Nova Stat Strip Update

Why is Training Necessary Medication & Healthcare Products Regulation Agency Nursing & Midwifery Council RCHT: Medical Devices Training Policy RCN Department of Health Care Quality Commission: Outcome 11 Safe Use of Medical Devices ‘Use of blood glucose meters by untrained staff, without adequate management supervision of the equipment and without the use of quality control procedures, can lead to misleading results, adversely affecting the treatment of patients’. MHRA 1996

Equipment Require on the wards Nova Stat Strip Connectivity Meter and Docking Station Work Station containing: Owen Mumford Unistix lancets Gauze for wiping finger after obtaining sample. Stat Strip Glucose Test Strips, 50 strips per vial Stat Strip Glucose Control Solution, Level 1(low), one vial Stat Strip Glucose Control Solution, Level 3(high), one vial

When should you not use the Nova Stat Strip to test glucose? When contraindications are presented. Severe dehydration Diabetic Keto-acidosis Hypotension Unconscious patients Shock Peripheral Circulatory failure Hyperosmolar non-ketotic Coma (HONK) The MHRA recommend that therapeutic decisions should not be based on a capillary sample in these circumstances. Venous samples should be sent to lab for verification of blood glucose level.

Spare battery at rear of docking station. Charging Light: Amber = Charging Green = Charged Green light on when connected to the network Charging Light: Amber = Charging Green = Charged Green light on when data is flowing

Storage and Stability The workstation and contents should be stored between 15° C and 40°C and away from moisture (<85% humidity). The test strips are stable for 6 months after opening. Write start date and expire date on the test strip container The quality control solutions are stable for 3 months after opening. Write expire date on the bottle. Clinical Chemistry will distribute new bottles every three months.

Please take care to keep moisture out of the test strip area. Cleaning the Meter Clean and disinfect the meter after each use using a sani-cloth disinfectant wipe (yellow top), blot with a dry paper towel and then follow with a water dampened cloth to remove any residue of cleaning solution Please take care to keep moisture out of the test strip area.

Children younger than one year Sample Collection Children younger than one year Collect from the lateral areas of the sole (see shaded area in diagram 1) During blood collection, the child must be held with foot facing towards the floor. A site which has all ready been punctured must not be punctured a second time. To improve blood flow you can warm the heel prior to sample collection for example by wrapping in a warm, moist cloth. The heel must be disinfected and then dried completely.

Children >1yr and Adults Collect capillary blood from the side of the fingertips (see shaded area in diagram 2) Thumb and index finger should be avoided for the puncture. The patient’s hands should be washed with warm soapy water or water and a damp gauze. Alcohol wipes / gel should not be used Collecting Blood Please note: the lancets are single-use, disposable devices Twist the sterility cap, remove and dispose. 1. Hold the device between index finger, middle finger and thumb. 2. Press device firmly against chosen puncture site 3. Using your thumb, press down trigger completely. 4. Remove device from puncture site and dispose in sharps bin as per Trust sharps policy

How to take a sample using the Nova Stat Strip When the drop of blood appears, touch the end of the test strip to the blood drop. The Strip fills via a “top fill” mechanism. Therefore the meter, with the strip in place, has to be inverted down, onto the drop of blood. The meter will beep when the test strip is full

Running a patient sample Remove meter from docking station. Press “Login”. Press “Scan” whilst pointing bar code reader at you barcode password. ( meter should be held at least 4 inches from barcode) From the Patient Test screen press “Accept” Scan strip lot number than press Accept Enter the patient’s 10 digit NHS number (not CR/Hospital number) For patients with unknown NHS numbers scan in the emergency barcode located on the inside of the workstation lid. Follow guidelines for using the lancet When ‘Apply Sample’ message appears apply strip to sample site until the meter beeps. Accept or Reject Results ( Comment when necessary, Rejects will require a comment)

Screen Comments StatStrip glucose meter reads between 0.6 - 33.3 mmol/L Glucose: < 4mmol/l - Diabetic - HYPO – Treat Glucose: <4 mmol/l - Not Diabetic – Review Glucose: 4 - 9 mmol/l -"Normal - No Action" Glucose: > 9 mmol/l - "Review needed" Glucose: > 15mmol/l " Review Ketone Test If result is greater than 33.3mmol/L, meter displays HI If result is less than 0.6 mmol/L, meter displays LO The result must be entered in the patient’s notes, along with any appropriate action taken.

Report abnormal or unexpected results to nurse in charge or doctor Any sample giving a meter result below 2.8 mmol / L or above 25 mmol / L and any unexpected result not in keeping with the clinical picture or a sample which gives more than one error message MUST be confirmed by sending an urgent venous blood sample to Clinical Chemistry. Any result less than 4 mmol /l or greater than 9mmol/l consistently or 15mmol/l at any one time should be reported to a trained member of the nursing or medical staff.

Quality Control Regime QC testing checks that the meter is working correctly that you have the correct technique QC testing is mandatory Two levels (level 1 & level 3) If no QC is successfully completed within the given timeframe, the meter will lockout. If QC still fails… Ring POCT IMPORTANT: the meter will ‘lock out’ if the QC fails. Patient tests cannot be performed until successful QC has been performed. In the instance that lockout is activated, both levels of QC (1 & 3) will need to be run

Trouble shooting Data won’t download: Make sure the docking station has a network connection point. Checked but still won’t work. Contact Chemistry! Meter reads flow error: To much blood on the sample stick. QC failure: Check the expiry date on the sample pots and stat strips or to much solution the stick. Bad Strip message: Try new strip Bad Sample: Take another sample verifying puncture site is suitably clean.

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