VersaCell™ System Connected to Dimension® Systems Online Training

Welcome to the VersaCell™ System Connected to the Dimension® System Online Training course. The Sample Transfer Module (STM) is an additional component for the Dimension® Systems that provides connectivity to the VersaCell™ System. The STM automates the transfer of samples from the Interface Wheel to the Dimension®  Systems sample wheel. Due to exterior and hardware changes, the Dimension® System will appear different with the addition of the STM module. Some of the software screens have been changed to allow monitoring of the STM.  Currently, the Dimension® Systems which can be connected to the VersaCell™ System are the Dimension®  EXL™ with LM, Dimension®  EXL™ 200 and Dimension®  RxL Max®  integrated chemistry systems. Select Next to continue.   Identify STM components and their functions Navigate Dimension® Systems Software to access STM information Perform the startup procedures for the VersaCell™ System to Dimension® System connection Replace STM consumables and perform STM maintenance Run controls on a VersaCell™System to Dimension® System connection Troubleshoot errors specific to the STM Troubleshoot VersaCell™System to Dimension® System connection errors Upon successful completion of this course, you will be able to: Select Next to continue. Parabéns! Você concluiu o treinamento online para Gerenciamento de Reagentes do Sistema Sysmex® CS-2000i e CS-2100i. Abaixo estão listados os principais pontos apresentados. Reserve um tempo para analisar o material antes de prosseguir para o teste final. Congratulations. You have completed the VersaCell™ System Connected to Dimension® Systems 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.    In this course, you learned how to:   Perform the startup procedures for the VersaCell™ System Connected to Dimension® System There are startup features that are unique when a Dimension® System is connected to the VersaCell™ System.  Shutting down the VersaCell™ System daily is recommended to initiate a system backup.  It is not required to shutdown the Dimension® System as part of the VersaCell™ System shutdown procedure, although certain startup steps are required to display Ready status.  After the VersaCell™ System is rebooted, the Dimension® System displays the error message "DMW Host Communication Problem" in red. The VersaCell™ System displays an Instrument Error message.  Press Reset on the keyboard to clear the message and initialize the Dimension® System.  The system is ready to process samples once the Instrument Status on the VersaCell™ System displays Ready in white. Run controls on a VersaCell™ System Connected to Dimension® System Control samples are ordered and placed directly on the Dimension® System. Manually ordered QC is programmed on the Enter Data screen on the Dimension® Systems.  If QCC PowerPak® software is programmed on the Dimension® System, barcoded sample tubes with QC in Small Sample Containers are loaded directly in a standard segment on the Dimension® System sample wheel. Identify STM components and their functions The Sample Transfer Module (STM) includes these components: Transfer Arm (Carriage and Carriage Drive System):  Transfers aliquot of sample using a pipette tip mounted on an probe   from a tube to the Dimension® System Pipette Tips:  Used to carry the sample from the sample tube and deposit it into an assigned aliquot segment position Tip Feeder: Holds up to two racks of 200 pipette tips each Tip Waste Container: Holds up to 1600 used tips STM Keypad: Used to Pause and Continue or Load the STM STM Segments:  Consists of segment base and an aliquot segment Fluidics System (Air Pump, Tubing, Pressure Sensing PCB): Controls aspiration, dispensing, and liquid level detection for each sample STM Control Board Navigate Dimension® Systems Software to Access STM Information STM Processing Status When the Dimension® System includes the STM, the Instrument Status Area at the top of the screen displays STM Status information in the 4th box position.  The following information may appear in the STM Status box: STM Standby: Ready to receive STM work STM Processing; Transferring samples from interface wheel to sample area STM Needs: STM aliquots, Pipette tips and Tips to Waste full needs must be met before STM can continue sampling STM Pausing: STM is completing current sample transfer and returning to Home position STM Error: Dimension® System will not accept any work until STM Error message is resolved Segment Status Screen With the STM, the Segment Status area displays an STM segment with a lowercase letter and a primary tube/sample cup standard segment with a capital letter. STM segment status boxes can appear in one of three background colors.  In addition to green and red background color used for primary tube/sample cup segments, the STM segments also can appear in yellow background.     RED: Do not remove or replace this STM segment or the aliquot segment from the sample wheel.  It is currently being used by the Dimension® Systems to process samples. YELLOW: The STM segment has unused aliquot positions available on it and should not be removed. The instrument is not using this segment to process samples. GREEN: This STM segment or aliquot segment is completely used and no more positions are available to process tests.  This STM segment or the aliquot segment can be removed or replaced if desired. Aliquot Segments Screen To access the Aliquot Segments screen, press the Alt/S key combination, and , if necessary, F2: STM. The Aliquot Segments screen displays: How many unused aliquot positions are available How many pipette tips are available How many pipette tips until the tip waste is full Current status of each aliquot position STM Backlog  Each STM aliquot segment contains 63 positions available for samples.  The Aliquot Segments screen will display the current status of each position.  In addition, to the standard letters used by the Dimension® Systems to indicate the status of samples on the screen, there are two STM specific marks that appear on the screen:   STM Mark Color Meaning - Red This aliquot position is not available for use.  It has been used or aborted. + Green This aliquot position has not been used.   Report Slips Report slips for samples processed using the STM have the same format and contain the same information as those processed without the STM. A lowercase letter in the Segment field indicates the STM sample. Preparing Samples Following your laboratory protocol, ensure the sample quality is acceptable before loading onto the VersaCell™ System. The sample must be free of clots, air bubbles, fibrin strands, and other impurities. Centrifuge previously frozen samples. Methods that have specific handling instructions such as urine drug screens or whole blood assays must be loaded directly onto the Dimension System. Pausing the STM The STM can be paused by: Raising the tip feeder cover on the STM Raising the IMT lid Raising the printer lid (Dimension® RxL Max® only) Pressing the Pause button on the STM keypad When the STM is pausing, it continues operations for the current sample that is being transferred until the carriage returns to its home position.  