Glucose Testing with the Roche Accu-Chek Inform system

MCL Quick Procedure for Daily Reference

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This is a abbreviated version of the complete procedure which is described in full detail in the Glucose Testing with the Roche Accu-chek Procedure in the Clinical Nursing Practice Manual. This does not supercede the full procedure but is intended to be a practical day-to-day quick reference.

• Power-up and log in with your user ID number. 
• Enter the patient's CSN number and verify the test strip code with the code in the Accu-Chek Inform system. If they are different, see the coding procedure.
• Insert the test strip (yellow target area facing up) when the "flashing strip" appears on the monitor display. photos
• Obtain the sample by fingerstick as described in the Clinical Nursing Practice Manual. Cleanse and lance the finger and lightly press the finger using a rocking motion to stimulate blood flow.
• When the "flashing drop" icon appears on the monitor, touch the finger to the indented side of the strip photos. This is called the "comfort curve". The blood must completely fill the test window. If you see any yellow color after you have applied the first drop of blood you may apply a second drop within 15 seconds. If more than 15 seconds elapses, you must discard the strip and start over.
• Read and properly record the result when displayed. Write your name, the date and time and value on the chart.
• Add any comment codes as necessary and press the arrow to record the test and return to the Main Menu. Discard the lancet in the sharps container. Remove the strip and discard then turn off both the meter cradle and the meter or continue to test other patients.

Critical Values—Testing limits and actions:

• Neonates(0-15 days): less than or equal to 30 mg/dl or above 300 mg/dl
• Adults(older than 15 days): less than or equal to 40 mg/dl or above 500 mg/dl
• If critical range, repeat the patient test
• If the repeat result is the same, perform QC for validation

If QC results are within range, take appropriate clinical action notify M.D and draw stat blood for lab confirmation

If QC results are out of range, refer to QC section in procedure manual

• If the repeat result is not within the critical range, repeat patient and perform QC for validation

Quality control:

• Daily, run high and low level of external quality control materials. Both levels must pass the acceptance criteria before any patient testing is performed. The instrument will lock out patient testing if the quality control check do not meet all criteria. All discrepancies in quality control must be documented with a comment code failure in the data manager. QC mode will not give you a numerical answer-- only pass or fail.
• Clean Accu-Chek with alcohol prep after each patient test.

WHEN TO RUN QC

Every 24 hrs. at QC Lockout as determined by your unit.	.If any system component has been dropped
Each time a new vial of test strips is opened.	When test results contradict clinical symptoms
When a vial of strips has been left opened.	When any QC result falls outside the acceptable control range
When the test strips have been exposed to extreme heat, humidity or cold