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"In terms of cleaning pre-sample we use the BD ChloraPrep 1ml Applicator to clean/wipe over the area that is going to be used, the area is left to dry before sampling.

We do use a very thin layer of Vaseline (paraffin - can't remember the hospital brand) to help the blood pool also."

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How to find the Serial Number for RAPIDComm while requesting a reboot?

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How to find the Serial Number for RAPIDComm while requesting a reboot?

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rom the main ribbon, click Help → About and a pop‑up window will display the Serial Number.

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RAPIDComm moves - 01/04/27

POCcelerator moves - 01/04/28

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Your current version is 3.6.12.15 SP16 and I would like to upgrade you to NovaNet 4.4 SP1. Downtime would be approx.. 4 -6 hours as this is probably the largest jump of software version.

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TPF > select blood gas analyser

Report:

22/05/2026, cart number: 1234567890, D code / error, - insert action taken e.g. expired WW twice, resolved after MM change

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Blood Gas - What are measurements used for (from the operator manual)

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Blood Gas - What are measurements used for (from the operator manual)

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Measurements of blood gases (pCO2, pO2) and blood pH are used to aid in the diagnosis and treatment of acid-base disturbances

Sodium, Potassium and Chloride measurements are used to aid in diagnosis and treatment of electrolyte imbalances.

Ionised calcium measurements are used to aid in the diagnosis and treatment of parathyroid disease, a variety of bone diseases, chronic renal disease, and tetany

Glucose measurements are used to aid in the diagnosis and treatment of diabetes mellitus, hypoglycemia and hyperglycemia.

Lactate test is intended to measure lactate in whole blood. Lactate measurements that evaluate the acid-base status are used to aid in the diagnosis and management of acidosis (anion gap), shock and sepsis.

Neonatal Bilirubin test is intended to measure the levels of bilirubin in the blood of newborn infants to identify hyperbilirubinemia that can lead to kernicterus.

Total hemoglobin measurements are used to aid in the diagnosis of anemia.

Oxyhemoglobin measurements are used to aid in the identification of impaired oxygen update leading to hypoxemia.

Carboxyhemoglobin measurements are used to aid in the diagnosis of carbon monoxide poisoning.

Methemoglobin measurements are used to aid in the diagnosis of methemoglobinemia.

Deoxyhemoglobin measurements are used to aid in the evaluation of hypoxemia.

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500 - can only input ranges for arterial; can't add ranges for venous or capillary. They will print ranges for all sample types but it will be arterial ranges.

500e - we can add ranges for all sample types; but currently we have only done this for arterial. This is potentially planned in to update along with the analyser refresh. Currently, they will print arterial ranges with results but they won't print ranges for the other sample types

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From RP500/500e operator manual

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Routinely (monthly) inspect the air filters, and clean or replace if they are dusty.

Depending on the level of dust and lint in the air where the system is being used, the air filter may need checking and replacing more frequently.

Keeping the air filters free of lint and dust prevents the analysers from experiencing temperature errors.

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Blood Gas - Resetting EXTERNAL Barcode Scanner

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Blood Gas - Resetting EXTERNAL Barcode Scanner

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From the RP500/500e Operator Manual

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Glucose meters erasing results if in storage

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Glucose meters erasing results if in storage

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When meters are left in storage for extended periods—especially without regular use or charging—it is possible that locally stored results may no longer be retained on the device itself.

This means we have to be careful if meters are removed to investigate discrepant results or datix incidents - if these aren't acted on quickly, and the meter is just kept in the office waiting for investigation, the results may delete themselves if not docked and backed up to NovaNet and BioConnect

Within NovaNet, there is a specific configuration under Data Archive > Discard Patient Results, which defines how long NovaNet retains results before they are archived. Once results have been sent from the meter to NovaNet and BioConnect, they can be retained and accessed in BioConnect indefinitely, as it has the capability to store this information long‑term.

Source: email from Nova, April 2026

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Log In ‹ Leeds Teaching Hospitals NHS Trust — WordPress

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When the RAPIDComm Data Management System indicates that a "device rejected the following operators," it means the point-of-care (POC) instrument has rejected the login credentials or user IDs of specific staff members during a data download or sync process.

Common Reasons:

Missing or Outdated Certifications: The operator has not completed the required training or recertification required for the system

Download Error: The instrument did not receive the updated user list from the RAPIDComm master database during the last synchronization.

Operator Database Synchronization Issues: The operator was recently added or updated in the system, but the changes have not yet propagated to the specific device.

How to Resolve the Error

1. Re-synchronize the Device: Force a manual communication download between the device and the RAPIDComm system to ensure it has the latest operator list.

2. Verify Operator Status in RAPIDComm: Check the RAPIDComm Web Application to verify that the operators in question are marked as "Certified" and are assigned to the correct device group.

3. Check Training Completion: Ensure that all certification, training, and assessment documents are updated for the rejected operators.

4. Confirm Device Connectivity: Verify that the device is online and properly communicating with the server.

If the issue persists, the operator may need to be removed and re-added to the operator management system, or the device may require a reboot to clear its operator database.