The blue “STM Paused” status appears in the Instrument Status box at the top of the Dimension® Systems screen. If the STM was paused by raising the tip feeder cover on the STM or the IMT lid or printer lid, closing the lid automatically will resume STM operations. If the STM was paused by pressing the STM Pause button, the operator must press the STM Continue button on the Dimension® RxL Max® or the Load button on the Dimension® EXL™ System to resume STM operations. Loading Aliquot Segments The options to load aliquot segments are: Wait until the "STM Needs" message appears in the STM processing status. Display the Aliquot Segments screen to see if the STM Aliquots field is zero, then pause the Dimension® System to replace the aliquot segments  OR Wait until most of the STM segment status boxes are green in color indicating that all the aliquot positions have been used. Pause the Dimension® System to replace the Aliquot segments. Loading Pipette Tips A rack of pipette tips can be loaded in the tip feeder at any time.  The tip feeder must be loaded when the Pipette Tips field on the Aliquot Segments screen displays zero. This halts the Sample Transfer Module from transferring samples and displays the "STM Needs" status. To load pipette tip racks: Raise the tip feed cover and wait for the tip tray to move the tip racks to the front of the feeder. Remove the empty pipette tip rack or racks and dispose of them using your facility's biohazard waste procedure. Place new rack or racks onto tip tray. Close tip feeder cover. The Dimension® System automatically inventories the number of tips in both racks of the tip tray. The total number of inventoried tips appears in the Pipette tips field at the top of the Aliquot Segments screen. Emptying the Tip Waste Container The Tip Waste container can be emptied at any time. It must be emptied when the Tips to Waste Full field on the Aliquot Segments screen is zero. This stops the STM from transferring samples and causes the “STM Needs” message to appear.  Removing the waste container automatically pauses the STM. To empty the waste: Open STM cabinet door. Remove and empty tip waste container Place biohazard bag liner inside empty container. Place container back into cabinet and close door. From Home screen, select F4: Systems Prep then F6: Sys Counters Move cursor box to Replace column of STM Tip Waste field Press Enter key to change NO to YES. Press F1: Store Changes. Answer the prompt by tyuping a "y" for yes. The Cycles column changes to zero and the Last Replaced column changes to the current date and time. Replace STM consumables and perform STM maintenance There is minimal maintenance associated with the STM and no required daily maintenance. Routinely clean the outside surfaces of the STM using a damp cloth and warm, soapy water. Clean up spills immediately.  After replacing the Photometric Sampler probe on the Dimension® System or the IMT Sampler Probe on the Dimension® RxL Max® System only, alignments must be performed.  When the STM is installed, the Dimension® System Cup Alignment gauge is no longer be used.  The STM Alignment Gauge is used instead.  The only recommended alignments to perform specific to the STM are the: Sample Probe to Aliquot Segment Outer/Inner Holes (all Dimension® Systems) IMT Probe to Aliquot Segment Outer/Inner Holes (Dimension® RxL Max®) All other STM specific alignments are performed by field service. Follow the instructions in the Dimension® clinical chemistry system Sample Transfer Module Operator’s Guide. Troubleshoot errors specific to the STM When an error message related to the STM occurs on the Dimension® System, an associated error message is displayed on the VersaCell™ System screen.  Depending on the error message, it may display on the VersaCell™ System as an Instrument Error, Inventory Error, Sample Error or Order Error. These buttons turn red when new error messages are posted then turn gray after viewing the error information. Resolve the error message and press the Reset key on the Dimension® System to initialize and resume sample loading. If an error message appears on the Dimension® System, press the Alt/M key combination to display troubleshooting help.  Not all STM error messages have the Alt/M troubleshooting help. The error message will display an error code number in parentheses, example, (801).  The Dimension® clinical chemistry Sample Transfer Module Operator’s Guide provides STM specific error message explanations and steps to resolve by the error code number displayed with the message. Troubleshoot VersaCell™ System Connected Dimension® System Connection Errors When the Dimension® System is connected to the VersaCell™ System, certain errors may occur:  Recovering from Control Stop: If an operator needs to abort a run and presses the Control /Stop key combination: The STM Status on the Dimension® Systems will display STM Error. The error message field on the Dimension® Systems will display User Aborted Processing in red. On the VersaCell™, the Dimension® Systems status bar will display Error Stop in red. Once the Reset key is pressed on the Dimension® Systems keyboard, the Dimension® Systems status on the VersaCell™ System will display Initializing. When initializing is complete, the Dimension® Systems status on the VersaCell™ System will display Ready Manual Order: Sample tests requested through the Dimension® systems Enter Data screen must be loaded manually on the Dimension® System. Insufficient samples: Sample and Order Errors: An example of a Sample Error and an Order Error message where sample handling options are available is when a short sample is processed through the VersaCell™ System. Inventory Errors: The Inventory Errors are dsiplayed when Flex® reagent cartridges are empty, unavailable for order, not in run and disabled. Consumable Errors:  Consumable messages are sent when a consumable (for example, cuvette film) is low or empty. Instrument errors:  Instrument Errors are displayed whenever the Dimension® system has an error message (for example, Bad Cuvette) Select Next to continue.     Carregar reagentes no sistema é simples. Para iniciar o carregamento de reagentes selecione Edit/Change na tela de reagentes no software para permitir que o sistema se movimente deixando acessível a posição apropriada. Uma vez que o sistema está pronto você pode colocar o reagente na rack apropriada e carregá-la no sistema. O sistema Sysmex® CS-2000i e CS-2100i irá identificar positivamente os reagentes carregados e atualizar o software com a informação. Selecione os links abaixo para saber mais sobre o carregamento de reagentes. The VersaCell™ System Robotic Arm scans information from the tube barcode then transfers the tube from the drawer to the Interface Wheel where the tube barcode is verified. The VersaCell™ System communicates to the Dimension® System that the tube is present and sends the order.  The Sample Transfer Module (STM) transfers an aliquot in a disposable pipette from the sample tube on the Interface Wheel to a well position in an aliquot sample segment on the Dimension® sample wheel. The Dimension® system processes the sample and sends the final test results to the VersaCell™ System which then are sent to the LIS. When the tube is no longer needed on the Interface Wheel, it is returned to an output drawer by the VersaCell™ System Robotic arm.   