ADVIA® 1800 Chemistry System Calibration Online Training

Monthly maintenance consists of two items; cleaning the left and right filters. When cleaning filters it is recommend that dust and debris be removed from filters using a vacuum cleaner or similar tool. Filters should not be cleaned using water.  When complete, you can document monthly maintenance on the maintenance screen.   Select the link below to learn more about cleaning the filters. Welcome to the ADVIA® 1800 Chemistry System Calibration Online Training course. In this course you will learn how to process: Single point calibrations Multi-point calibrations Single and multi-point calibrations simultaneously ISE calibrations Select Next to continue.    Describe common calibration issues Determine when to perform a calibration List the steps required to run a calibration for colorimetric assays List the steps required to run a calibration for ISE assays Upon successful completion of this course, you will be able to: Select Next to continue. Congratulations.  You have completed the ADVIA®  1800 Chemistry System Calibration Online Training course. Listed below are the key points that have been presented.  Take time to review the material before you proceed to the final quiz. Determine when to perform a calibration Calibration needs to be performed as per assay protocol as defined in the assay Information for use Following a lamp change After troubleshooting failed QC limits List the steps required to run a calibration for colorimetric assays Perform a barcode scan Determine which assays need to be calibrated Prepare calibrators following procedures listed on their package inserts Load calibrators on the CTT for single point calibration Load calibrators on the STT for multipoint calibration Schedule the calibration through the Start button on the Operation Panel List the steps required to run a calibration for ISE assays Load ISE calibrators on the CTT Load Serum calibrators in position 11 and 12 of the CTT Load Urine calibrators in position 13 and 14 of the CTT Program calibration through the Start button on the Operation panel Program calibration through the ISE Operations window after maintenance or when troubleshooting Describe common calibration issues Calibrator issues Calibration programming issues Reagent stability issues Select Next to continue   Calibration on the ADVIA 1800 Chemistry System is required in the following instances: The calibration interval expires for an assay There is a change in the reagent lot number After a lamp change If warranted by QC When to calibrate an assay See when a calibration is required. Slide NumberText BlocksCalloutsAudio ScriptImage File1Accessing the Reagent Inventory Window From the Menu panel, select the Reagent button, then select the Reagent Inventory button which opens the Reagent inventory window. Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.The reagent inventory window tracks the calibration status of all reagents onboard the reagent trays. To determine if an assay requires calibration, open the Reagent Inventory window. From the Menu Panel, select the Reagent button and then select the Reagent Inventory window button. Select Next to continue.2Performing a Reagent Barcode Scan Select the Barcode scan button to perform a reagent barcode scan and update the reagent inventory window. Select Next to continueAfter the Reagent Inventory window opens, select the Barcode scan button to perform a barcode scan and update the Reagent Inventory screens. Select Next to continue.3The Cal Interval Days Column Cal Interval Days:   Displays the number of days before the calibration expires Displays yellow or red to alert the operator of the necessity to calibrate Displays a C flag for new reagent lots or a failed calibration Data is derived from the assay Information for Use or IFU   Select Next to continueTo determine if a reagent needs to be calibrated, the operator needs to check the Cal interval Days column in the Reagent Inventory window. When a reagent exceeds its calibration interval which is defined in its information for use or IFU, then the cal interval field for that reagent will be backlit yellow. In cases whereby a new reagent lot is placed on the system, an upper case C flag will be posted for that reagent in the Cal Interval Days column. Note: the instrument calibrates at maximum 2 different reagent lots per assay. Select Next to continue4Assess Quality Control It may be necessary to calibrate an assay when quality control results exceed their stated ranges. The QC column on the Reagent inventory window depicts the status of ADVIA QC if in use. If you are not using the ADVIA QC software package, refer to your QC data to determine if calibration is warranted. Select Next to continueOccasionally, it may be necessary to calibrate an assay when quality control values exceed their range. Good laboratory practice supports troubleshooting the causative quality control issues before recalibrating. Note, that the QC column on the Reagent Inventory window depicts the