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Brief summary of what the lab use the blood gas analyser for

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Brief summary of what the lab use the blood gas analyser for

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Sodium (Pseudohyponatraemia)

Purpose: Check for pseudohyponatraemia caused by lipaemia

Requirements: Serum sample. Avoid EDTA samples (damages potassium sensor). Must be capped if not checking gases.

Stability: No time limit if capped; if uncapped, sodium levels may change due to evaporation

Pleural Fluid pH

Purpose: Determine if pleural effusion is Transudate or Exudate

Requirements: Heparinised blood gas syringe. Hand deliver only. Hand delivery prevents gas displacement.

Stability: Must be run within 30 mins of collection.

Carboxyhaemoglobin

Purpose: Detect carbon monoxide poisoning

Requirements: Non-gel heparin tube (green and black). Run as whole blood (plastic capillary tube or syringe)

Stability: 28 days

Methaemoglobin

Purpose: Check for methaemoglobinaemia, reduced oxygen carrying

Requirements: Non-gel heparin tube (green and black). Run as whole blood (plastic capillary tube or syringe)

Stability: 2 hours

Patient ID and Record Keeping:

Use Winpath nomenclature. Lab numbers are 7 digits like PAS numbers, so using a lab number can mean that the result will assign to an incorrect patient on EPR.

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Paeds Diabetes (Pink Building) - DCA Cartridge Standing Orders

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Paeds Diabetes (Pink Building) - DCA Cartridge Standing Orders

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Paeds Diabetes receive a standing order of DCA cartridges from Siemens.

This is 5 boxes (20 white boxes) every month.

Siemens send out the order at the end of the month, so will arrive with the ward around the start of the month.

We should have some DCA Carts in our cold room in case they need some ad hoc between SO deliveries.

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Glucose/Ketone Troubleshooting Flowchart - Meter Won't Work Outside of the Dock

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Glucose/Ketone Troubleshooting Flowchart - Meter Won't Work Outside of the Dock

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Clinitek Status+ Urine Meter - how to remove a stuck test table

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Clinitek Status+ Urine Meter - how to remove a stuck test table

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Blood Gas - Putting analyser in DEMO mode (for training)

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Blood Gas - Putting analyser in DEMO mode (for training)

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DCA Vantage Quarterly Maintenance Siemens Job Aid

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DCA Vantage Quarterly Maintenance Siemens Job Aid

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Glucose/Ketone Troubleshooting Flowchart - Physical Damage / Error Message

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Glucose/Ketone Troubleshooting Flowchart - Physical Damage / Error Message

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Glucose Exchange Log - Prioritising the Steps

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Glucose Exchange Log - Prioritising the Steps

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Setting up a new glucose/ketone meter flowchart

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Setting up a new glucose/ketone meter flowchart

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Nova - Instructions for Erasing Patient Data (Glucose/Ketone)

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Nova - Instructions for Erasing Patient Data (Glucose/Ketone)

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NTFS (New Technology File System)

Standard format for PCs running Windows OS only

Not ideal for cross-platform use or embedded/medical devices

FAT32 (File Allocation Table 32)

Most versatile and widely compatible format

Cannot store files larger than 4 GB

Ideal for medical devices and embedded systems

exFAT (Extensible File Allocation Table)

Newer version of FAT with support for very large files

Good for modern USBs with large files, but not always compatible with older or embedded devices

UDF (Universal Disk Format)

Designed mainly for optical media (DVDs, Blu-ray discs)

Can handle large files and is cross-platform

Not supported on medical devices; should not be used

✅ Simple Takeaway

UDF → designed for discs, not typical USB use

FAT32 → most compatible, especially for devices

exFAT → best modern choice for large files

Most USBs we use are already formatted as FAT32. Some may have other formats, but FAT32 is the safe default.

i-Stat Alinity Software Updates, VAS/eVAS, etc:

Must be FAT32 format

Must be USB 2.0

Allocation unit size can be the default but safest choice is: 4096 bytes (4 KB)

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Guide to Waste - What goes in each type of bin

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Guide to Waste - What goes in each type of bin

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Find local businesses, view maps and get driving directions in Google Maps.

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395 meter license (correct June 2024)

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Here is a simple way to determine the problem:

Find a spare meter, dock, and ethernet cable. Make sure they are all working correctly before taking them onto the ward.

Use the spare, working equipment to troubleshoot. Try each item one at a time — do not replace all of the ward’s equipment at once, as this defeats the purpose of troubleshooting.

Try the new meter in the ward’s dock.

If it works, this is a meter issue. Check the meter settings or swap the meter.

Try the ward’s meter in the new dock.

If it works, this is a dock issue. Swap the dock.

Try the ward’s meter and dock with a new ethernet cable.

If this works, the issue was a faulty cable. Leave the working cable on the ward and bring the faulty one back for disposal.

If none of the above works, the issue may be the network port. Contact IT to:

Activate the port if required

Confirm multiple MAC address access (especially for dual or quad docks)

This process should help identify which element is causing the problem.

More In-Depth Instructions:

1. Dock & Power Checks

Is the meter connecting in the dock?

