POC Test: Hemoglobin- HemoCue 

AFTER TAKING ONLINE TEST AND READING THE POLICY, EMPLOYEE PERFORMS A TEST AND  MARKS RESULTS BELOW.  THE PRECEPTOR OR TSM GRADES RESULTS FOR ACCURACY.

1. Reads entire Policy/Procedure
2. Completes and passes written test (Passing criteria is 100%)
3. Return demonstration

 CRITICAL POINTS FROM POLICY AND PROCEDURE

OPERATOR INITIALS

 a. Reagents- Verifies reagent cuvettes are current (per expiration date) & states expiration dates for open vials

  b. Acceptable specimen- States acceptable specimen options: blood collected in EDTA or blood collected in syringe (must be tested immediately to beat coagulation process).

 c. SOURCES OF INCORRECT RESULTS

·         Incorrect specimen collection (general): specimen collected in citrate (blue top) tube, or gel separator, specimen hemolyzed, specimen improperly mixed prior to testing (cells have settled or concentrated in bottom of syringe or tube. Blood must be collected in EDTA (purple top) or syringe (specimen collected in syringe must be tested immediately due to coagulation process)

·         Incorrect specimen collection (capillary blood): The first drop of blood was used (proper procedure calls for first 2 drops wiped off; also only the middle finger must be used).

·         Incorrect handling of reagent cuvette: Cuvettes expired (90 date open vial expiration date or manufacturer whichever is sooner). Improper storage (cuvettes must be stored at room temperature).  Use of unused cuvettes (cuvettes must be removed from vial as needed, and any unused cuvettes must be discarded)

·         Incorrect test procedure: Bubbles present in or near center of cuvette, failure to wipe excess blood from sides of overfilled cuvette (prevents accurate reading plus it will soil the Hemacue’s  internal lens), failure to immediately test blood filled cuvette.

·         Improperly maintained meter or instrument: A dirty internal lens will lead to incorrect results. The optronic unit must be cleaned monthly and the cuvette tray must be cleaned after each use

d.  Describes maintenance (instrument cleaning) procedures

·         Optronic unit
·         Cuvette loading tray

e.  Quality Control

1. The instrument calibration control cuvette Check is to be performed on each day of use before patient testing (NOTE: Hemacue 201+ does not require calibration cuvette. Instrument self calibrates when powered on).
2. Two controls are performed and documented on day of testing
3. A sample will be submitted monthly for comparison to a reference lab.

f. PERFORMS PATIENT TEST    

Uses only the middle finger for sampling
Wipes off the first two or three drops of blood before completely filling cuvette. Checks cuvette for the presence of air bubbles
Wipes off sides of overfilled cuvette
Tests filled cuvette immediately
Obtains correct result  (passing criteria=  7% variance)
Reviews patient results for critical values