17
IN
-SER
VICE
GUIDE
OPERATOR CERTIFICATION CHECKLIST
CERTIFIED INSTRUCTOR:
Complete one checklist for each operator-trainee. Before signing this checklist,
the trainee must meet objectives as listed below.
A. Familiarization with Components of the EVENCARE G3 Blood Glucose Monitoring System
1. EVENCARE G3 Meter
□
Features (test strip port, test strip ejector, battery compartment and screen)
□
Serial Number
□
Toll-Free Customer Service Number
□
Cleaning and Disinfecting
□
Storage
2. EVENCARE G3 Blood Glucose Test Strips
□
Expiration Date
□
Lot Number
□
Control Solution Ranges
□
Handling of Strip
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Proper Insertion of Strip
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Storage
3. EVENCARE G3 Control Solution
□
Expiration Date
□
Lot Number
□
Acceptable Range
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Test Procedure
B. Describe/Demonstrate
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Obtain a Blood Sample — Preparation, Obtaining Sample
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Perform a Blood Glucose Test
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Quality Control — Dropping Solution on Flat Surface, Marking Control Test in Meter,
Perform Quality Control Test, Log Quality Control Result
C. Explain
□
Battery — Replacement Procedure
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Memory Function — Describe Process
Instructor Name
Date
Operator-Trainee Name
Operator Certified
□
Yes
□
No