status of ADVIA QC if in use. If you are not using the ADVIA QC software package, refer to your QC data to determine if calibration is warranted. Select Next to continue.5After a Lamp Change It is recommended that all colorimetric assays are calibrated following a lamp change.When complete, select the X in the upper-right corner to close the window and continue.Colorimetric assays on the ADVIA 1800 system rely upon a halogen lamp to measure absorbance values. It is recommended that all colorimetric assays be calibrated following a lamp change. Be sure to always process quality control samples following calibration. When complete, select the X in the upper-right corner to close the window and continue. A colorimetric test is a test which forms a color which is then measured. A reagent blank is performed to determine the amount of color that is attributed solely by the reagent during colorimetric testing. Most assays on the ADVIA 1800 system require that a reagent blank is performed only during calibration. However, some assays such as enzymatic assays require a daily reagent blank. Refer to the method's information for use or IFU to determine the frequency of performing a reagent blank.   Perform a Reagent Blank Learn how to perform a reagent blank. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_Calibration_RgtBlank_800x600_9/sim_1800_Calibration_RgtBlank_800x600_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_Calibration_RgtBlank_800x600_9/index.htmlPDF File: Calibration is required to substantiate the continued accuracy of the test system throughout the laboratory’s reportable range. To ensure accuracy of results, a reagent blank should always be performed when calibrating. For single point calibration, de-ionized water is used as the blank sample. For multipoint calibration, the lowest calibrator is often used as the blank sample. Select Next to continue   Prior to using a calibrator on the system, you must ensure that the appropriate calibrator is used for the intended assay, and is prepared according to the calibrator preparation procedure listed in the calibrator package insert.   Preparing and Loading Calibrators View the steps required to prepare and load calibrators on the instrument. Checklist TitleChecklist TypeChecklist ContentReview calibrator package insertHTML Select each checkbox to learn more about calibrators. Follow the instructions in the calibrator package insert sheet for calibrator preparation. Note that some calibrators come ready to use and do not require reconstitution. Always use fresh de-ionized water to reconstitute calibrators.  Allow the calibrator to equilibrate as per protocol and gently mix before using. Loading a single point calibratorHTML For single point calibration, remove the Calibrator Control Tray, or CTT cover. Load the calibrator and blank sample in their assigned positions and container types on the CTT. Replace the cover.  Loading multi-point calibratorsHTML Load multi point calibrators on the Sample Tray or STT. Remove the STT cover and load the multipoint calibrators in their assigned positions and container types. Replace the cover. Note sample trays 98 and 99 are designated for multi-point calibrators only.  Programming a calibrationHTML Schedule a single point calibration, a multi point calibration, or both from the Start button on the software Operation Panel. When complete, select the X in the upper-right hand corner to close the window and continue.   After the calibrator samples are loaded on the system, you may schedule and initiate the calibration run. Types of Calibrations: Single point calibration Multi point calibration Simultaneous single and multi point calibration Single Point Calibration Run Learn how to schedule a single point calibration. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_OnePointCal_800x600_9/sim_1800_OnePointCal_800x600_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_OnePointCal_800x600_9/index.htmlPDF File: Running Single and Multi Point Calibration Learn how to simultaneously schedule a single and multi point calibration. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_One andMultipointi_9/sim_1800_One andMultipointi_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_One andMultipointi_9/index.htmlPDF File: Multi Point Calibration Run Learn how to schedule a multi point calibration. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_MultiPointCal_800x600_9/sim_1800_MultiPointCal_800x600_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_MultiPointCal_800x600_9/index.htmlPDF File: After the Start button from the Start Conditions window has been selected, the calibration run will begin. The Test Result Monitor: Displays single point calibrators on the CTT Displays multipoint calibrators on the STT Has a color legend which is used to determine sample processing status Displays the amount of time left for processing  by double-clicking on a colored circle   Monitor a calibration run Learn how to monitor a calibration run. Tab TitleTextChecking Aspiration Monitoring a sample run From the software Menu panel, select the Request button, then select Test Result Monitor button to open up the Test Result Monitor screen.    