Tube Journey View a tube journey on a VersaCell™ System connected to a Dimension® System.   Select the play arrow to begin the video.  When complete, select the X in the upper-right corner to close the window and continue. Parabéns! Você completou o Treinamento onLine de Processamento de Amostras do SIstema Sysmex® CS-2000i e CS-2100i. Abaixo estão listados os principais pontos apresentados. Reserve um tempo para analisar o material antes de prosseguir para o teste final. There are unique startup features when a Dimension® System is connected to the VersaCell™ System.  Shutting down the VersaCell™ System daily is recommended to initiate a system backup.  It is not required to shut down the Dimension® Systems as part of the VersaCell™ System shut down procedure, however certain startup steps will be required to display a Ready status.   Start Up Learn about new start up features. Slide NumberText BlocksCalloutsAudio ScriptImage File1DMW Host Communication  After the VersaCell™ System is rebooted, the Dimension® System displays the error message "DMW Host Communication Problem" in red. The VersaCell™ System displays an Instrument Error message. Press Reset on the keyboard to clear the message and initialize the Dimension® System. Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.After the VersaCell™ System is rebooted and back online, the Dimension® System displays an error message in red stating "DMW Host Communication Problem". This generates an Instrument Error message in red on the VersaCell™ System. To clear the message on the Dimension® System, press the Reset key on the keyboard. The Instrument Error status on the VersaCell™ System will clear as a result.2Ready  The system is ready to process samples after the Instrument Status on the VersaCell™ System displays Ready in white. Select Next to continue.The system is ready to process samples after the Instrument Status on the VersaCell™ System displays Ready in white.3Run The Run key on the Dimension® System does not need to be pressed before processing samples on the VersaCell™System. Select Next to continue.It is not necessary to press the Run key on the Dimension® Systems before processing samples on the VersaCell™ System.4Inventory An Inventory Error message may display in red briefly on the VersaCell™ while it checks for the Flex® reagent cartridges required to process new samples on the Dimension® System. If there are no inventory errors after the inventory information has been communicated, the message disappears. If there are inventory errors, check that test inventory is activated, loaded, and calibrated, and that QC has been performed. Select Next to continue.When new samples are loaded from the VersaCell™ System and inventory information is being refreshed, the VersaCell™ System may display an Inventory Error in red. This message disappears if there are no inventory errors. If there are inventory errors, check that the test inventory is activated, loaded, and calibrated and that QC has been performed. Check and replenish consumables on the Dimension® Systems, perform Daily Maintenance every 24 hours, and run QC when scheduled before processing samples from the VersaCell™ System.5Consumables An Instrument Error displays if there is a need for consumables on the Dimension® Systems. A warning message or Error Report indicates which consumable needs to be replenished. Select Next to continue.An Instrument Error displays if there is a need for consumables on the Dimension® Systems. A warning message indicates which consumable needs to be replenished. 6Daily Start Up Perform Daily Maintenance every 24 hours, and run QC when scheduled before processing samples from the VersaCell™ System.  When complete, select the X in the upper-right corner to close the window and continue.Perform Daily Maintenance every 24 hours, and run QC when scheduled before processing samples from the VersaCell™ System. A sequência de processamento de uma amostra no sistema Sysmex ® CS-2000i e CS-2100i é um processo complexo e interessante. A amostra se move do tubo principal para uma cubeta e através do instrumento para gerar o resultado da análise. Selecione o link abaixo para visualizar a seqüência de processamento da amostra. The Sample Transfer Module (STM) is an additional component for the Dimension® System that provides connectivity to the VersaCell™  System. The STM automates the transfer of sample from the Interface Wheel to the Dimension® System sample wheel. With the addition of the STM module to the Dimension® System, the physical appearance of the instrument changes.  In addition, some of the software screens will include data regarding the monitoring the STM performance on the Dimension® System.   Dimension® EXL View the Dimension® EXL™ with LM connected to a VersaCell System. When complete, select the X in the upper-right corner to close the window and continue. Dimension® RxL Max View the Dimension® RxL Max® connected to a VersaCell™ System. When complete, select the X in the upper-right corner to close the window and continue. A área de Calibração do software é o local aonde todas as calibrações são gerenciadas. Com base nos recursos disponíveis no software as calibrações são facilmente realizadas, armazenados e excluídas do banco de dados, conforme a necessidade. Novas calibrações podem ser utilizadas imediatamente ou armazenadas para uso futuro, tornando mais fácil alternar entre os lotes em uso e os novos. Passe o mouse sobre as imagens para saber mais. Control samples are ordered and placed directly on the Dimension® System.  Manually ordered QC is programmed on the Enter Data screen on the Dimension® Systems.  If QCC PowerPak® software is programmed on the Dimension® System, barcoded sample tubes with QC in Small Sample Containers (SSC) are loaded directly in a standard segment on the Dimension® System sample wheel.  Monitor the status of control test orders on the Dimension® System, as pending control orders do not display on the VersaCell™ System. Select Next to continue.   Reagentes, calibradores e padrões com valores atribuídos específicos têm códigos de barras 2D na bula. Estes códigos de barras 2D que estão na folha de inserção contém informações importantes, tais como o nome do reagente, número de lote, data de validade e valores específicos atribuídos ou ISI. Antes de executar uma calibração precisamos inserir as informações com valores do calibrador ou padrão no sofware. Essas informações podem ser inseridas manualmente ou automaticamente usando o Leitor de Còdigo de Barras 2D. Vamos aprender mais sobre o leitor de código de barras e como digitalizar informações do calibrador no banco de dados. Selecione o link abaixo. The Sample Transfer Module (STM) includes these components: Transfer Arm (Carriage and Carriage Drive System) Pipette Tips Tip Feeder Tip Waste Container STM Keypad STM Segments Fluidics System (Air Pump, Tubing, Pressure Sensing PCB) STM Control Board Components and Functions Learn about STM components and functions. Slide NumberText BlocksCalloutsAudio ScriptImage File1Transfer Arm The transfer arm consists of the carriage and the carriage drive system. The carriage probe transfers an aliquot of sample from the sample tube on the interface wheel to the Dimension® System sample wheel. A disposable pipette tip is mounted on the probe for each sample. Sensors monitor the position of the carriage as it shuttles back and forth on the carriage drive. The carriage drive system moves the carriage between the sample access position and the Dimension® sample wheel. Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.The transfer arm consists of the carriage and the carriage drive system. The carriage probe transfers an aliquot of sample from the sample tube on the Dimension® interface wheel to the sample wheel. A disposable pipette tip is mounted on the probe for each sample. Sensors monitor the position of the carriage as it shuttles back and forth on the carriage drive. The carriage drive system moves the carriage between the sample access position and the Dimension® sample wheel. 2Pipette Tip A pipette tip carries the sample from the sample tube and deposits it into an assigned position of an aliquot segment in the Dimension® System sample wheel. Tips are mounted and removed automatically for each sample transfer. An optical sensor checks for the presence of a tip. As needed, the operator loads racks of 200 pipettes into the tip feeder. Select Next to continue.A pipette tip carries the sample from the sample tube and deposits it into an assigned position of an aliquot segment in the Dimension® sample wheel. As needed, the operator loads racks of 200 pipettes into the tip feeder. The tips are mounted automatically onto the STM probe before each sample transfer then removed from the probe after the sample transfer. An optical sensor checks for the presence of a tip.3Tip Feeder The tip feeder tray holds 400 pipette tips in two racks of 200 tips each. Lifting the tip feeder cover activates a sensor which pauses the STM transfer movements. The tip tray moves to the front of the tip feeder compartment where the tip racks can be removed and replaced. The STM resets to normal operation after the cover is closed.  Optical sensors inventory the number of tips in the tip racks each time the cover is raised and closed, ensuring that the Dimension® System maintains an accurate count of available tips.  Select Next to continue.     The tip feeder is located inside the upper compartment of the STM cabinet. Pipette tips are housed in tip racks on the tip tray inside the tip feeder. The tip tray holds two racks of 200 tips each for a total of 400 pipette tips. When the tip feeder cover is raised, a sensor is activated, pausing all transfer movements on the STM. The tip tray moves to the front of the tip feeder compartment where tip racks can be removed and replaced. The STM resets to normal operation once the lid is closed. Each time the tip feeder cover is opened and closed, optical sensors inventory the number of tips remaining in the tip racks. This ensures that the Dimension® System maintains an accurate count of available tips. The available tip count is displayed in the Pipette Tips field at the top of the Aliquot Segment screen. When the field reaches zero, an “STM Needs” status message displays, and STM operations pause. The empty tip racks must be replaced before STM operations can continue.4Tip Waste Container The tip waste container is located inside the compartment underneath the tip feeder and holds up to 1600 pipette tips.  After the transfer of each sample, the used pipette tip is stripped from the STM probe at the tip removal station and deposited into the container. To ensure that this capacity is not exceeded, the number of used pipette tips is monitored continually by the Dimension® System and is displayed. Select Next to continue.   Select each number to review the corresponding text.CalloutsDimension® EXL™ Tip Waste ContainerDimension® RxL Max®  Tip Waste ContainerLocated inside the compartment underneath the tip feeder, the Tip Waste Container holds up to 1600 pipette tips. After the transfer of each sample, the used pipette tip is stripped from the STM probe at the tip removal station and deposited into the container. The number of used pipette tips is monitored continually by the Dimension® System. 5STM Keypad The STM keypad is used to pause the STM.  If the STM is paused by pressing the STM Pause button, press the STM Continue button on the Dimension® RxL Max System or the Load button on the Dimension® EXL™ System to resume operations. Select Next to continue.   Select each number to review the corresponding text.Callouts Dimension® EXL™ System STM keypad Dimension® RxL Max System STM keypad Another modification is the STM keypad. If the STM is paused by pressing the STM Pause button, you must press the "Continue" or the "Load" button on the STM keypad in order for the Dimension system to resume operations.6STM Segment An STM segment consists of two components: Segment base: The STM segment base contains a bar code label which identifies the segment with a lower case letter. This letter appears in one of the six boxes of the STM segment status area on the screen. Aliquot segment:   Each aliquot segment also is identified by a unique barcode number and contains 63 sample positions. The aliquot segment is placed securely on the segment base to create an STM segment. The sample wheel holds up to six STM segments or any combination of STM segments and standard Dimension® Systems primary tubes/sample cup segments. Aliquot segment lids are provided to keep sample fluid from splashing out of the aliquot segment while transferring the used segment to the laboratory disposal container. Select Next to continue.Select each number to review the corresponding text. CalloutsSegment BaseAliquot SegmentAliquot LidA sample is carried within the pipette tip then dispensed into an STM segment on the Dimension® System sample wheel. The STM segment consists of two components: a segment base and an aliquot segment. The segment base contains a bar code label which identifies each specific STM segment letter. This letter appears in one of the six boxes of the STM segment status area on the screen. Each aliquot segment is identified by a unique barcode number, contains 63 sample positions and comes with its own lid. This lid is not a permanent seal for used samples in the aliquot segment, but has been provided to keep sample fluid from splashing out of the aliquot segment while transferring the used segment to the laboratory disposal container. The aliquot segment is placed on the segment base to create an STM segment. Ensure the aliquot segment seats completely into the segment base and that the segment base when loaded on to the Dimension® System is fully seated in the sample wheel. The sample wheel holds up to six STM segments or any combination of STM segments and standard Dimension® Systems primary tubes/sample cup segments.7Fluidics System The fluidics system consists of four components for sample aspiration and dispensing and liquid level detection: Air Pump:  Provides volumetric displacement needed to generate the air pressures required to aspirate and dispense the sample  Pipette:  Carries sample from the sample tube to the sample wheel Pressure Sensing Printed Circuit Board (PCB):  Monitors the air pressure within the fluidics system during sample transfer operation Tubing:  Provides the pneumatic interconnection between the air pump, pipette, and the PCB board. NOTE: Image shown is the fluidics system in the Dimension® EXLTM with LM. Select Next to continue.    