAUTION: Do not test patient sample until a control solution test result is within expected range. Figure 2. Display Screen Figure 3. (above) Page 6 of 10 Figure 4 (below)

Legacy Laboratory Services Barcode scanning To scan the patient ID/Account Number (CSN), press the Scan soft key on the screen (Figure 2). Then scan the patient's wrist band using the linear barcode for the CSN barcode. If there is an ADT feed, the patient name appears. If this is the correct patient, press the Accept soft key. If there is no ADT name match, Invalid Patient ID appears on the screen and a New Patient Override button appears. Press this button to continue with testing. Note: You must scan the barcode on the patient armband, not on any part of the chart. Exception: sterile field Scan the test strip in the same manner you would use or QC testing. Press Accept soft key to validate lot number. Insert Test Strip in meter appears on screen and apply patient sample to strip (Figure 5). The strip must fill completely upon touching the drop of blood. Do not touch the tests strip or apply a second drop of blood. The test will result in 6 seconds. Figure 5. Note: a single UP arrow displays for abnormal high result and 2 UP arrows indicate critical high value. A single DOWN arrow displays for abnormal low result and 2 DOWN arrows for critical low value Page 7 of 10

Legacy Laboratory Services Test Results Results appear on the screen as indicated in Figure 6. Press the Accept key to accept the results. If you question the results based on patient condition or symptoms, select the Reject soft key, enter reason for rejecting the result, and repeat the test. Selecting reject does not delete the result from the glucometer but does prohibit its transmission to the patient record. If you question the result with the repeated test, contact LIP for orders for a serum glucose test and perform QC test on the glucometer. Remove the test strip manually or by using the ejector button on the back of the meter. Place used strip into biohazard container. Clean the meter after each patient use as instructed below. Figure 6. Documentation: Results will automatically populate the flowsheet wirelessly or when docking the glucometer. Results of the blood glucose tests are documented in the patient record in the Point of Care flowsheet. When patient tests blood glucose using own glucometer, as permitted by LIP order and per policy, enter the result in the same flow sheet in the row clearly labeled as patient meter. If patient medications are to be adjusted, testing must be performed on the hospital glucometer. To add a comment to any results, press the Comment key on the results screen. Once you have entered your comment, press Accept. Additional documentation of results and interventions are to be documented in the medical record. Key Point: RN must enter a note describing their nursing actions in the Provider Notification/Critical Value section of flow sheet when test results are outside of the normal and have not been documented in the meter. Page 8 of 10

Legacy Laboratory Services Clean the meter after each patient test and prior to docking using the hospital approved wipe (e.g. Oxovir) or the Micro-Kill Bleach wipe for C. difficile patients. (see instructions below). Docking / charging the glucometer: Following each test, or series of tests, the results are uploaded into the electronic health record via the wireless network or by placing meter in the Docking/Charging station. When the meter is not in use, place in in the docking/charging station. This enables the meter to stay fully charged and connects the meter to the computer network. Wireless connection will display on meter (Figure 7): o 4 green bars indicate system is ON and connected to the wireless network. o Three green bars ¾ signal strength o 2 yellow bars ½ signal strength o 1 red bar 1/4 signal strength o Empty bars no connection. o Bars with this symbol indicate no connection. o Yellow dot symbol indicates meter is connected and is communicating with device manager. Figure 7. Docking/Charging Station o The left green light is on if the station is connected to the wireless network o The middle green light is flashing if data is transferring o The right green light is on when meter is fully charged. An amber light means the meter is charging. Page 9 of 10