Sample Positions Test Result Monitor screen The Test Result Monitor screen displays sample positions on the sample tray (STT) and calibrator/control tray (CTT). Please be aware, ISE calibrators are not displayed on the Test Result Monitor.   Sample Status Test result Monitor color legend The left side of the Test Result Monitor screen has a color legend which is used to determine sample processing status. For example, a pink circle indicates that the sample is in process, whereas a white circle may indicate that a sample is not present or a barcode did not read. To avoid confusion, load patient samples on the STT consecutively without leaving spaces.   Time to Completion Time to completion The amount of time left for processing may be determined by double-clicking on a colored circle. When complete, select the X in the upper-right corner to close the window and continue.   After the calibration is completed, the calibration status may be viewed through three different screens:  Reagent Inventory  Calibration RBL History  View Cal Curve Monitoring colorimetric calibration status Learn how to check calibration status. Slide NumberText BlocksCalloutsAudio ScriptImage File1Reagent Inventory Window The Reagent Inventory screen posts real time calibration status, and may be accessed through the software menu panel by selecting the Reagent button and then the Reagent Inventory button. For easy access, the Reagent Inventory window never closes and is always minimized at the bottom of your screen.  Updated calibration status may be viewed in the Calibration status column.   Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.We will first look at the Reagent Inventory screen which posts calibration status in real time. To access this screen, select the Reagent button located on the software Menu panel. Then, select the Reagent Inventory button to open the Reagent Inventory window. Note that calibration data, date and time of calibration are not posted on this screen. To make access to Reagent Inventory easier, the window never closes but always minimizes to the task bar at the bottom of your screen. Select Next to continue.2Calibration/RBL History Window The Calibration/RBL history window also updates reagent calibration status. Calibration data information may be viewed by selecting the radio button for Latest or Select. Calibration status may be verified by viewing the Status column. Select Next to continue. The second screen used to verify calibration status is the Calibration/RBL window. It may be accessed from the Menu panel through the Calibration button. The Calibration/RBL window has two radio buttons: Latest and Select. The Latest radio button defaults on the screen and displays recent calibration data. The Select radio button allows you to display calibration information for photometric tests, ISE tests, or Other. The Other option allows you to view up to 100 calibration curves per assay reagent lot. The Calibration/RBL window is a very useful tool for tracking trends when troubleshooting failed calibration. Select Next to continue.3Calibration Curve Window The calibration status may also be verified through the Calibration Curve window. Calibration data can be viewed for only one assay at a time on this screen. The system stores up to 2 separate calibration curves for each method based on the reagent lot numbers.When complete, select the X in the upper-right corner to close the window and continue.The third screen used to verify calibration status is the Calibration Curve window. To access this screen, select the Calibration button from the Menu panel. Select the View Calibration Curve button. Select the drop down arrow in the Test name box to pick an assay. This will open the most recent calibration data for that assay. The Status section displays the latest calibration status. Note calibration data for only one assay at a time may be viewed from this screen. The system is able to store two distinct calibration curves per assay, for two different lot numbers of reagents. When complete, select the X in the upper-right corner to close the window and continue. The ADVIA 1800 Chemistry system processes three assays through Ion Selective Electrodes, or ISE methodology. The assays are: Sodium Potassium Chloride Select Next to continue. Next we will review ISE calibrators and the steps to load them onto the instrument. ISE calibrators are loaded on the CTT ISE calibrators are in an liquid form and stored at room temperature ISE calibrators are available for serum and urine calibration Labeling the calibrator bottles helps prevent pour off errors Prepare and Load ISE Calibrators Learn how to prepare and load ISE calibrators. Checklist TitleChecklist TypeChecklist ContentCheck ISE calibratorsHTML Select each checkbox to learn more about ISE calibrators. ISE calibrators come ready for use. Two level calibrators for both serum and urine are available.  