VVMC ACCU-CHEK Inform II Skills Checklist
Critical Elements
Yes
No
Comment
1.
Demonstrates knowledge of Accu-chek Inform II meter and the dock station
Demonstrates knowledge of proper equipment used (soap, water, gauze pads)
Demonstrates knowledge and importance of proper lot number verification)
Demonstrates knowledge of proper test strip application
Properly doses the test strip
Enters Operator ID and Patient ID according to policy (Scan own badge, and wristband)
Understands why meter needs to be docked after use (charges battery)
2.
Quality Control
States when controls are routinely run (once every 24 hrs—or every use day)
States when to discard control solution (at exp. date or 90 days after opening)
States what to do when control result fails to fall within the acceptable range
(repeat the test and document remedial action with a comment)
Demonstrates correct procedure for Hi & Lo solution testing
3.
Hospital Critical Limits, Documentation and Follow-up
States critical values (<60 or >450 mg/Dl; notify provider of critical results)
0-6 months (<40 or >200 mg/dL
Demonstrates importance of comments (notify provider/ or notify RN) and repeat criteria
States when venous sample is sent to central laboratory for confirmation
(<30 or >500 mg/dL 6 months to Adult) (<30 or>500mg/dL 0-6months)
States emergency ID # when patient is unidentified (0911911). Verbalizes how to enter a
custom comment (patient’s name)
5. Cleaning
States proper infection control and safety practices
States cleaning techniques for the meter – wipe ACCU-CHEK Inform II meter with
Asepti-
wipes
States the importance of not getting
liquid into the strip port- If liquid does get into the
test strip port, immediately dry the components with a dry cloth or gauze pad.
State cleaning frequency (after
each
patient use, at time of quality control, once every 24
hours)
States how to document cleaning electronically in the meter
States cleaning precautions – After cleaning, wait until the meter is completely dry before
docking.
Employee: I have read the Guidelines of Practice for Point of Care Accu-Chek Inform II Blood Glucose Monitoring System.
I feel competent to perform above skills. I understand that the use of another person’s ID or a false patient identification in
the ACCU-CHECK Inform II meter is considered falsification of a document and may result in disciplinary action.
Signature:______________________________________/Lawson No____________Date______________________:
Trainers: The above skills have been successfully demonstrated and stated correctly. By signing this competency check list.
Signature: ____________________________________ Date: ____________