Is it connecting according to NovaNet? You could check BioConnect to see if we are receiving QC or patient results

Are the dock lights working?

Is there any physical damage?

Damaged cables

Damage where the meter connects

Damage to the network port socket

Is the dock plugged into:

Power socket

Network port socket

Has the ward:

Changed the dock location?

Used the network port for another device as well as the dock?

What type of dock is it?

Dual/Quad docks may not be set up to allow multiple MAC addresses

Make a note of the network port details and the door number – contact IT to check if the port is active or not – and if it is active for multiple MAC address if a dual/quad dock.

This will help us determine if the network port is the issue, or something else.

2. Swap & Test Equipment

Take:

A meter you know docks successfully

A spare dock that you know works

Spare ethernet cables that you know work

Make sure all the above are working before you take them out to the ward.

Test in this order:

1.      Dock the known working meter in the problem dock. If it docks the issue, is the original meter.

2.      Dock the problem meter in a new dock – if it docks, the issue is the original dock

3.      Try a different ethernet cable. If it docks, the issue was a damaged cable

Actions after testing:

If cables work → leave them

If new dock works → consider an exchange

If meter is faulty → check settings or exchange meter

👉 Always update inventory and exchange log if an exchange is performed

3. If the issue is definitely the meter – Check Settings

Check Srv Host:

Must be POCT-NOVANET or POCT-NOVANET2 (site dependent)

This is often left blank, as it won’t allow both Srv Host and IP to be input when setting up. After the first dock/update, you can usually enter the Srv Host manually. This has fixed connectivity issues for me before.

Additionally – check the entire IP and Port numbers, there are sometimes typos.

All meters should be set to DHCP

Meter settings should be:

LGI:

Srv Host: POCT-NOVANET

Srv IP: 163.160.231.49

Srv Port: 57386

SJUH:

Srv Host: POCT-NOVANET2

Srv IP: 163.160.231.45

Srv Port: 57386

You can try swapping the Srv Host and IP to the other site’s details, to see if that works.

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Hypoglycaemic treatment kits / checklists

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Hypoglycaemic treatment kits / checklists

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Wards get these via pharmacy stores (medicine & pharmacy stores)

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Maps of the ward layout on each floor of the different wings of our hospital sites.

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Log In ‹ Leeds Teaching Hospitals NHS Trust — WordPress

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Common sodium sensor interfering substances that reach the sodium sensor from outside of the instrument are:

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Common sodium sensor interfering substances that reach the sodium sensor from outside of the instrument are:

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Silver sulfadiazine

Chlorhexidine

Perhexiline Maleate

Atomoxetine Hydrochloride

Benzalkonium compounds

Source: Siemens engineers

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QPulse Acknowledgements - why we need to acknowledge them regularly

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QPulse Acknowledgements - why we need to acknowledge them regularly

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Part of KPIs for each dept. is showing that we are regularly logging into QPulse and reviewing documents

We get flagged if we aren’t doing this regularly

It can stop appraisals being signed off

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Blood Gas - Cartridge Failures (Errors) Reimbursed by Siemens

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Blood Gas - Cartridge Failures (Errors) Reimbursed by Siemens

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To ensure you are fairly compensated for any cartridge failures relating to quality or manufacturing issues, Siemens Healthineers will replace the unused portion of an MCart in a consolidated monthly shipment beginning 1st October 2025.

To do this we will require you to submit a Trace Log from the RP500e to the Siemens Healthineers POC Helpdesk. The submitting of the Trace Log is crucial as it not only allows us to investigate the root cause of the issue and seek to implement product improvements but also calculate the unused percentage of the affected cartridge that we need to replace and send to you.

Trace Logs can either be submitted automatically by the RP500e via email if given the necessary permissions by your local IT Network team or copied on to a USB stick inserted into the RP500e and then attached to an email which is then sent to the Siemens Healthineers POC Helpdesk team.

In the middle of each calendar month, we will collect up each of your submitted Trace Logs, calculate the percentage of the cartridge we need to replace and organise the delivery of every full cartridge (100% volume owed) to be sent to you, as well as provide you with a report stating the cause of the cartridge to be replaced, and the percentage of the cartridge each Trace Log instructed us to replace for complete transparency throughout the process.

Where an owed percentage is less than 100% of a cartridge this will not be replaced in the current calendar month but will be carried over to the following month before being replaced. (e.g. Should Siemens Healthineers owe you 425% of an MCart over a calendar month, we will issue 4 x MCart replacements and carry the remaining 25% over to the following month).

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Have finally had some success with finding an alternative to Siemens for paper rolls.

You can order these through Oracle.

Options:

Urinalysis labels:

Product details for HHH473 - NHS Supply Chain Online Catalogue

Urinalysis sticky labels:

Product details for HHD219 - NHS Supply Chain Online Catalogue

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The phenomenon of Siemens urine quality control (QC) turning into jelly is primarily due to the breakdown of the stabilizing agent in the QC material, often caused by contamination or improper storage conditions.

