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Blood Glucose Management System Accu-Chek® Performa User manual for healthcare professionals
CONTENTS 3 Introduction 4 Staff Responsibilities 5 Protocol 6 About the Accu-Chek® Performa 7 Coding/Calibrating Your Meter 8 Performing an Internal Quality Control Test Performing a Blood Glucose Test 11 Dosing from a syringe 11 Capillary sampling using the Safe-T-Pro Plus 13 Capillary sampling using the Safe-T-Pro Uno 14 External Quality Assurance Scheme 15 Cleaning & Maintenance 16 Changing the Batteries 17 Contra-indications & Test Interference 18 Display Code Explanation
INTRODUCTION Roche Diagnostics is part of an international health care organisation with an outstanding record in scientific achievement and innovative product development. Dedicated to achieving the best possible standard of patient care, we are the largest provider of diabetes products and services in the world. Designed to help you This manual has been compiled by Roche Diagnostics to help you, the healthcare professional, achieve consistently reliable and accurate blood glucose results.
STAFF RESPONSIBILITIES It is essential that staff undergo formal training and understand the importance of a strict quality control programme. Use of meters by untrained staff can adversely affect the treatment of patients. IMPORTANT: A management or therapeutic decision based on an unreliable blood glucose result could be fatal.
RECOMMENDED BLOOD GLUCOSE MONITORING PROTOCOL 1. Follow the manufacturer’s guidelines and hospital policy (standard operating procedure) on testing at all times 2. Only a healthcare professional who has received appropriate training may carry out blood glucose monitoring at ward level1,2 3.
ABOUT THE ACCU-CHEK ® PERFORMA Back view of meter Front view of meter Display Meter Serial Number Code Chip Slot Battery Compartment Left Buttons Right Buttons Code Chip Test Strip Slot Code Number Golden End (Electrodes) On/Off/Set Button Yellow Window Top view of meter 6 Test Strip Test Strip Container
CODING/CALIBR ATING YOUR METER When to code/calibrate Before you use your meter for the first time and every time you open a new box of test strips, you need to code/calibrate the meter to match the strips. Each code/calibration key provides your meter with the specific information it needs to accurately measure blood glucose. Do not use any other code/calibration key, except the one that arrives in the box with the pot of test strips.
PERFORMING AN INTERNAL QUALIT Y CONTROL TEST What are Internal Quality Control Tests? They ensure that your system is working properly, that you are doing a test correctly, and the meter is providing accurate and reliable results.
PERFORMING A QUALIT Y CONTROL TEST 1. Insert a test strip into the meter. The meter turns on. 2. 1. Make sure the code number on the display matches the code number on the test strip container. If you miss seeing the code number, take the test strip out and reinsert it into the meter. 3. 2. Select the control solution you want to test. You will enter the level later in the test. 4. Put the meter on a flat surface, like a table. 5. Remove the control bottle cap.
PERFORMING AN INTERNAL QUALIT Y CONTROL TEST What if the result is not within the acceptable range? If the result is not within the acceptable range.
PERFORMING A BLOOD GLUCOSE TEST Capillary sampling using the Safe-T-Pro Plus/Uno 1. Wash hands thoroughly. Put gloves on 2. Clean the side of the patients’ finger using soap and water (rinse well) or gauze swabs. Ensure that the finger is thoroughly dry 3. Promote blood flow to the site by allowing the arm to hang down by the side for a few seconds and then flex arm and fingers. If the hand is very cold, allow it to warm up before trying to obtain a blood sample 4. Check expiry date of strips.
Dosing from a syringe 1. Transfer pipettes, small capillary tubes, adjustable volume pipettors (i.e. Eppendorf pipettes) and syringes may be used to apply venous, arterial and capillary blood to the test strip 2. Check expiry date of strips. Switch meter on 3. Check that the code on the meter matches the code on the vial of test strips you are using See image A 4. Open test strip vial and remove the test strip. Replace vial cap 5.
E XTERNAL QUALIT Y ASSUR ANCE (EQA) SCHEME Roche Diagnostics have the largest EQA scheme using the nationally accredited Quality Laboratory (QL) at the University Hospital of Wales. The EQA scheme is available to any hospital using a Roche Blood Glucose monitoring system. How does the scheme work? Samples are sent from QL to a central administrative site on a regular basis. These should be tested exactly the same way as a sample from a patient.
CLE ANING & MAINTENANCE Cleaning • The meter should be cleaned regularly, in line with the policy in your organisation • • Always switch the meter off before cleaning Wipe with a slightly moist cloth and mild cleaning agent Do not let liquid drip into the meter and take special care to keep moisture out of the code key slot and the test strip guide Storage • • • Keep your meter in the workstation to protect it from damage Keep the meter free from dust Protect the meter from extremes of temperature a
CHANGING THE BAT TERIES Warning Signs When a battery symbol appears on the display, your battery is weak and has only enough power to run a few more tests. 1. Inserting a battery 1. Push the recessed plastic tab of the battery compartment forward (toward the arrow) to flip open the battery door 2. 2. Insert the battery into the compartment with “+” side facing you 3.
( TEST INTERFERENCES) IMPORTANT. A minority of your patients may be affected by the following test interferences Substance Interference Limit Interference due to treatments Therapeutic Range Icodextrin / Maltose* > 0.38 mmol/L Treatments containing Icodextrin / Maltose N/A *EXTRANEAL™ *OCTAGAM™, Gammagard (for patients on CAPD) (i.v. human immunoglobulin preparation) Interference due to medical conditions Physiologic Range Galactose > 0.44 mmol/L < 0.28 mmol/L Lipids > 39.6 mmol/L 0.
DISPL AY CODE E XPL ANATION Screen messages Never make treatment decisions based on an error message. If you have any concerns, call Roche Diagnostics. The meter will not turn on or the display is blank. • Battery is dead – Insert new battery • Display is damaged – Call Roche Diagnostics • Meter is defective – Call Roche Diagnostics • Extreme temperatures – move the meter to a more temperate area Battery power is low. Change the battery soon. The meter is ready for you to insert a test strip.
Meter Errors DISPL AY CODE E XPL ANATION 18 The test strip is damaged. Remove the test strip and reinsert it, or replace it if damaged. If the message reappears, call Roche Diagnostics. The code chip is incorrect. Turn off the meter and insert a new code strip. If this does not fix the problem, call Roche Diagnostics. An error occurred during the test. Discard the test strip and repeat the test.
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