Select each number to review the corresponding text. CalloutsAir PumpTubingPCBThe fluidics system has three primary functions: sample aspiration, sample dispense, and liquid level detection. Disposable pipettes transport the sample from the sample tube to an aliquot position on the Dimension® sample wheel. The fluidics system cycle begins with the detection of the level of sample as the pipette descends into the sample tube. Once liquid level is determined, a volume of sample is aspirated into the pipette tip and transported to the Dimension® sample wheel where it is dispensed into an STM segment. During this cycle, in addition to level sensing, a pressure profile is recorded and analyzed to determine that the proper amount of sample was aspirated successfully. The fluidics system consists of four components. The air pump provides volumetric displacement needed to generate the air pressures required to manipulate the sample. The pipette carries sample from the sample tube to the sample wheel. The Pressure Sensing Printed Circuit Board monitors the air pressure within the fluidics system during a sample transfer operation. The tubing provides the pneumatic interconnection between the air pump, pipette, and the PCB board which is sized to provide appropriate response to determine proper level sensing and aspiration of the sample.8STM Control Board An additional Control Board on the Dimension® System is required for the STM.When complete, select the X in the upper-right corner to close this window and continue.  CalloutsDimension® EXL™  with LM Control BoardDimension® RxL Max®  Control BoardAn additional Control Board is required for the STM on the Dimension® System. A tela lista de trabalho exibe solicitações e resultados de pacientes e de CQ. A tela lista de trabalho é usada para procurar os resultados da análise do CQ. Na tela do gráfico do CQ , você pode acompanhar os resultados de CQ para ver tendências como; limite de desvio padrão e violações de regras. Você também pode usar a tela gráfico do CQ para imprimir os resultados e relatórios e manipular erros de CQ. In this section, you will learn how to use the Sample Transfer Module by accessing system software screens and performing routine operations: STM Processing Status Segment Status Screen Aliquot Segments Screen Report Slips Preparing Samples for Use Pausing the STM Loading Aliquot and STM Segments Loading Pipette Tips Emptying the Tip Waste Container Select Next to continue.   Outra tarefa envolvida na gestão de CQ é revisar os resultados de CQ que excedam os limites de desvio superior ou inferior do padrão ou violem as regras de westengard do CQ. Os limites e regras de decisão são definidas para cada ensaio durante a instalação do CQ. Nesta seção, você vai aprender a identificar erros de CQ na tela gráfico do CQ , encontrar erros de CQ que ocorreram, avaliar os resultados e inserir um comentário para documentar ações corretivas e confirmar o erro. When the Dimension® System includes the STM, the Instrument Status Area at the top of the screen displays STM Status information in the 4th status box. STM Processing Status Learn more about STM Processing Status Descriptions. STM Processing Status Description STM Standby Ready to receive STM work STM Processing Transferring samples from the interface wheel to the sample area STM Needs   STM aliquots, Pipette tips and Tips to waste full needs must be met before STM can continue sampling STM Pausing STM is completing current sample transfer and returning to Home position STM Paused Dimension® System will not accept any STM work STM Error The Dimension® System will not accept any work until the STM error message is resolved   When complete, select the X in the upper-right corner to close this window and continue. With the STM, the Segment Status area displays an STM segment with a lowercase letter and a primary tube/sample cup standard segment with a capital letter.   STM segment status boxes can appear in one of three background colors.  Green and red background colors are used for primary tube/sample cup segments. The STM segments also can appear on a yellow background.   Segment Status Area Boxes Learn about STM segment status area boxes.   The six boxes indicate which segments were in each position the last time the Dimension® system scanned the sample wheel.   For example, this segment status box indicates aliquot segments in positions 1, 2, 4, and 5 on the sample wheel.  No segment is in position 3, and a standard primary tube/sample cup segment is in position 6. When complete, select the X in the upper-right corner to close this window and continue. Segment Status Area Box Colors Learn about STM segment status box colors.   When complete, select the X in the upper-right corner to close this window and continue. RED:  Do not remove or replace this STM segment or the aliquot segment from the sample wheel.  It is currently being used by the Dimension® System to process samples. YELLOW:  The STM segment has unused aliquot positions available on it and should not be removed. The instrument is not using this segment to process samples. GREEN: This STM segment or aliquot segment is completely used and no more positions are available to process tests.  This STM segment or the aliquot segment can be removed or replaced if desired. Note:  A dash (-) can also appear in a green background box.  This means the Dimension® System has not identified an STM segment or regular segment in that position on the sample wheel. Warning:  Never place a previously used or partially used aliquot segment onto the sample wheel. This will cause erroneous patient results. To access the Aliquot Segments screen, press the Alt/S key combination, and if necessary, F2: STM. The Aliquot Segments screen displays: How many unused aliquot positions are available How many pipette tips are available How many pipette tips until the tip waste is full Current status of each aliquot position STM Backlog Aliquots Segment Screen Learn about the Aliquot Segments Screen. Slide NumberText BlocksCalloutsAudio ScriptImage File1 Sample wheel position numbers, 1-6 on the left side of the Aliquot Segments screen correspond to the Dimension® System sample wheel positions 1-6. Select Next to continue.  Note: If audio does not automatically start, select the play arrow in the top left to begin.On the left side of the Aliquot Segments screen are sample wheel positions. Positions 1-6 correspond to the sample wheel positions on the instrument.2Each STM aliquot segment contains 63 sample positions.  The Aliquot Segments screen displays the current status of each position.  In addition to the standard letters used by the Dimension® Systems to indicate the status of samples on the screen, there are two STM specific marks that appear on the screen:   STM Mark Color Meaning - Red This aliquot position is not available for use.  It has been used or aborted. + Green This aliquot position has not been used. The letters that appear on the screen have the same meaning and colors as those used with the Dimension® Systems. For example a yellow B indicates the sample has begun processing. Select Next to continue.    