Key reasons for this gel-like transformation include:

Bacterial Contamination: The most common cause is the introduction of bacteria into the vial, which metabolizes the preservatives and causes the liquid matrix to turn into a jelly-like substance.

Improper Storage/Temperature Excursion: If the control is left at room temperature for too long or exposed to heat, the stability of the solution is compromised, leading to polymerization.

Expiration/Degradation: Over time, the chemical composition of the QC material degrades, which can cause it to become unstable and form a gel.

Recommendation:
If the urine control has turned into jelly, it should be discarded immediately, as it is no longer suitable for accurate testing. Always ensure the bottle is capped tightly and stored at the recommended temperature (usually 2-8°C, or as specified on the package insert) to maintain stability.

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Pre-Analytical Procedures for Glucose & Ketones

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Pre-Analytical Procedures for Glucose & Ketones

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If a finger prick sample cannot be taken from the patient and taking a syringe sample is not feasible you can suggest to prick the ear.

Ketone testing is not validated for arterial blood

If patients hands are overly cold before pricking, suggest the staff warm it up by filling a glove with warm water to stimulate the blood flow

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Follow the procedure for 'What happens if a ward report suspected Incorrect Results?'.

If a ward reports suspected incorrect results from a blood gas analyser:

Change the cartridge: As a precaution, replace the measurement cartridge.

Check the environment during installation:

Ensure there are no Clinell wipes nearby.

Look for analyser messages such as “Excessive sodium interferent detected.”

Note the time cleaning staff were present. If cleaning coincides with the analyser issue, it may suggest Clinell wipes were used around or on the analyser.

Report details: Share all observations with the Band 4/6/7 staff.

Escalation if recurring: If they identify this as a regular occurrence, they can liaise with the relevant departments to ensure the issue is addressed promptly.

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Blood gas analysers use cartridges that come with an “install by” date and an "expiry date", recorded in the stock log.

If a cartridge is installed on or before the install by date, it works at full capacity (100%).

If it is installed after the date has passed, the analyser will still accept it, but the cartridge won’t perform at its full potential. Its usable capacity is reduced (for example, to around 80%), meaning it will need to be replaced sooner than usual.

A cartridge should not be installed once it has passed the expiry date - it should be disposed of

In simple terms: Think of the “install by” date like the freshness date on food. You can still use the cartridge after that date, but it won’t last as long or work as efficiently, so you’ll have to change it earlier.

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Hi Tom

Yes, theoretically the Coaguchek does have this capability. Sadly, it hasn't been set up for our Trust. I've attached the Ward Handbook mentioned in the business case so you can take a look at the system currently in place.

I have queried if we could make your idea the thing that pushes for connectivity work to begin, unfortunately the info I have gotten back from my coordinator is that the departments involved in implementing this, namely DIT does not currently have the capacity to take it on. They are currently working through their workload in order of highest risk, and for the work to proceed it needs to be ranked as one of the CSU's top priorities.

I am in a meeting tomorrow where I can ask for further clarification on how you could request this (how realistic is your implementation of using POC INR testing, if results needed to be transcribed over to PPM+?). But I think it's important to note it sounds like implementation of this would not be quick. In short, it involves an Expression of Interest (EOI) submission followed by some pretty in depth end-to-end testing involving POCT, DIT, and middleware/PPM+ reps.

Please let me know your thoughts on this, or if you need any more information.

Best,

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iSTAT Alinity

SJUH + LGI Radiology/CT have the iSTAT Alinity - CT scans often involve injecting an iodine-based contrast dye to improve image clarity. Since healthy kidneys are necessary to safely excrete iodine, it’s important for the wards to know if their patients kidneys are compromised before administering the contrast.

To check kidney function, the ward monitors creatinine levels using the Alinity. Creatinine is a waste product from muscle metabolism, and elevated levels can indicate impaired kidney function.

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iSTAT - why POCT generate tighter ranges

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iSTAT - why POCT generate tighter ranges

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My original email referred to a lot of QC with the following ranges for creatinine:

Level 1 Mean: 371 umol/L

Level 1 Range: 301-442 umolL

Level 3 Mean: 44 umol/L

Level 3 Range: 9-80 umol/L

Although the ranges are from an old lot, we have found that similar ranges have been applied to subsequent lots. They are unfortunately excessively wide and could result in considerable deteriorations in renal function going undetected.

To give just one example, an elderly patient with low muscle mass, and therefore a low baseline creatinine, who has an increase in creatinine from 35 to 79 umol/L (consistent with acute kidney injury stage 2) could have their creatinine reported as 40 umol/L (or even 9 umol/L, if you want to take it to the extreme) rather than 79 umol/L due to an analytical problem. This analytical issue would not be detected using your QC ranges, as any result between 9 and 80 umol/L would be considered a pass, and the inaccurate patient result would therefore be issued. As acute kidney injury can lead to permanent irreversible kidney failure, administering contrast to this patient could have serious consequences. Use of such wide QC ranges on the iSTAT could lead to this very scenario. Use of tighter QC ranges (which we have shown in LTHT the device is capable of – see below) would detect poor performance much more readily, and significantly reduce the chance of this occurring.