Before use, be sure to check the expiration dates on bottles and verify use of the proper calibrators. The calibrator ranges are already embedded in the software, therefore you do not need to update ranges.  Load ISE calibratorsHTML   Load ISE calibrators in their assigned positions on the CTT. Serum calibrators are assigned in positions 11and 12, while urine calibrators are assigned in positions 13 and 14 of the CTT. ISE calibrators are poured into individual sample cups with adapters and loaded on the CTT. To insure the integrity of the ISE calibrators, new calibrator samples should be poured with every calibration.    Schedule ISE calibrationHTML   After the calibrators are poured and loaded on the CTT, calibration may be programmed. Depending on the situation, calibration may be initiated through the Start Conditions window under normal operating conditions, or through the ISE Operation window after maintenance or when troubleshooting. When complete, select the X in the upper-right corner to close the window and continue.      ISE calibration under normal operating conditions should be programmed through the Start button in the Operation panel.  After maintenance or when troubleshooting, use the ISE Operation window. Note that ISE calibration is recommended at minimum, once every 24 hours.   Program Calibration from Start Condition Window Learn how to program ISE calibration using the Start Conditions window. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_ISE Calib Start Conditions_800x600_9/sim_1800_ISE Calib Start Conditions_800x600_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_ISE Calib Start Conditions_800x600_9/index.htmlPDF File: Program Calibration from the ISE Operation Window Learn how to program ISE calibration using the ISE Operation window. Instructions:If media does not automatically start, select the play arrow to begin.Flash File:/content/generator/Course_90004841/sim_1800_ISECalib_ ISEops_800x600_9/sim_1800_ISECalib_ ISEops_800x600_9.swfHTML5 File:/content/generator/Course_90004841/sim_1800_ISECalib_ ISEops_800x600_9/index.htmlPDF File: Hypo perfusion may or may not cause symptoms. This is because the reduction in blood supply to the surrounding area may not be significantly compromised because of compensatory mechanisms. If the perfusion deficit is too great, however, pain will be felt in the affected region. Narrowing of the coronary arteries, for example, results in the typical chest pain symptoms of angina pectoris. Stress-dependent hypo perfusion of peripheral muscles may lead to a condition called intermittent claudication - limping and pain in the muscles of the legs during exercise, such as walking.     Features of the Calibration/RBL history window include: Updates ISE calibration status Calibration data may be viewed by selecting the Latest or the Select radio buttons Calibration status may be verified from the Status column Note:  Detailed ISE Calibration data is also posted in the Real Time Monitor screen. This screen allows you to view the number of replicates processed for each calibrator, along with associated calibration flags. Select Next to continue This process is accelerated if blood coagulability is already increased. This explains the protective effect of the substance acetylsalicylic acid (ASA, aspirin): the anticoagulative action of ASA is based on reducing aggregation of thrombocytes. Plaque rupture followed by thrombus formation in the coronary arteries leads to acute myocardial infarction. A heart attack often comes without warning - in one third of cases, patients have not experienced any prior symptoms.   Failed Calibration: Troubleshoot the failure before recalibrating Always pour the calibrators again before recalibrating Refer to the Operator's Guide Calibration Troubleshooting Learn how to perform basic calibration troubleshooting. Slide NumberText BlocksCalloutsAudio ScriptImage File1No Calibration Result Posted Symptom:  No calibration result Probable Cause: Short sample, no sample, no reagent, assay not selected for calibration Corrective Action:  Check the Error log Verify the sample volume and container type Ensure that the calibrators are placed in their assigned positions Check the Real Time Monitor screen for assay calibration data Perform a reagent barcode scan prior to calibrating Repeat calibration Select Next to continue. Note: If audio does not automatically start, select the play arrow in the top left to begin.In some instances, calibration data may not be updated or posted. The problem may be due to a short sample, no sample, no reagent, or the assay was not selected for calibration. First, check the Error log for error messages pertaining to the assay with no calibration data. Verify that there is enough sample in the container. Keep in mind, that the dead volume for a 10 milliliter tube is 200 microliters, and 50 microliters for a sample cup. Ensure that the calibrators are placed in their assigned positions on the CTT for assays using one calibrator, or placed on the