Dimension® EXL™ with LM Integrated Chemistry System Reagent Management System Online Training

Access and use the RMS Module System Counters screen Describe how RMS module components load, hydrate and automatically remove  Flex® reagent cartridges Identify key components of the RMS module Identify key features of the RMS module Perform Daily and Other RMS Maintenance Welcome to the Reagent Management System (RMS)  course for the Dimension® EXL™ with LM integrated chemistry system. After completing this course, you will be able to: Select Next to continue. ご利用のシステムはハイブリッドスキャナであるため、それに関連した複数のコンピュータとワークステーションが存在します。その中にはユーザーの対話操作が必要のものもあれば、システムに組み込まれていてユーザーの対話操作が不要なものもあります。デュアル高解像度モニターにより、一度に2つの画像、アプリケーション、タスクカードを表示することが可能です。CTのコンピュータとワークステーション、PETのコンピュータについては、以下のリンクを選択してください。  Important components of the RMS module can be grouped according to the following systems: Loading System Hydration System Transfer System Storage System Waste Removal System RMS Components View the location of the functional RMS components. Base ImageHotspotsText BlocksImage File Storage System Loading System Transfer System Hydration System RMS Components Learn about the function of each of the RMS components. Slide NumberText BlocksCalloutsAudio ScriptImage File1 In this section,  you will learn about the components of the RMS and their functions.  Select Next to continue.   Note: If audio does not automatically start, select the play arrow in the top left to begin.In this section, you will learn about the components of the RMS system and their functions2  RMS Loading System The operator places the Flex® reagent cartridges into the load tray, which can hold up to 18 at one time, and then presses the Flex® Load button to begin the loading process. The bar code reader reads the bar code label on each Flex® reagent cartridge to keep track of reagent inventory. The load tray moves each reagent cartridge into the elevator. The elevator lowers each reagent cartridge into the turntable.   Select Next to continue.Select each number to review the corresponding text.CalloutsLoad ButtonLoad TrayFlex® Reagent CartridgeBar Code ReaderElevatorThe RMS loading system loads Flex reagent cartridges from the load tray onto the turntable. The bar code label is read on each cartridge before the load tray moves the cartridge into the elevator. The elevator then lowers each reagent cartridge into the turntable.3 RMS Hydration System: Hydration Station The RMS hydration station includes the following components: The refrigerated slot maintains reagent cartridges at  2–8°C The R3 probe on the R3 reagent arm hydrates and mixes the Flex® cartridge reagents using ultrasonics   Select Next to continue. TIP: For additional information, refer to the Hydration section of the Reagent Monitoring and Preparation online training module.Select each number to review the corresponding text.CalloutsRefrigerated SlotR3 ProbeFlex® Reagent CartridgeThe RMS hydrates Flex reagent cartridges automatically as needed or when directed by the operator. When a Flex reagent cartridge needs to be hydrated, the turntable transfers the reagent cartridge to the hydration station, and then transfers the hydrated cartridge to the RMS or Dimension system reagent trays for use. The RMS hydration station includes two components: the refrigerated slot which maintains reagent cartridges at 2-8 degrees C and the R3 probe located on the R3 reagent arm which hydrates and mixes the Flex cartridge reagents using ultrasonics. 4RMS Hydration System: Pump Panel The 2500 μLsyringe in the RMS pump panel delivers water to the R3 arm to hydrate Flex® cartridge reagents. Select Next to continue. CalloutsRMS Flush PumpFlex reagent cartridges are hydrated with water delivered by a 2500 uL syringe in the RMS pump panel.5 Transfer System The RMS turntable has two shuttles to transfer Flex® reagent cartridges between various locations, depending on the reagent needs of the instrument. For example: From the elevator into either the RMS or the Dimension® system reagent trays From either reagent tray into the hydration station From the hydration station to either reagent tray Between the RMS and Dimension®system reagent trays Into the RMS waste container chute Select Next to continue.  Select each number to review the corresponding text.CalloutsRMS Reagent TrayDimension system Reagent TrayTurntableHydration StationTwo shuttles on the RMS turntable transfer Flex reagent cartridges depending on the reagent needs of the instrument.6 RMS Storage System The RMS reagent tray (shown open) and the Dimension®system reagent tray are identical. The RMS reagent tray can store 44 Flex®reagent cartridges The RMS reagent tray has its own refrigeration and temperature monitoring system to maintain reagent cartridges between 2–8°C Select Next to continue. CalloutsRMS Reagent TrayThe RMS reagent tray and the Dimension system reagent tray are identical. The RMS reagent tray can store 44 Flex reagent cartridges and has its own temperature monitoring system to maintain reagent cartridges between 2-8 degrees C.7 RMS Waste Removal System The RMS automatically discards empty or expired Flex®reagent cartridges through the waste chute into the RMS waste container. The operator also can remove reagent cartridges manually from the instrument using the Flex®reagent cartridge loader. Select Next to continue.  