Our own QC ranges for this specific QC lot were:

LTHT level 1 QC range: 368-396 umol/L

LTHT level 3 QC range: 35-45 umol/L

These were derived using a total of 60 data points collected from four machines over three different days (mean +/- 2SD). You can see that these are much tighter than the official ranges from Abbott, and show that the device is far more capable than your own QC ranges suggest.

Because of this issue, we have to determine our own ranges for every new lot of QC used. This causes a significant administrative burden, in addition to patient safety issues, and as I believe I mentioned when we met, would influence our decision to use the iSTAT if given the choice again.

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Connectivity Troubleshooting

Even though the analyser was on DHCP mode, it doesn’t request DHCP address every time its moved around, or been off for a longer time. It holds the old IP given by DHCP, doesn’t release it when it goes off.

As DHCP addresses are dynamic, they will be reused if they aren’t live in the network.

Manually force the device to initiate a new DHCP request from the analyser by disabling and reenabling the connection to reset it.

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Erasing patient data

The process below describes how to erase patient data from StatStrip Glucose/Ketone, StatStrip Lactate or StatSensor Creatinine meters. Patient data must be erased before the meter is returned to our offices, in order to comply with The Data Protection Act 1998.

1. Dock the meter and wait until communication is completed.

2. Undock the meter

3. Change the date e.g. one year in advance

a)     by logging in

b)      go to the ‘Menu’

c)     press ‘Admin’

d)     Time/Date to a year in advance

4. Dock the meter

There should no data on the review results screen and the review facility should disappear from the screen.

For any problems or queries, please email support@novabiomedical.co.uk

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Jawad - 60381

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SJUH Office: (0113 20) 64791

LGI Office: (0113 39) 22338

LGI POCT Only Ext: (0113 39) 23639

Mobile: 07775996028

SJUH POCT Only: (0113 20) 69410

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POCT (within University of Leeds, Academic Department of Rehabilitation Medicine)

Martin Wing D Floor

Leeds General Infirmary

Great George Street, Leeds LS1 3EX

Acute Hospital Laboratory

Jubilee Wing A Floor

Leeds General Infirmary

Great George Street, Leeds LS1 3EX

Centre for Laboratory Medicine

St James Hospital

Beckett St

Harehills

Leeds LS8 5RA

W3W//listed.successes.lodge

Chapel Allerton Hospital

Chapeltown Rd

Leeds LS7 4SA

Seacroft Hospital

York Rd

Seacroft

Leeds LS14 6UH

Wharfedale Hospital

Newall Carr Road

Otley, LS21 2LY

Pathology Reception

Chancellor Wing

St James Hospital

Beckett Street

LS9 7TF

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SJUH CT: x68612

LGI CT:x23617

Please call before iSTAT troubleshooting to ensure no clinics.

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The POCT Knowledge Base is a central hub for everything we’ve learned together in one place. It’s built to outlast emails, chats, and personal notes, so the knowledge we gather doesn’t leave with us. By sharing what we know, we make things easier for each other today — and for every POCT team that comes after us. Over time, this hub will grow into a go-to guide, helping teams spend less time hunting for answers and more time fixing problems and moving forward. Please update as knowledge changes.

Use the search function at the top right to narrow down results.

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POCcelerator Process Monitor Connection Symbol Meaning - LIAT

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POCcelerator Process Monitor Connection Symbol Meaning - LIAT

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Connection troubleshooting

If you are not seeing the green connected symbol, try logging in so the analyser has some info to send.

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Chek-Stix UA Diptube Liquid QC contains both Level 1 (negative for all chemistry parameters and positive for hCG) and Level 2 (positive for all chemistry parameters and negative for hCG), packaged in one box. Both Level 1 and Level 2 diptube controls are ready-to-use liquid quality controls for use with the CLINITEK Status®+ Analyzer, CLINITEK Advantus® Analyzer, and visual-read urine strips.

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Chek-Stix Urinalysis Liquid Quality Control Products

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Blood Gas Air Filters - Difference between 1200 and 500 analysers

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Blood Gas Air Filters - Difference between 1200 and 500 analysers

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1200 - White and soft (also for DCAs)

500 - Grey

The fan speed for the RapidPoint (500) is faster than the RapidLab (1200) and having a filter part number for each suggests that the filter material is different for this reason

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Scan

Add to invoice box

Send to supplies

The Trust doesn't pay until they have had invoices

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Blood Gas Analyser - Cartridge Components

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Blood Gas Analyser - Cartridge Components

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Find this info on the RP500E Operator manual.

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Pleural fluids cannot currently be processed on the wards.

Samples must be hand delivered to CfLM within 30 minutes of collection (do not send via pneumatic tube, as it can interfere with the gas measurements and pH levels, which may compromise the accuracy of the results.)

Upon arrival at the lab, kindly inform reception that the sample is pleural fluid requiring immediate or time-sensitive blood gas analysis. The team will ensure it is prioritised accordingly.

Do they need to send an ICE form?

It needs to be requested in the same way that they would request any other pathology investigation. They should be able to find it on ICE by searching for the term “fluid ph”.

