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BJH POCT Hemochron Annual Competency. Basic Specifications. Objectives. Why am I doing this?.
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Why am I doing this? It is a Joint Commission and CAP (College of American Pathologist) requirement that all staff performing Point of Care Testing have their competency tested at least annually. To be considered competent, you must complete this course, take quiz and run both low and high EQC. Since this is considered moderately complex testing by CLIA, a separate checklist of competencies must be completed off line.
Policies and Procedures How do I find the procedure that gives me directions on how to run the meter? The POCT procedures can be found on the BJHnet Policies & Procedures. It is located under Patient Care: Point of Care Testing. Refer to BJH Policy and Procedure "Point of Care Testing: PT/INR, aPTT, and ACT using Hemochron Elite.”
Review Patient Testing Proper patient testing requires that you follow the step by step procedure you find in the on-line policy. It is important to follow the procedure to ensure accurate testing. If testing is not performed correctly or if your sample is not obtained correctly you could get an erroneous result.
Review Patient Testing Test Procedure The cuvette must be inserted into the instrument and warmed to 37 degrees before sample can be added. The meter will turn itself ON automatically. The Hemochron will identify the test cuvette and initiate the pre-warm/self check mode.
Review Patient Testing Test Procedure Scan badge when screen displays Enter OID.
Review Patient Testing Test Procedure When PID is displayed, enter Patient ID via barcode scanner or numeric keypad. If numeric keypad is used, press and hold enter key.
Review Patient Testing Test Procedure Draw sample when the "Apply sample" prompt appears on the instrument. You have 5 minutes to draw and add the sample. Press START immediately after adding sample. When Start is pressed, the instrument precisely measures 15 ul of blood and automatically moves it into the test channel within the ACT-LR cuvette. Remember to press the START button immediately after adding the sample. Delay between applying sample and when you actually press START will decrease your overall clotting time.
Review Patient Testing Test Procedure Patient results will display on screen. Document results. Once cuvette is removed the results will disappear from screen. Note: If performing PT/INR or aPTT, only use the plasma equivalent values. Do not use the whole blood results.
Review Patient Testing Test Procedure Cartridge Stability • Stable refrigerated until the stamped expiration date. • Stable at Room Temperature for twelve weeks. • Re-dating is necessary if stored at room temperature. Please be sure all room temperature cuvettes have new expiration documented. Exp 12/31/2014
Review Patient Testing Interfering Substances & Conditions • The following will interfere with measurement. If present, values may be inaccurate and alternate analysis by the clinical laboratory method is warranted. • Delay in testing could result in falsely low results. • Poor technique including blood collection • Foaming samples • Clotted or partially clotted blood • Hematocrit <20% or >55% are not recommended due to an optical density outside of the level of detection of the instrument. May give optical density error of “no sample seen”. • Hemodilution, cardioplegic solutions, hypothermia, platelet dysfunction, hypofibrinogenemia, other coagulopathies, and certain medication may affect the ACT. • Improper storage of test kits outside specified guidelines may affect the results
Review Patient Testing Download patient results • Please download at the end of the case or at least once every 8 hours. • Plug the red data cable into the Ethernet port on the left side of the instrument. • Press START button to turn on. (If EQC starts, CANCEL) • Press DATA BASE key, then option 6-POCT >>NET. Instrument will connect to the network and send results. • Export is complete when message “ Disconnecting Network” is displayed. Ethernet Port
Quality Control Electronic Daily Quality control EQC include 2 levels of Electronic Quality Control (EQC) and a temperature check. The meter is programmed to automatically perform EQC every 8 hours if used. You may perform upon demand by pushing the QC button and then “1”=Run EQC. If the meter is turned off, the meter will automatically perform the EQC when it is turned on if it is past due. If the meter is on the EQC will automatically run.
Quality Control Electronic Daily Quality control The Hemochron will run both the 30 and 300/500 second QC when initiated. Please be sure to allow enough time to complete. It is recommended that you turn on the meter 10 minutes ahead of time to allow for the EQC completion.
Quality Control Electronic Daily Quality control If EQC is due and you insert a cuvette to run a patient sample, the hemochron will ask if you: Press 1 to abort. Insert cuvette. Instrument will ask if you want to perform an emergency 911 patient. Once patient test is complete, remove cuvette and EQC will proceed. You are only allowed one emergency patient interruption before EQC must be performed.
Quality Control Liquid weekly Quality Control LQC is required every other week. The LQC is a test on the cuvette, instrument and the operator to be sure the entire system is operating correctly.
