Hemochron QC

Welcome to POC Melva! We use the Hemochron for both the Cath lab (ACTLR) and the CVOR (ACT+). I have found that most of the time the controls fail when they are not mixed correctly. There is a certain technique that must be handled very quickly. Once the mixing begins, the timing starts. Any delays can result in QC being out. Being slow usually means the QC is out-low. If not properly mixed and the first drop not wasted, the QC is out-high. We usually have more problems with the low control, especially when we have a new employee. Also beware that the correct bar code is being used. Lot number changes can occur without the testing staff being aware if they are too busy for details like that. I wish my group would just move to the ISTAT but alas, the docs are generally hardcore Hemochron users.

Hi Melva.  We have been using the Hemochron system for 15+ years.  The controls are the break and shake type that are very finicky.  I've found it best to use the QC during competencies to get staff used to the break/shake/waste steps and having them get a sense of how time sensitive it is.  This helps with reducing the need for rerunning QC.  It's hard to move from a test system like this if Provider staff are used to the quality.

Hi Melva, 
If all failed, you can establish your own QC range.  Not sure how the manufacturer establish the QC ranges; probably did not use RNs as operators.  

We are so happy 5 years ago when our new Cardiac team decided that they want i-STAT to do the ACT in Cath Lab. They were used to using them.  We had the Hemochron then. The i-STAT is so much easier to run QC and patient wise.   The doctors are used to the results. 
The Hemochron was easy to run for patients but you practically have to stand on your head to make the QC work especially Level 1. You have to mix it very, very, very well.  We also have to order almost double the amount of Level 1  because it never fail that someone has to repeat it. We hit them on the counter to make sure everything in the ampule was dislodged to the solution.  If you can get past the QC performance, the Hemochron is a good instrument.   We were always nervous that we will not pass the Proficiency test because  the samples were like the QC material.  With the i-STAT, the nurses have not had any problem with running proficiency testing, QC or patient tests. 

Hi Melva,
QC is the biggest issue with the Sig Elite specifically because of the mixing issue.  When I train I tell them to remove the plastic, to crack it on the side of table in multiple places, shake it like it owes you money :), dispense a drop and then put the next drop in the cartridge and hit start ... all within 10 secs.  The important parts in the process is the cracking of the glass and shaking.  If they crack it in multiple places and shake it with the cap down we have seen better success at passing.