We don’t have any plans to make pleural fluid testing available at ward level in the near future.

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Why don't we use the 'EQA' sample button on the blood gas analysers?

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Why don't we use the 'EQA' sample button on the blood gas analysers?

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The EQA function was only introduced to the RP500E from software version 5.1 onwards – the historical reason is that it didn’t exist for a portion of the time, and depending on the model / software version it may be an option on some but not all.

During EQA testing, barcode entry can only be used for Operator ID – Just something to also consider.

Basically - this function only exists on the RP500E analysers, and we currently have less of these than we do the older model

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Root cause of Na+ interference due to doctors using clinell wipes on kidney dishes?

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Root cause of Na+ interference due to doctors using clinell wipes on kidney dishes?

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Tends to happen following a sample being run - time of interferent message coincides with patient test being run - must be the way samples are being handled ? - Noticed with a capillary sample. - AP - 02/10/2025

1. could the gloves be near clinell wipes?

2. could the capillaries be stored near clinell wipes?

3. could the patients be cleaned with chlorhexidine prior to taking sample?

4. could they be drawing samples from lines cleaned with clinell without flushing them first, or discarding of first few drops of blood?

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Request on IT service desk.

FilePath =  G:\Point of Care

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Support will be until September 2029 (Adam, 07/10/2025)

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Why do CAH have a Coaguchek when they never use it?

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Why do CAH have a Coaguchek when they never use it?

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Ward C3 managers which we work closely with are Debbie Hardy and Julie Foster.

debora.hardy@nhs.net

julie.foster19@nhs.net

'There is a clinical need for the analyser, but it's use is infrequent so any training offered would be well received.

BW,

Julie.'

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The wards use these for taking swabs to run on the Liat analysers.

UTM = Universal Transport Media

VTM = Viral Transport Media

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How do wards order Viral Transport Media tubes (VTM) for respiratory testing

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How do wards order Viral Transport Media tubes (VTM) for respiratory testing

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Via Oracle. They come from Dolly Lane, so there is a 3 day turnaround.

Some buffer stock is stored within Pathology.

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If an E50 error comes up, alongside other troubleshooting, check the stock the ward has.

Multistix 8SG - correct strips

Multistix GP - incorrect, EXACT same packaging apart from name.

See picture for difference, the analyser wont recognise the GP strips as they don't have the extra white pad with ID on.

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Please find a summary of known RAPIDComm connectivity issues below:

Issue 1

For an operator download to be accepted by the instrument all the operator certification date fields must contain valid date information. RAPIDComm does not check that this field is filled during operator import or download, and this can lead to empty certification date fields being included in the operator download from RAPIDComm to the instruments.

Every time the instrument receives an operator record without a certification date it sends a 'REJECT' message to the data manager. RAPIDComm then restarts the communication link and the process will start again, leading to an endless loop where stable communication is never re-established until the operator download contains valid data.

A tool has been released that allows quicker diagnosis of the cause of these issues.

Interim Solution:

Siemens PC Informatics R&D have released a software tool that will identify and automatically correct RAPIDComm operator accounts that are missing a certification date. When the tool finds an operator with a missing certification date it will enter a certification date 7 days into the future by default, but this value is configurable and can be set to a value that suits the customer's needs.

Issue 2

When existing operators are edited, if the RAPIDComm system notices that a value entered into a unique field is non-unique (e.g. a duplication of an operator ID or similar), RAPIDComm provides a warning that this information cannot be saved and prompts the user to make another attempt. The user enters unique data, and the information is encrypted. There is an issue within RAPIDComm that retains the encryption from the first attempt, and the second attempt before sending it to the device. The device attempts to decrypt but can only do so with the second decryption. This causes the password of the operator to appear to the device as either falsely too long, or contain special characters.

Every time the instrument receives an operator record where the password is too long or contains unsupported characters, it sends a ‘REJECT’ message to the data manager. RAPIDComm will then restart the communication link and the process will start again, leading to an endless loop where stable communication is never re-established until the operator download contains valid data.

A complete solution is being considered for a future release of RAPIDComm software.

Mitigation

To mitigate these issues, firstly please speak with Tim Hodkinson and ask if the tool is installed upon your server to help diagnose issues quicker.

Secondly, please make sure that all operators have a valid certification date, to prevent blank information being sent to the devices (and therefore rejected).

Thirdly, please be careful when amending current operators, and be mindful of creating duplicate data within fields that should be unique. This prevents data being encrypted twice, and being rejected by the device.

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Why do we use syringes without heparin for co ox EQA

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Why do we use syringes without heparin for co ox EQA

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The EQA has a slightly different matrix to patient blood, so the risk of clotting is less. For co ox EQA it shouldn't affect the results if we run the samples straight away but for patient testing the wards should always use heparinised syringes as fresh blood still has all the clotting factors active. (ideally we should follow the same protocol for EQA too).

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POCT Analysers - poster by Ayesha Ansari (POCT 2022-2025)

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POCT have their own logins for Canva.

