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  1. Competency Assessment

    I just joined the site, and have some questions about competency assessments. We have staff that rotate between two different campuses of the same hospital, but the labs have different CLIA numbers. So we were recently informed that we have to demonstrate competency at each site where our staff works. (Even though we use the same procedures, follow the same standard work, and have standardized things completely.) So I am trying to put this into practice without overwhelming our staff, but I still want to make sure we are doing a thorough check. We have a high percentage of new staff right now, so I don't want to half-a$$ it. Question 1: Competency must be assessed for every "test system," but what are the Blood Bank test systems you assess? Do we need to assess competency for every method of testing we use every year? Or would I be able to assess IAT as a test system and rotate yearly on what method we use? I cannot seem to find any Blood Bank-specific listing of test systems that require annual competencies! It seems pretty clear for other areas, but I am getting a bit stressed out trying to make sure we are fulfilling the requirements for CAP/AABB. And I also don't want to overwhelm our staff with 17 yearly competencies. In my lab, we perform the following tests: ABO/Rh - automated gel and tube testing Antibody screens - automated gel, manual gel, and tube testing DATs - manual gel and tube testing Antibody titration - manual gel and tube testing Antibody identification Antigen typing Elutions Fetal bleed screens Question 2: How do you handle items that you want to do a competency assessment on that are not tests? For example, we do quite a bit of component preparation, so we generally try to do an annual competency assessment and direct observation of our staff splitting a platelet into a pediatric dose. I am familiar with the 6 elements of competency assessment (show below), but I struggle with how to apply these to processes. "The following six (6) procedures are the minimal regulatory requirements for assessment of competency for all personnel performing laboratory testing: Direct observations of routine patient test performance, including patient preparation, if applicable, specimen handling, processing and testing; Monitoring the recording and reporting of test results; Review of intermediate test results or worksheets, quality control records, proficiency testing results, and preventive maintenance records; Direct observations of performance of instrument maintenance and function checks; Assessment of test performance through testing previously analyzed specimens, internal blind testing samples or external proficiency testing samples; and Assessment of problem solving skills." Thank you in advance! Susan