There are 63 positions available for samples in each STM aliquot segment. The Aliquots Segment screen displays the current status of each position. Two STM specific marks also will appear on this screen. A minus sign with a red background color indicates there are no positions available for use. A plus sign with a green background color indicates the position has not been used. 3The Aliquot Segments screen provides information on the consumables required for sample processing and the available STM aliquots positions and pipette tips. The Tips to Waste Full field indicates the number of tips that can be added to the waste. Select Next to continue.   The Aliquot Segments screen provides information about the consumables required for sample processing and the available STM aliquots positions and pipette tips. The Tips to Waste Full field indicates the number of tips that can be added to the waste. 4The STM backlog indicates the time until the last sample transferred by the STM to the Dimension System® sample wheel will be processed. The VersaCell™ System uses this time to stop sending samples to the Dimension® System which prevents loss of volume from evaporation in the aliquot segment.  When complete, select the X in the upper-right corner to close the window and continue.   The STM backlog indicates the time until the last sample transferred by the STM to the Dimension® System sample wheel will be processed. The VersaCell™ System uses this time to stop sending samples to the Dimension® System which prevents loss of volume from evaporation in the aliquot segment. Congratulations. You have completed the ADVIA Chemistry XPT System Competitive Positioning Online Training course. Listed below are the key learning objectives presented. Select the link below to view/print your review material before proceeding to the final quiz. Report slips for samples processed using the STM have the same format and contain the same information as those processed without the STM.  A lowercase letter in the Segment field indicates the STM sample. Select Next to continue.   Following your laboratory protocol, ensure the sample quality is acceptable before loading it onto the VersaCell™System. The sample must be free of clots, air bubbles, fibrin strands, and other impurities. Centrifuge previously frozen samples. Methods that have specific handling instructions such as urine drug screens or whole blood assays must be loaded directly onto the Dimension® System. Select Next to continue.   The STM can be paused by: Raising the tip feeder cover on the STM Raising the IMT lid Raising the printer lid (Dimension® RxL Max® System only) Pressing the Pause button on the STM keypad When the STM is paused, it continues operations for the current sample that is being transferred until the carriage returns to the home position.  The blue “STM Paused” status appears in the Instrument Status box at the top of the Dimension® Systems screen.   If the STM was paused by raising the tip feeder cover on the STM or the IMT lid or printer lid, closing the lid automatically resumes STM operations. If the STM was paused by pressing the STM Pause button, press the STM Continue button on the Dimension® RxL Max® System or the Load button on the Dimension® EXL™ System to resume STM operations. Select Next to continue.   The options to load aliquot segments are: Wait until the “STM Needs” message appears in the STM processing status.  Display the Aliquot Segments screen to see if the STM Aliquots field is zero. Pause the Dimension® System to replace the aliquot segments. or Wait until most of the STM segment status boxes are green in color, indicating that all the aliquot positions have been used. Pause the Dimension® System to replace the aliquot segments. Warnings: Never remove an STM segment or aliquot segment that has a red segment status box.  This segment is currently being used to process a sample. Press the Pause key on the Dimension® System keyboard before replacing aliquot segments or STM segments while the instrument is processing. In either case, potential exists for erroneous patient results if you remove the wrong segment or splash/spill fluid from one segment into another. Helpful Hint:  Leave at least one regular segment in the sample area for performing Daily Maintenance, IMT Condition and Dilution Check, alignments (position 1), and manual sample loading.   Loading Aliquot Segment Learn about loading Aliquot Segments. Checklist TitleChecklist TypeChecklist ContentSelect PauseHTML Press the Pause key to halt the movement of the sample wheel.  After the “Sampler Paused” status appears, the sample wheel can be moved manually to remove the aliquot segments. Select each checkbox to learn more about loading Aliquot Segments.  Remove SegmentHTML Remove the used aliquot segment from the segment base. Place a lid on the used aliquot segment to keep fluids from splashing and discard according to your laboratory’s biohazard disposal procedures.  Load SegmentHTML Place a new, unused aliquot segment on the segment base and ensure it is fully seated.  Select PauseHTML Select the Pause key on the Dimension® System keyboard.  Select Run KeyHTML Press the RUN key. The Dimension® System scans the sample wheel and updates the Aliquot Segments screen and Segment Status box. The aliquot segments replaced will appear with green “+”’s in all positions.  Note: To access the Aliquot Segments Screen, press the Alt/S key combination and if necessary, F2: STM.    When complete, select the X in the upper-right to close this window and continue. A rack of pipette tips can be loaded in the tip feeder at any time.  The tip feeder must be loaded when the Pipette Tips field on the Aliquot Segments screen displays zero. This halts the Sample Transfer Module from transferring samples and displays the "STM Needs" status.   Loading Pipette Tips Learn how to load a pipette tip rack.   Steps to load pipette tip racks: Raise the tip feeder cover and wait for the tip tray to move the tip racks to the front of the feeder. Remove the empty pipette tip rack or racks and dispose them using your laboratory’s biohazard waste procedures.  Do not reuse the empty pipette tip rack. Place the new rack or racks onto the tip tray. Close the tip feeder cover. The Dimension® System automatically inventories the number of tips in both racks of the tip tray.  The total number of inventoried tips appears in the Pipette Tips field at the top of the Aliquot Segments screen. When complete, select the X in the upper-right corner to close the window and continue. The Tip Waste container can be emptied at any time. When the Tips to Waste Full field on the Aliquot Segments screen is zero, the container must be emptied.  This stops the STM from transferring samples and causes the “STM Needs” message to appear. Removing the waste container automatically pauses the STM.   Emptying Tip Waste Container Learn how to empty the tip waste container. When complete, select the X in the upper-right corner to close the window and continue. Open the STM cabinet door and remove and empty the tip waste container. Place a biohazard bag liner inside the empty container, place the container back in the cabinet and close the door. Display the Systems Counter screen from the Home Screen by pressing F4: Systems Prep, then F6: Sys Counters Move the cursor box to the Replace column of the STM Tip Waste field. Press the Enter key to change the NO to YES, and then press F1: Store Changes.  