ACT LQC lockout
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For those using Hemochron Elite ACT instruments….How many “fail” LQC do you allow before lockout?
Thank you,
Tessa Shaw, MT (ASCP)
Point Of Care Coordinator
Parkwest Medical Center
Work: 373-1606
Fax: 373-1611
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We allow 4. It may seem a bit excessive, but with new employees learning the control reconstitution technique, it gets tiresome resetting because of a learning curve. If your timing is not exact, you are out of luck. Once they get it, I do not see many repeats at all on my monthly QC review.
3
Kompan (Opal) Hallman, MBA, CLS (ASCP)
Area Laboratory Manager / POCT Coordinator
Riverside Medical Center & Moreno Valley Medical Center Areas
Phone: 951-251-6152 or Tie line 8-299-6152
Fax: 951-251-6151
Kompan.Hallman@kp.org
they are locked out for any QC failure if overdue, but I do not limit the amount of times they can try. As others have said, it is so technique-dependent that until they get it down, there are going to be failures - usually lots of them. Once they get the hang of it, they are generally OK. But at first, all complain that "there's something wrong with the machine!"...when in fact it is always their technique issues.
I agree with James. We do not limit the number of tries. But this test is so operator dependent that one could have 10 different staff running the same QC and get 10 very different results!! We have very specific steps (especially for our Proficiency Testing) that the operators need to follow for consistent results. Now, whether they follow them or not...wellll............!
Gayle,
What is your exact procedure for preparing the QC vials? When our Operators use the procedure on the Accriva website we have a lot of low out values. If I tell them to shake the dickens out of it for 15 seconds it will pass every time!
There is a fine balance between adequately mixing the vial and taking TOO much time mixing it so that it has already begun the clotting process without even being in the cuvette yet. That will give out of range low values.
Generally I find that most users - although they believe to be adequately mixing - are in truth not really ensuring that the contents are actually moving from end to end in the vial and adequately getting the diluent to saturate the dry blood pellet. To make that happen, I describe the required motion as "like shaking down an old mercury thermometer".
Of course only a few these days are old enough to remember mercury thermometers, lol.....
We have them mix by snapping wrist. See below:
6. Place the QC vial in the protective sleeve. Crush the inner glass ampoule by crushing the vial between fingers. Repeat the crushing action several times and mix the control material by snapping wrist back and forth 10x to mix contents thoroughly. Do not break ampoule until instrument is ready for sample.
7. Tap the vial on the table top cap side down to insure control material flow to the tip. Discard the first drop of QC material into the cap or on piece of gauze or paper towel
8. Fill cuvette sample well flush with top with appropriate QC level. If it extends above the top of the well, push excess into overflow channel with tip of vial. Press START button.