Posters must pass quality checks e.g.:

Index code = document control code for qpulse (given by Emma)

Version number = So staff know which is the most up to date document

Page number = page 1 of 1 to make sure there is no further information/page missing

Things to keep in mind when designing posters:

1. Does it already exist? Search key words on qpulse/ask team

2. Quality Improvement = does it improve the service/is there a need for it

3. LTHT/professional branding

4. Accessible to those who's first language is not English

5. Accessible to those with visual impairment - see Trust guidance on this

6. Is it aesthetic - we want to make wards look interesting for staff, as well as driving engagement with the poster

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Dear Colleague,

Please test the enclosed sample as if it were a patient sample, using your usual method.

Please record your results, meter serial number and strip / cassette lot number on the results return sheet (input sheet) below, scan and send it to the following email address:

Leedsth-tr.pointofcare@nhs.net

All results must be returned by the return date stated above. Please keep a hard copy of the results for your records.

Please ensure that all operators take turns to participate in the EQA programme. This procedure should not be carried out by the same operator on each distribution.

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Have you ever noticed that each pad on the test strip is read at a different time frame?

Quality Benefits

Printed results/connectivity = no transcription = reduces medication errors (e.g. starting/withholding antibiotics based on wrong UA values)

Blocks results from compromised strips = avoids acting on invalid data

Traceability for audits (UKAS/ISO)

Identifies bad strips and common interferences = reduces false positives/negatives

Reduced risk of missed UTIs

How: UTI diagnosis often relies on nitrite and leukocyte esterase on dipsticks.

Visual reads are vulnerable to timing errors (reading too early or late) and colour misinterpretation, especially under poor lighting (sluices).

Clinitek provides precise timing and uses a colorimetric reader, eliminating human subjectivity.

Impact:

·        Fewer false negatives = timely antibiotic initiation, avoids sepsis progression in frail/catheterised patients.

·        Consistent interpretation across staff = less reliance on experience/shift variation.

AKI Screening

How: Dipsticks detect protein and blood which can indicate renal injury.

Autamated reading reduces under-reporting of trace or mild positives, (can be early markers of AKI or glomerular disease).

Impact:

·        Early recognition = faster escalation (bloods, fluids, medication)

·        Especially relevant for post-op, septic, elderly patients, where AKI risk is high.

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We have received your request regarding the use of splitters. Under normal circumstances, their use is not permitted, as they are typically only provided as a temporary measure when new network sockets are ordered through the Estates department. However, given the importance of these devices and the uncertainty around whether new sockets would be funded by POC or the ward/unit, we are prepared to approve their use in this instance.

We strongly recommend first checking for an available free socket, even if this requires relocating the device. If no free socket is available and the device fails, the use of a splitter may be considered as an acceptable last resort.

Please be aware that in certain areas of the hospital, for example Jubilee (LGC02, 03, 04, 05 & 06 sockets) and certain areas of CAH, we are unable to use splitters, but we can confirm that when you raise a ticket.

Unfortunately, we do not stock splitters, we would therefore be grateful if you could arrange to purchase some using the link below, so that they can be kept in your storage for future use – we would just need to arrange to pick one up from you for the cab side when needed.

Please note that for each socket there is a requirement to use two splitters—one at the socket side and one at the cab side.

Buy CE RJ45 Ethernet Splitter/Economiser - Pair - Cable adaptor

Going forward, if any device fails and a splitter is required, please quote WO252658 as confirmation that this is approved.

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If you can make digital versions, that would be better – for example digital training registers, or completing the EQA receipt sheets on the spreadsheet. Everything we complete by hand will need scanning and saving to G Drive – especially training registers, EQA/QC receipt sheets and audit sheets as we sometimes need to check these records.

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I have an idea for an improvement, what should I do?  

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I have an idea for an improvement, what should I do?  

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This is a CQI. We discuss these in the huddle. We also have a CQI board at LGI currently – there is a form to fill in with your idea, the reason for it, steps to take, etc. If this is filled in and added to the CQI board, Quality review this regularly.

Q-Pulse: Opportunity and Solution Form (CQI board) BSHC-FOR-6

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How often should I change blood gas cartridges? How could I check if a cartridge will need changing? 

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How often should I change blood gas cartridges? How could I check if a cartridge will need changing? 

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There is a guide on how to work this out.

Some low usage wards will expire on time, meaning the date on the cartridge is when the cartridge will expire, because they won’t use all of the samples. It’s useful to be aware of the high/low usage wards and how to check if a cartridge needs changing, as replacing them too early is wasteful and it also means we go through stock quicker. For example, when a measurement cartridge is on 20% - at a high usage area this could last another 1-2 days, on a low usage area this could last up to a week.

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What is the format for naming training sessions on the calendar? 

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What is the format for naming training sessions on the calendar? 

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The format should follow how many people are booked onto the session, the location of the session and then the type of training – this means we can see at a glance the most important information. This will also make it easy when booking sessions, as you can see straight away if there is already training booked on the same ward/nearby, and if there is room for extra staff to join.

