22
IN
-SER
VICE
GUIDE
EVENCARE G3 BLOOD GLUCOSE
MONITORING SYSTEM:
CERTIFIED INSTRUCTOR RECORD —
COMPETENCY CHECKLIST
Certified Operator
Unit/Nurses Station
Date
Certified Trainer
The Certified Trainer should observe the Operator perform the following tasks:
1. Select and prepare the finger-stick site correctly.
□
Yes
□
No
2. Use lancet/lancing device correctly.
□
Yes
□
No
3. Insert EVENCARE G3 test strip into EVENCARE G3 meter correctly.
□
Yes
□
No
4. Apply blood to test strip correctly.
□
Yes
□
No
5. Dispose of lancet correctly.
□
Yes
□
No
6. Identify when to repeat test or check result with a laboratory test
□
Yes
□
No
7. Record patient result correctly.
□
Yes
□
No
8. Follow correct infection control procedures.
□
Yes
□
No
9. Follow facility protocol for quality control testing.
□
Yes
□
No
10. Clean/disinfect EVENCARE G3 meter correctly.
□
Yes
□
No
11. Change battery.
□
Yes
□
No