NOTE:  The Dimension® EXL™ with LM integrated chemistry system tracks the number of reagent cartridges that have been deposited into the RMS waste container. When 50 or more cartridges have been discarded, the Daily Maintenance Routines screen displays F4:Check RMS Counts, which will indicate the need to empty the waste container. Select each number to review the corresponding text.CalloutsWaste chuteRMS Waste ContainerEmpty or expired Flex reagent cartridges are discarded automatically by the RMS through the waset chute into the RMS waste container. Reagent cartridges also can be removed manually using the autoloader.8 Congratulations. You have learned the components and functions of the RMS. When complete, select the X in the upper-right corner to close the window and continue.Congratulations. You now have learned about the components and functions of the RMS. In the next section, you will see the RMS in action. Congratulations. You have completed the Reagent Management System (RMS) course for the Dimension®  EXLTM with LM integrated chemistry system. Listed below are the key points that have been presented.  Take time to review the material before you proceed to the final quiz.  Identify key features of the RMS module The Reagent Management System (RMS) is a module that allows storage of 44 additional refrigerated Flex® reagent cartridges on board and ready for use. The RMS automatically transfers, hydrates, and removes Flex® reagent cartridges while processing samples.Identify key components of the RMS module Key components of the RMS module include the Loading, Hydration, Transfer, Storage, and Waste Removal Systems. Refer to those sections of the course to identify the components of each system. Describe how RMS module components load, store, hydrate, and transfer Flex® reagent cartridges as needed by the Dimension® system   Loading System: The operator loads Flex® reagent cartridges into the load tray, where the bar code reader reads each Flex® cartridge bar code label to keep track of reagent inventory. The load tray moves the reagent cartridges into the elevator, which lowers the reagent cartridges into the turntable. Hydration System: When a Flex® reagent cartridge needs to be hydrated, the turntable transfers a reagent cartridge to the hydration station. The 2500-µL syringe in the RMS pump panel delivers water to the R3 arm to hydrate Flex® cartridge reagents. Then the turntable transfers the hydrated cartridge to the RMS or Dimension® system reagent trays for use. Transfer System: The turntable has two shuttles to transfer Flex® reagent cartridges to and from the RMS reagent tray or the Dimension® system reagent tray, from the reagent trays to the hydration station, from one reagent tray to the other, or into the RMS waste container chute depending on the reagent needs of the instrument. Storage System: Like the Dimension® system reagent tray, the RMS reagent tray stores up to 44 Flex® reagent cartridges. Its refrigeration and temperature-monitoring system maintains reagent cartridges between 2–8°C. Waste Removal System: The RMS module automatically discards empty or expired Flex® reagent cartridges through the waste chute into the RMS waste container. Perform Daily Maintenance Clean the Reagent Area: With the instrument in Standby, first press PAUSE, then wipe the bulk loader with a damp cloth. Press PAUSE to resume operation. Check for Other RMS Maintenance: From the Daily Maintenance Routines screen, F4: Check RMS Cnts will be displayed, if other RMS maintenance is required. Pressing F4 will display the RMS Module System Counters screen. This screen can also be accessed directly through F4: System Prep > F6: System Counters > F7: RMS Counters. Always perform this maintenance prior to running the System Check. Record RMS Daily System Check Results: The temperatures of the RMS Hydration Station and Reagent Tray must be in the range of 2°- 8 °C. The RMS System Check specifications are: Mean = Assay value ± 12 mAU SD = ≤ 3.8 Perform Other Maintenance: The 2 maintenance items that are listed on the RMS System Counters screen are: Replace R3 probe tip every 48,000 cycles Empty Flex® Reagent Cartridges from waste which holds up to 50 discarded reagent cartridges. This needs to be monitored routinely so that the waste does not overfill.   Select Next to continue.   The RMS turntable transfers Flex® reagent cartridges from the load tray to the RMS reagent tray, the Dimension® reagent tray, and the hydration station. In the “RMS In Action” silent video, you will observe the loading and processing of 3 reagent cartridges.  You will see the elevator as it lowers them to the transport shuttle, then moves them between the loading area, the 2 reagent trays and the hydration station.  In the hydration station, you will see how the R3 probe performs hydration functions. RMS In Action See the RMS In Action.     Select the play arrow to begin the video. When completed, select the X in the upper-right corner to close the window and continue. Prior to adding reagents to Dried Conventional Gram Postive or Gram Negative panels, it is important to verify that all of the reagent addition criteria have been met.  Reagent addition criteria is defined for: Gram-negative fermenters Gram-negative non-fermenters Gram-positive organisms There are several resources available to help evaluate these critera.  The resources include the panel procedure manual and the jobaid provided later in this course. Select the icon to learn to identify and interpret these criteria. It is important to perform maintenance on the RMS at the same time as you perform Daily Setup on the  Dimension® EXL™ with LM integrated chemistry system.  