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FMC 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 (≤45 or ≥450 mg/dL; notify provider of critical results)
newborns (≤30 or ≥300 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).
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
Chlorox Bleach 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 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.
The employee listed above agrees to take the on-line quiz within 2 days of completion of
this skills lab.
Signature: ____________________________________ Date: ____________