STT for assays using multipoint calibrators. Check the Real Time Monitor screen for assay calibration data. Perform a reagent barcode scan prior to calibrating. This allows you to verify that the reagent is on the system, is identified as the primary reagent, and has sufficient volume. Repeat calibration. Select Next to continue.2Failed Calibration Symptom: Failed Calibration Probable Cause: Calibrator, Reagent, Instrument Incorrect calibrator,  incorrect calibrator reconstitution, incorrect calibrator factor value Old or expired reagents Poorly Maintained Instrument Corrective Action: Verify calibrator vial and check package insert sheet for calibrator reconstitution procedure Check the Calibration/RBL screen, check the FV and the CF columns of previous calibrations Check that the reagent is not expired or exceeded its on board stability Ensure that maintenance has been performed on the instrument and that the instrument is functioning properly. Repeat calibration, call the Technical Solutions Center if problem persists Select Next to continue.A failed calibration may be associated with problems stemming from the calibrator, the reagent or the instrument. You will need to determine the cause of the failure. In instances when other assays calibrated with the same calibrator fails, the problem is most likely related to the calibrator itself. The probable causes of failure associated with a calibrator may include: incorrect calibrator used, incorrect calibrator reconstituted, or incorrect calibrator factor value used. To troubleshoot a calibration issue caused by the calibrator, prepare a fresh calibrator vial and repeat the calibration. Be sure to verify the factor value of the calibrator in use by accessing the Cal/RBL screen. In instances when the calibration failure is only occurring for one assay, the problem may be related to the reagent. To rectify this failure, check that the reagent is not expired or exceeded its on board stability and that it was properly stored. To troubleshoot a probable reagent issue, place a new reagent wedge on the instrument and recalibrate. In instances when many different assay calibrations fail, the problem may be related to the instrument itself. Ensure that maintenance has been performed on the instrument and that the system is functioning properly. Repeat the calibration. If problem continues, call the Technical Solutions Center.3Only RBL Results Posted Symptom:  A full calibration was ordered (calibrator and reagent blank), but results are posted only for the reagent blank sample. Probable Cause:  Calibrator was not selected while ordering calibration. Corrective Action: Repeat calibration. Be sure to order a blank and calibrator when calibrating the assay. Select Next to continue If only the reagent blank or RBL results are posted in the Real Time Monitor screen after ordering a full calibration, it's possible that only the blank sample was ordered for calibration. For systems using the XL2 software when calibrating, you must make sure to select the assays through both the Blank or BLK and Standard or STD radio buttons after selecting the Temp.item select button. The assays will need to be first selected on the Ordinary Calibration (BLK) screen which is defaulted. Then select the Ordinary Calibration STD radio button to open that screen and select the same assays on that screen. At this point, the Return button is selected. Note, if you select the Return button of the BLK screen, the instrument will only perform a blank calibration and not a full calibration for the assays. Select Next to continue4Failed ISE Calibration Symptom: Failed ISE calibration Probable Cause: Incorrect calibrator used, leak in between electrodes, salt bridges, old electrodes, slope errors Common Flags include: C, *, L, l, H, h, D, T, d, NG Corrective Action: Check the Real Time Monitor for flags or marks posted on the calibration report Note that lower case flags (l, h) associated with electrode slope issues do not invalidate the ISE calibration run Repeat calibration When complete, select the X in the upper-right corner to close the window and continue.ISE calibration failure may be attributed to the calibrators, improper assembly of the electrodes, salt deposits, missing O rings, slope errors, and old electrodes. Check the Real Time Monitor screen to view marks or flags posted on the calibration report. Determine the number of calibrator aspirates for the high and low calibrators. A posted "C" flag is related to an accuracy failure, whereas a posted "asterisk" flag is related to a precision failure. The following are flags or marks that invalidate the ISE calibration: asterisk, upper case C, upper case L, upper case H, upper case D, or T flags. Note that lower case l and h flags which are associated with slope errors do not invalidate the ISE calibration run. Refer to the ADVIA Chemistry Quick Reference Guide or the Operator's Guide to resolve ISE failed calibration issues. When complete, select the X in the upper-right corner to close the window and continue