Tech gone for 4 months, returning

[Kathy]

We have a tech who was working every other weekend in the blood bank.  Her competency was due in January, but I did not do it, since it was at the time that she was leaving and I didn't expect her to be working here anymore.  Now, 4 months later, she is back working in other areas of the lab every other weekend and the techs working in the blood bank would like for her to cover them in case of emergencies or if they need to go on break.  Their argument is that she works in another hospital blood bank full time.  I don't think I can take that into consideration when determining her suitability to work in our blood bank. I feel like the full competency needs to be re-done before I can let her touch anything in the blood bank, but some people think that is overkill.  Is there anything she can do in here without me doing the full competency?  I also have concerns about anyone that works in my department who only does so infrequently.  What is the minimum amount you would have someone work in your blood bank and still feel confident that they would remember your procedures? 

[swede]

Float techs in our blood bank can check-in blood products, run the ProVue, and issue blood products.

They usually are not responsible for antibody ID and Kleihauer-Betke testing. 

 

When we need help in an emergency, it is usually with checking in more products or issuing routine products while the regular staff takes care of the trauma.

 

 

[Malcolm Needs ☆]

I wouldn't let ANYONE work in my lab without a full competency check.

 

I would also not expect anyone to allow me to work in their lab without me having to undergo a FULL competency check.

 

Every lab is different.

[goodchild]

I agree with Malcolm. We do a final check of pretransfusion testing and transfusion orders at the time of issue as a final barrier to mistransfusion, if someone wasn't trained and competency assessed on a number of areas they wouldn't be able to issue blood products. If someone only rarely logged in donor units, I wouldn't trust them not to make a mistake - we see enough simple errors as it is. As far as logging in specimens, we don't even let the specimen processors from the stat lab do that. Maybe we're just paranoid, but I like paranoid.

Edited May 13, 2013 by goodchild

[Eagle Eye]

I agree with Malcolm. We do a final check of pretransfusion testing and transfusion orders at the time of issue as a final barrier to mistransfusion, if someone wasn't trained and competency assessed on a number of areas they wouldn't be able to issue blood products. If someone only rarely logged in donor units, I wouldn't trust them to make a mistake - we see enough simple errors as it is. As far as logging in specimens, we don't even let the specimen processors from the stat lab do that. Maybe we're just paranoid, but I like paranoid.

 

 

I wouldn't let ANYONE work in my lab without a full competency check.

 

I would also not expect anyone to allow me to work in their lab without me having to undergo a FULL competency check.

 

Every lab is different.

agree with both of you. Issuing is the last thing we release our techs. on.

Edited May 11, 2013 by Eagle Eye

[Likewine99]

I agree with Malcom.  From a compliance standpoint and patient safety perspective, this tech needs to complete competencies for any testing procedure or non-technical process they would be doing.  I once had a CLIA inspector ask to see employee competency records for every tech that was working in the Blood Bank the day he was onsite. 

 

I currently work PRN in the Blood Bank, about 1 or 2 shifts a month, and I do all of the same competencies as anyone who works there full time. 

[AMcCord]

 A competency was due when the tech left. Now that she/he is back, I vote with the folks who say a competency should be done.

 

Part timers who rotate through Blood Bank here do full competencies. They may be one of 2 or 3 techs on the evening shift, so I thinks it's very important that they be able to perform all blood bank functions except daily QC/maintenance and complex antibody IDs.

[Eoin]

We are a multi-disciplinary lab as far as on-call goes. Even though scientists are doing the odd crossmatch or three per month on-call, we have the "floaters" (I like that word - conjures up all sorts of images) go through a competency check each six months. Yearly for full timers in BB. Regulators are happy with that.

Cheers

Eoin

[bmsjbatt]

Regulators in the UK expect clear competencies on ANYONE working in the bloodbank. If they are "in training" they MUST be supervised by someone with current competency in the tasks being completed.

This includes Locums, part-timers and students.

In fact they have reccommended that part-timers on shift are specifically rota'd onto days for a specific period of time in blood bank annually to ensure their competencies are still valid.

we also have to have a plan of reassessing competency on any staff member who has been out of the department on sickness / maternity leave etc for more than 3 months.

Edited May 14, 2013 by bmsjbatt

[swede]

Float techs in our blood bank can check-in blood products, run the ProVue, and issue blood products.

They usually are not responsible for antibody ID and Kleihauer-Betke testing. 

 

When we need help in an emergency, it is usually with checking in more products or issuing routine products while the regular staff takes care of the trauma.

I want to add that we do keep the float techs fully competent and they do complete the same competencies as the regular blood bank techs. They are required to work in the blood bank 4 days a month to keep their skills up.  We give them a lot of practice on the above tasks because that is what they will be needed for when we call for help.

[Kathy]

Thanks for the replies.  I went ahead and got her to come in on the day shift to do the full competency.

 

As for what Goodchild said about seeing enough simple errors as is...this is the part I dislike about my job. It is so frustrating. There are so many details to remember in the blood bank and the only people who remember them all are people who work in the blood bank a lot.  I struggle with which of these little errors to let go by and which ones to talk to the techs about.  Obviously, the ones that are patient safety issues are dealt with promptly, but there are others that I let slide like ordering and billing problems.  I fix them myself or have my one dedictated blood bank tech take care of them. 

[tbostock]

Yes, definately do a full competency.  If you only need her to do some things and not others, I would see if you could set up your computer system's security to limit what she can do.  Then do the competency for the duties that she will be responsible for.

[John C. Staley]

Thanks for the replies.  I went ahead and got her to come in on the day shift to do the full competency.

 

As for what Goodchild said about seeing enough simple errors as is...this is the part I dislike about my job. It is so frustrating. There are so many details to remember in the blood bank and the only people who remember them all are people who work in the blood bank a lot.  I struggle with which of these little errors to let go by and which ones to talk to the techs about.  Obviously, the ones that are patient safety issues are dealt with promptly, but there are others that I let slide like ordering and billing problems.  I fix them myself or have my one dedictated blood bank tech take care of them. 

 

Unless it was something "real serious" I would generally let the little stuff slide ONCE with seldom more than a friendly reminder, if that, especially if I knew the person committing the infraction really knew better.  What I actually tried to focus on were trends and repeats and if more than one person seemed to be making the same mistakes.