CAP Proficiency Testing for Blood Bank

[yiams]

A question just came up in our transfusion service regarding the CAP Comprehensive Blood Bank survey. We have traditionally assigned this to one individual to perform all testing. The question is: Can we split this survey to test five different techs by assigning one specimen to one tech? We've been debating this. Has this happened at your facility? How did your inspectors look on this action? We'll accept all opinions!

Thanks

[ashshaq]

you will split by giving each tech a different specimen?? or you will split one specimen?? so you test five techs at one stone.

this what you mean???

[BLipkin]

I don't see why that would be a problem. We routinely assign a tech to ABO/Rh, another to do screens, a third for phenotyping, and then have them each do an identification- if there is enough to go around. There has never been a problem with any of our inspectors (CAP, NYS, CMS). I think it is better to spread them out rather than overloading one individual- just my opinion.

[Cliff]

Just remember that these specimens are supposed to be tested in a manner that mimics "real" specimens.

[roberman]

We routinely split them into 5 samples, with each tech getting 1 specimen and doing the type, screen and xm. We just got CAP inspected and either they didn't have a problem with it or didn't notice.

[yiams]

ashshaq, one individual sample would go to one individual tech. Surv Samp-1 would go to Tech 1; Surv Samp-2 would go to a second tech, etc.

[velliott]

I divide up my survey and give a different sample to 5 or 7 techs depending on what the educational challenge is. I'm inspected by FDA, AABB and the Joint Commission and they have made comments about this practice. Especially on the transfusion challenges you want to make sure all your techs are performing unknowns.

[KKidd]

We have been told by an inspector that the samples should be run by all shifts as well as different techs. My manager wants me to assign them, but I feel that this is not integrating it into your workload. I just put the information out and a tech will choose a sample to run as time allows. For any given survey, 5 different people are involved. Hopes this helps!

:highfive:

[adiescast]

We assign each sample to a different tech on a rotating basis across all shifts. After all results are entered into CAP and the deadline is passsed, we go through and reassign samples to another tech. We do this to get as many techs involved in the proficiency process as possible. We also use this data for competency. The samples are handled like patient samples as far as possible, but at some point you have to admit that they are not patient samples and they cannot always be handled exactly like patient samples due to some of the restrictions CAP places on them (such as involving techs on all shifts, crossmatching "units" you know are going to be incompatible before you even start, etc.)

[tbostock]

I agree with adiescast, we split them up to allow as many techs as possible to rotate them throughout the year. And I have gotten every inspector over the years to agree that they way the BB proficiencies are designed, they cannot truly be done "like patients" or "integrated into the workflow". We try the best we can as adiescast said.

[MAGNUM]

I cannot see how this would be a problem. You receive 5 samples for the antibody screen/id. Just insure that you include all names on the last page of testing personnel.

[rcollins]

We have been told by an inspector that the samples should be run by all shifts as well as different techs. My manager wants me to assign them, but I feel that this is not integrating it into your workload. I just put the information out and a tech will choose a sample to run as time allows. For any given survey, 5 different people are involved. Hopes this helps!

:highfive:

I would just be careful to make sure that everyone is involved at one time or another in proficiency testing.

@Yiams--We split up our CAP surveys exactly as you suggest and it works out well. We've never had an inspector question it. Good Luck!

[skopti]

We make sure that all our techs are involved in the Proficiency testing . I see no problem with splitting the samples among more than one tech

[heathervaught]

The Attestation form has about 8 or 10 spaces for signatures/names of individuals involved in testing. It seems like they anticipate that one survey may be completed by many individuals.

[Peggy]

We split by sections, I will assign a tech to do Type and screen. Another for antibody ID, etc.

[L106]

We split by sections, I will assign a tech to do Type and screen. Another for antibody ID, etc.

But is that the way your dept would normally handle real patient testing?

[mcgouc]

A different tech gets each CAP specimen and I keep a spreadsheet so I can make sure each tech gets a variety of CAPs - if the tech got a DAT last time, then they may get a fetal screen this time or one of the "J" samples. The techs complete the paperwork as if it is a real patient, but there is no way they don't know it is a CAP. The only problem we have had is that we did get low on the "donor" cell one time with each tech doing his own antigen types on the donor. Now we put one of our antigen typing stickers on the donor red cell bottle so we don't antigen type the donor multiple times. If it were a real donor, we would label the unit with the antigen types we had done so I decided we could do that.

[richardsonj]

A different tech gets each CAP specimen and I keep a spreadsheet so I can make sure each tech gets a variety of CAPs - if the tech got a DAT last time, then they may get a fetal screen this time or one of the "J" samples. The techs complete the paperwork as if it is a real patient, but there is no way they don't know it is a CAP. The only problem we have had is that we did get low on the "donor" cell one time with each tech doing his own antigen types on the donor. Now we put one of our antigen typing stickers on the donor red cell bottle so we don't antigen type the donor multiple times. If it were a real donor, we would label the unit with the antigen types we had done so I decided we could do that.

We have had this same problem...running out of the donor cell due to multiple people doing antigen types on the bottle. I like the idea the mcgouc presents...thank you.

[crldehart]

We assign each sample to a different tech on a rotating basis across all shifts. After all results are entered into CAP and the deadline is passsed, we go through and reassign samples to another tech. We do this to get as many techs involved in the proficiency process as possible. We also use this data for competency. The samples are handled like patient samples as far as possible, but at some point you have to admit that they are not patient samples and they cannot always be handled exactly like patient samples due to some of the restrictions CAP places on them (such as involving techs on all shifts, crossmatching "units" you know are going to be incompatible before you even start, etc.)

At my facility, every Blood bank tech is required to perform at least one CAP specimen per year. Each tech is assigned a calendar quarter in which to perform the testing. Whatever CAP survey arrives during that quarter, the techs assigned get to select which sample to test (on a first come, first served basis). This includes all techs all shifts. Only one tech per sample. If the tech has done a simple CAP (like the DAT), I will require another survey when everyone has had a chance to perform once during the year.

After reporting, we usually retest the samples using a different method (manual tube vs Provue or manual Gel). This way we demonstrate tech competency and method correlation.

[AMcCord]

I assign ours like adiecast and have for years. Never any problems with inspectors.

[David Saikin]

Have always assigned the BB survey to 5 techs . . . all techs/all shifts are involved so each has at least one CAP challenge/year.

[BloodBank]

At our institution, we devide in a way that all techs. on all shifts get to perform proficiency testing. For example, JA series we assign to two techs, first three samples to one tech and other two and antigen testing to another tech. In a year you get 3 times JA so that we cover 6 techs. Same with eluate, DAT, titer, fetal screen etc.

This is our practice for many years and none of the assessors (AABB, CAP or FDA) have questioned this. At the begining of the year when we get the schedule from CAP web site, we prepare and post schedule for each test, and tech. This way when survey comes, supv. and tech. knows who will be performing the proficiency testing.

[San]

We have always split this among 5 different people and have never encountered any problems

San

[DBRITT]

We start the beginning of the year with a schedule, each sample is assigned to a different tech. This is perfectly fine for CAP as long as two techs don't work up the same sample. After results are submitted, you can then assign these samples to someone else for in house competencies.

[amym1586]

Sorry to bring a post back from the dead.

 

We haven't missed a survey in so long!  I start and we have an unsatisfactory ! We aren't in any trouble YET but now I have to fill out this evaluation  as to why it happened/corrective steps to solve the problem and corrective action to avoid the problem in the future.  And said employee that missed the survey won't be here for a week!  I have no idea what she did wrong.  GGGRRR

 

 

Rant over.