Example: (4) J81 Glu/Ket KT Training

Once you have done a training session, it can be useful to edit the entry on the calendar to say how many of those booked on attended, and make a note of who did and didn’t attend, and any other changes that may have happened while on the ward (e.g., if someone booked in for glucose training and then also asked for blood gas training, or they weren’t originally going to be a Key Trainer and then changed their mind. Or if you go to a ward to train 1 person, and when staff see you, they ask to join).

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What is the format for naming glucose meters? 

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What is the format for naming glucose meters? 

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The format for naming glucose meters is the initial for the hospital, then the ward number/name, then the meter number, then a letter that changes for each swap.

For example, SJUH Ward 81 are given a 4th meter, this would be J-81 4A. If that breaks and they need a replacement, the next meter is J-81 4B.

If the ward only has 1 meter, stick to letters rather than numbers – for example, if LGI Maternity Assessment have 1 meter, this would be L-MAC A, then L-MAC B and so on as they get replaced. This is to avoid any confusion in how many meters a ward should have – for example if it was named L-MAC 1 this might suggest they should have more than one. And if it’s replaced with L-MAC 2, someone might think they should have 2 meters.

It’s also important as we use NovaNet to check connectivity, if the meters are all named in different formats, it will be harder to look for them, and unless we check for or notice that the naming format is different, it might be assumed that some meters don’t exist (as in, were never given to the ward or docked).

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Why don’t we have enough Dual and Quad docking stations?  

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Why don’t we have enough Dual and Quad docking stations?  

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Nova sent out a bulletin (Customer Information Bulletin CIB 04-24SS Dual & Quad Docking Stations) – the parts inside are no longer available so these docks are obsolete. There may be new dual/quad docks in the future, but currently the only thing we can do once we run out of the ones we have in the office, is to use spare docks – but this would mean using more plug sockets and network ports on the ward.

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We have meters specifically for training at each site. We use these for our own training sessions, but can also lend these out to trainers (e.g., Shine/Bootcamp).

The meters need updating regularly – dock them every couple of weeks to update. The connectivity of the training meters should always be off, so remember to switch it on to dock and then switch back off. They should also be deleted from BioConnect and NovaNet regularly.

When handing out training meters – make sure there are enough batteries and that they have been charged. Make sure there are plenty of strips and QC fluid and that they are all in date.

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What do we do with Non-Trust Satellite meters? 

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What do we do with Non-Trust Satellite meters? 

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Non-Trust meters are swapped every 6 months – this is because they can’t dock and update their meters, so we need to ensure patient data is backed up and also that they regularly have updated meters with the newest lot numbers/etc. The dates of swap outs are recorded on the glucose inventory – there is a tab for non-trust meters.

When you send a new meter to a non-trust satellite, after it has been set up and docked, switch the connectivity off – this is because they have docks for charging, and it may confuse the meters if they are docked and can’t connect.

Barcodes – as they aren’t connected, training isn’t updated like it is on wards at main sites/trust satellites. They are given sets of barcodes that we print. When the Key Trainers train their staff they give them one of these barcodes and send us a training register, so we can update this on the spreadsheet.

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Inputting EQA Results – Things to Remember 

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Inputting EQA Results – Things to Remember 

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When inputting, results should be input under the correct serial number rather than location. In some cases, particularly for urine meters, the meter will have been swapped with a spare while it has gone for repair. In this case, the result should be input under the spare serial number and NOT the ward it is on (e.g., currently J-Spare 1 is on J-97, so you will run the EQA on ward J-97 but the result MUST be input under Spares).

Double check the serial number on WEQAS against the serial number on the print out.

Make sure the information that has been requested is completed – this is usually date received and date of running and storage conditions. For Liat, they will need the Lot number and expiry date of the cartridge used.

Also, double check the Distribution (e.g., BG0824) is correct.

Blood Gas:

Inputting Blood Gas - H+ should be left empty.

Watch out for the parameters as they are usually a slightly different order on WEQAS than the print out.

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We need to hand out samples to J06 and W01 for their i-Stat 1

We need to run the samples on i-Stat 1 Spares 1 and 2 in our office

We need to hand out a set of samples to LGI and SJUH labs for them to run Lactate – ask if the machine is working and they are ready for the sample beforehand, as we can give them the samples, we run on the lab BGAs. LGI will give the results to us to input for them.

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When running EQA, check the results as you run it. Make sure there is a result for all of the parameters, and that nothing looks unusual. If you notice anything missing or any results that look strange, run the sample again – keep the sample until you are satisfied with the results. We don’t always have enough spare/leftover to run repeats if issues are found when inputting. If you aren’t sure, message the group chat at the time for advice.

Things to watch out for:

Urine EQA - Blood results should be negative. If they aren’t, this usually means the test table needs cleaning or the sample is contaminated.

Bilirubin - Like Co-Ox EQA, we can usually run 3 machines per sample. This is light sensitive. Remember to switch display question result on/off.

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How do we know when EQA is due to arrive and when the deadlines are? 

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How do we know when EQA is due to arrive and when the deadlines are? 

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On the WEQAS website, they post the distribution dates. We then add this to the EQA spreadsheet and the calendar. On the calendar – the EQA information is in yellow.