Answer the prompt by typing a “y” for yes. The Cycles column changes to zero and the Last Replaced column changes to the current date and time. There is minimal maintenance associated with the STM and no required daily maintenance.  Routinely clean the outside surfaces of the STM using a damp cloth and warm, soapy water.  Clean up spills immediately. Helpful Hint: Perform Dimension® System Daily Maintenance while performing the VeraCell™ System Daily Shutdown. Select Next to continue.   Alignments must be performed after replacing the Photometric Sample probe on the Dimension® Systems or the IMT Sample Probe on the Dimension® RxL Max® system. When the STM is installed on the Dimension® System, the Cup Alignment gauge is no longer be used.  The STM Alignment Gauge is used instead. The only recommended alignments specific to the STM are the: Sample Probe to Aliquot Segment Outer/Inner Holes (all Dimension® Systems) IMT Probe to Aliquot Segment Outer/Inner Holes (Dimension® RxL Max systems) All other STM specific alignments are performed by field service.  Follow the instructions in the Dimension® clinical chemistry system Sample Transfer Module Operator’s Guide. Select Next to continue.   When an error message related to the STM occurs on the Dimension® System, an associated error message displays on the VersaCell™ System screen. Depending on the error message, it may display on the VersaCell™ System as an: Instrument Error Inventory Error Sample Error Order Error These buttons turn red when new error messages are posted and turn gray after viewing the error information. Resolve the error message then press the Reset key on the Dimension® System to initialize and resume sample loading.   Troubleshooting the STM Learn more about troubleshooting the STM. Slide NumberText BlocksCalloutsAudio ScriptImage File1If an error message appears on the Dimension® System, press the Alt/M key combination to display troubleshooting help.  However, not all STM error messages have Alt/M troubleshooting help. The error message displays an error code number in parentheses.  The Dimension® clinical chemistry Sample Transfer Module Operator’s Guide provides STM specific error message explanations and steps to resolve by the error code number displayed with the message.   Select Next to continue.Note: If audio does not automatically start, select the play arrow in the top left to begin.If an error message appears on the Dimension® System, press the Alt/M key combination to display troubleshooting help. Not all STM error messages will have the Alt/M troubleshooting help. The error message displays an error code number in parentheses. The Dimension® clinical chemistry Sample Transfer Module Operator’s Guide provides STM specific error message explanations and steps to resolve by the error code number displayed with the message. 2Examples of aliquot segment related error messages which may display on the Dimension® System are: STM Invalid Aliquot Segment caused by missing or bad aliquot segment (801) Explanation: The barcoded aliquot segment was not detected by the barcode reader in the sample wheel Possible Solution: Check for proper installation of aliquot segment and press Run. If the error reoccurs, replace it with new unused aliquot segment and press Run. STM Invalid Aliquot Segment caused by STM attempt to reuse a used aliquot segment (802) Explanation: A previously used aliquot segment was found on the sample wheel and the segment has been deleted. Solution: Check the Aliquot Segments screen for all red dashes in the display. Remove the aborted aliquot segment and load a new unused one. Select Next to continue.   Aliquot segment related error messages display on the Dimension® System . The error message posted is STM invalid aliquot segment. When the error is caused by a missing or bad aliquot segment, error code 801, this indicates that the barcoded aliquot segment was not detected by the barcode reader in the sample wheel. The first step to resolve is to check for the proper installation of the aliquot segment and press Run. If the error reoccurs, replace it with a new aliquot segment then press Run. When the error is caused by the STM attempting to reuse a used aliquot segment, error code 802, a previously used aliquot segment was found on the sample wheel and the segment has been deleted. Check the Aliquot Segments screen for all red dashes in the display, remove the aborted aliquot segment and load a new unused one.3During a sample aspiration and dispensing cycle, the STM fluidics system monitors air pressure to determine that the proper amount of sample was detected and transported.  STM sample aspiration problem error messages can be caused by: STM aspirated air (782)  Explanation:  Abnormal pressure data indicates no fluid was aspirated  Solution:  Check for crimped tubing and bubbles or foam on top of the sample STM tip leaking (780) Explanation:  Abnormal pressure data indicates sample leaked from tip. The sample and pipette tip are discarded. Solution:  Check for a leak in the tubing, defective pipette tip(s) or air pump syringe STM tip plugged (781) Explanation:  Abnormal pressure data indicates the pipette tip was plugged during aspiration Solution:  Check sample quality for clots or fibrin and insufficient sample for possible gel aspiration    Select Next to continue.During a sample aspiration and dispensing cycle, the STM fluidics system monitors air pressure to determine that the proper amount of sample was detected and transported. STM sample aspiration problem error messages can be caused by the STM aspirating air and the tip leaking or plugged. Abnormal pressure data indicates that no fluid was aspirated, that sample leaked from the tip or the tip was plugged during aspiration. To resolve these issues, check for crimped or leaking tubing, sample quality and sufficient sample depending on the specific error code.4Similar to other components on the Dimension® System, the STM also may have error messages that display “Cannot Find Home” or “Lost Steps”. “Cannot Find Home” messages Explanation: The control system did not detect movement of the component. Solutions: If the component did not move through a complete cycle check for either interference or replace the home sensor for the particular component; for example, STM probe or shuttle If the component did not move at all, first check the fuse. “Lost Steps” messages  Explanation: The component did not move the proper distance Solutions: Check for either something restricting or interfering with the movement of the component.  If nothing is observed, then alignments or lubricating the module may be recommended. Follow the guidelines for troubleshooting outlined in the Dimension® clinical chemistry system Sample Transfer Module Operator’s Guide for the error code number displayed. If either type of error message is not resolved by following the troubleshooting help, contact the Technical Solutions Center.   