Daily Maintenance on the RMS includes: Cleaning the Reagent Area Checking for Other RMS Maintenance Recording the RMS Daily System check results Cleaning the Reagent Area Learn about Cleaning the Reagent Area When the instrument is in Standby, select Pause. Raise the reagent and RMS lids. (Insert a strong slender tool into the reagent lid latch. Press firmly to raise the lids.)   Clean the inside of the bulk loader with a damp cloth.   Close the lids and select Pause. Select the X in the upper-right corner to close the window and continue. Other RMS Maintenance Learn about about Other RMS Maintenance While performing daily maintenance, if any RMS maintenance is required, the function key F4: CHK RMS CNTS is displayed on the Daily Maintenance Routines screen.   Display the Daily Maintenance Routines screen by selecting F4: System Prep, F8: Daily Maintenance from the Operating menu. Select F4: to display the RMS Module System Counters screen. Other Maintenance will be covered in the Maintenance course for the Dimension® EXL™ with LM integrated chemistry system. Select the X in the upper-right corner to close the window and continue.    Recording Results Learn about Recording Results When the System Check results are printed, record the hydration and reagent temperatures and the mean and SD results for the RMS. RMS Module Temperature Specifications RMS Hydration Station: 2°- 8°C RMS Reagent Tray : 2°- 8°C   System Check Specifications RMS Mean=Assay value ±12 mAU (listed on the end flap of the ABS Carton) SD:  ≤ 3.8 Note:  Refer to the Dimension® EXL™ with LM Daily Setup course for instructions on how to run a System Check. When complete, select the X in the upper-right corner to close the window and continue. Susceptibility wells are coated with doubling dilutions of various antibiotics.  The Minimum Inhibitory Concentration (MIC) is the lowest antimicrobial concentration showing inhibition of growth.  When growth occurs in all concentrations of an antimicrobic the MIC is recorded as greater than  the highest concentration.  When no growth occurs in any of the concentrations of the antimicrobics, the MIC is recorded as less than or equal to the lowest concentration. Growth is determined by comparing the turbidity in the antimicrobic dilution well with the turbidity in the Growth well.  MIC wells should be read against a dark or indirectly lit background for optimal viewing. Select the link below to practice interpreting the susceptibility wells of a dried gram positive combo panel. The RMS Module System Counters screen shows the status of maintenance items for the RMS. Items appearing in red have exceeded their counts and should be attended to before performing the System Check or operating the instrument. The 2 items that are monitored in this screen are the R3 probe tip, which is replaced every 48,000 cycles, and the number of Flex® reagent cartridges in Waste, which needs to be emptied at 50. Refer to the Dimension® EXLTM with LM Maintenance course for information on how to change a probe tip. After performing Other Maintenance, update the Replace or Empty value to Yes by pressing the Enter key. Remember to select F1: Store Changes to save and reset the cycle count. In the previous section, you learned how to access this screen from the Daily Maintenance Routines screen when Other RMS Maintenance is due. This screen also can be displayed by selecting F4: System Prep > F6: System Counters > F7: RMS Counters.   Emptying Waste Container Learn about Emptying the Waste Container. Used reagent cartridges are biohazards. Place a liner in the RMS waste container and follow your laboratory’s safe handling procedures. Although the system indicates when to empty the waste during daily maintenance, you may want to check the RMS waste more frequently depending on your laboratory workflow volumes. The RMS will continue to load and empty cartridges even if the 50 limit is exceeded. If you do not check and empty the waste container, the cartridges could overflow. For example, if there are 45 cartridges in the waste, the system will not advise you to empty the waste. If 5 or more are discarded during the day, they could spill out of the waste container. Select the X in the upper-right corner to close the window and continue.   There are many ways that Adobe Captivate 5 can fit into an instructional strategy.  The tool allows you to create software deomonstrations where the learner can preview a procedure.  You can also create an interactive simulation providing the learner the opportunity to practice the procedure with guidence.  Or even assess the learners skills by allowing them to perform the procedure with immediate feedback.  All of these simulation modes can be published to a flash file and used within online training courses. Adobe Captivate 5 does require a Windows XP, Vista or Windows 7 operating system on PC based platorms.  If your instrument platform uses a different operating system, contact education solutions for a consultation. Select the link below for addition system requirement details. The Dimension® EXL™ with LM integrated chemistry system provides the most proactive approach to managing reagents through the Reagent Management System. The RMS module stores an additional 44 refrigerated Flex® reagent cartridges on board and ready for use. Extra reagent storage reduces hands on time spent adding Flex® reagent cartridges needed to perform high-volume tests. The RMS automatically transfers, hydrates, and removes Flex® reagent cartridges while the Dimension® EXL™ with LM integrated chemistry system is processing samples. Select Next to continue.  PHSの動作に関するガイドラインについて取り上げます。身体の傷害や装置の損傷を避けるために、ガントリ上の操作ボタン類を患者に触れさせないでください。頭→足方向であれ、足→頭方向であれ、PHSが常に目的の方向に移動することを確認してください。また、スキャン中は、患者とガントリを常に監視してください。