When complete, select the X in the upper-right corner to close the window and continue. As with any component on the Dimension® System, the STM may have error messages that display “Cannot Find Home” or “Lost Steps”. “Cannot Find Home” messages generally are associated with either interference or a home sensor for the particular component; for example, STM probe or shuttle, if the component did not move through a complete cycle. If the component did not move at all, first check the fuse. “Lost Steps” messages generally are associated with something restricting or interfering with the movement of the component. If nothing is observed, then performing alignments or lubricating the module may be required. Follow the guidelines for troubleshooting as outlined in the Dimension® clinical chemistry system Sample Transfer Module Operator’s Guide for the error code number displayed. If either type of error message is not resolved by following the troubleshooting help contact the Technical Solutions Center for assistance. There are other troubleshooting situations that may occur when the Dimension® System is connected to the VersaCell™ System: Recovering from Control Stop Running Barcoded Samples Manually Insufficient samples: Sample and Order Errors Inventory Errors Consumable Errors Instrument errors Select Next to continue. If the Control /Stop key combination is pressed when a run needs to be aborted: The STM Status on the Dimension® System displays STM Error. The error message field on the Dimension® System displays User Aborted Processing in red. On the VersaCell™ System, the Dimension® Systems status bar displays Error Stop in red. After the Reset key is pressed on the Dimension® System keyboard, the Dimension® System status on the VersaCell™ System displays Initializing. When initializing is complete, the Dimension® System status on the VersaCell™ System displays Ready. Note: If Pause is pressed, the VersaCell™ System displays Analyzer Paused in the Dimension® Systems status bar. If only the IMT is paused, the system still displays Ready. Select Next to continue.   When running barcoded sample manually on the Dimension® System: Load the sample directly on the instrument and press Run If the Instrument Error "Order Delayed to Instrument" posts on the VersaCell™ System, press RUN again.. The VersaCell™ System will send the order to the Dimension® System When running manually ordered tests on the Dimension® System not sent by the LIS: The Dimension® System cannot request sample tubes from the VersaCell™ System. The sample tube must be retrieved from the VersaCell™ System. The operator cannot use the Send button on the Drawer screen to transfer tubes from the VersaCell™ System to the Dimension® System. Manually ordered Dimension® System tests are not sent until completed. Select Next to continue.   An example of a Sample Error and an Order Error message where sample handling options are available is when a short sample is processed through the VersaCell™ System.  When the STM probe tries to aspirate a sample that is insufficient, the Dimension® System displays an error message, STM Sample Aborted or STM Probe found no sample during level sense.  Press Reset on the Dimension® System keyboard to clear the error message once the situation is resolved.   Running Insufficient Sample Learn how to run an insufficient sample. Tab TitleTextLoad on Dimension® System Sample Error Locate and remove tube from the drawer position on VersaCell™ System. Transfer sample to sample cup (<1 ml) and program on the Enter Data screen or an SSC (>1 ml) that is placed on the barcoded tube Load sample directly onto sample wheel and press Run Note: If a Sort drawer is designated, the tube with the Sample Error will be placed in the first column of the Sort drawer for easy access.    Load on VersaCell™ System Without Sort Drawer Sample Error displays on VersaCell™ System screen. Locate  tube from the drawer position on VersaCell™ System. Remove tube from drawer location, check and add additional sample, if available, to tube. Replace tube in new position in drawer then press Continue on the VersaCell™ System screen. Sample tube in new position generates an Order Error. Press Order Error, select tube, and press Resend from VersaCell™ System screen  With Sort Drawer Follow steps 1-3. Sample will be placed in Column A of Sort drawer Clear the Order Error Place sample into an input drawer to rerun When complete, select the X in the upper-right corner to close the window and continue.     The Inventory Errors screen displays information about Flex® reagent cartridges and indicates when empty, unavailable for order, not in run or disabled. When inventory information is being refreshed, the VersaCell™ System temporarily may indicate an Inventory Error. If there are Inventory Errors, the Dimension® System sends a zero value to the VersaCell™  System and the test will appear on the Inventory Errors screen.  This error may be caused by no reagent on board or calibration or QC being required. If a method is disabled on the VersaCell™System, it will appear in the Missing column with an asterisk. Refer to the Using the Test Activation Screen section in the  VersaCell™System Operator's Guide to enable or disable tests.   Select Next to continue.   Consumable warnings are sent to the VersaCell™ System and can be viewed on the Instrument Error screen.  A warning will display in yellow in the Dimension® Instrument Status field. Consumable Stop messages are sent when a consumable is empty.  The instrument status box will display Consumable Stop in red, and the Error Report will indicate which consumable needs to be replaced. Select Next to continue.   Instrument Errors are displayed whenever the Dimension® System has an error message.  For example, if there are IMT flow issues, the VersaCell™ System will display "An IMT Module Event was reported.  At the instrument, review the message."  If a mechanical error message occurs such as "Cuvette Wheel cannot find position" or "Bad Cuvette" the VersaCell™ System will display Error Stop and "A Cuvette System event was reported.  At the instrument review the message."   Select Next to continue.   IMT 소모품은 남아있는 분석, 남은 시간, 그리고 카운트 업데이트를 위한 지시 사항을 표시하는 Change IMT Consumables 화면을 사용하여 쉽게 교체할 수 있습니다. IMT 소모품을 교체하고 변경 사항을 저장하면 시스템은 자동으로 프라이밍을 하고 필요에 따라 칼리브레이션을 하게 됩니다. In this section, you have the opportunity to think about these STM questions. Read each question then see if you match the response. Question Response On the Dimension® System, an STM segment appears with which type of case letter in the segment status box? An STM segment appears with a lower case letter, ex., a What does a red background color for a segment status box indicate? A red background color for a segment indicates it is currently being used for processing and should not be removed. What does a yellow background color for a segment status box indicate? A yellow background color indicates the STM segment or the aliquot segment has unused aliquot positions available for use. What does a green background color for a segment status box indicate? A green background color indicates the STM segment or the aliquot segment is completely used and can be replaced. Why should a partially or partially used aliquot segment never be placed back on the segment wheel? Never place a previously or partially used aliquot segment on the sample wheel as this could cause erroneous patient results. Select Next to continue.