By Carrie Easley
Another one for hospital transfusion services:
For those of you in complex blood banks (multiple ABID's, adsorptions, elutions, irradiation, neonatal aliquots, titers, student interns, Trauma, etc...), do you maintain a dedicated blood bank staff or are they all cross-trained in other areas of the laboratory?
Can anyone provide some help/insight into how they identify each "Test System" to satisfy the 6 elements of competency for CAP? Personally, I feel like "Blood Bank" should be it's own "test system" and I should be able to assign all the different testing we do into one of the 6 elements based on the errors/problems I see throughout the year. Then rotate all the different testing systems, using the 6 elements, annually.
it specifically says "if there are any tests with unique aspects, problems, or procedures within the same testing platform competency must be assessed as a separate test system system to ensure staff are performing those aspects correctly"
Am I really supposed to perform all six elements for:
ABORH/ABS using echo, gel, tube
XM using gel, tube
Antibody Identification using gel, tube, ficin, diluting 3% down to 08% for gel testing, etc,etc,etc
Dat using Gel, tube
Just using the above examples that's documenting 66 elements annually and that's only scratching the surface!
How many "test systems" have been able to narrow your blood banking down to? I feel like I need to hire someone just to do competency assessments!
According to CLIA (and I think Joint Commission and CAP), evaluating and documenting competency of personnel responsible for testing is required at least semiannually during the first year the individual tests patient specimens.
How do you define 'semiannual'? Is this 6 months into employment? 6 months after the completion of initial competencies?
Furthermore, how many sets of competency assessments do you have after 1 year of service? 3: initial, semiannual and annual? or just 2 semiannual and annual?
I haven't seen much discussion relating to competency assessment on these forums. I find this odd because it is such an albatross at our institution. (This post is focused on USA regs, I can't even imagine what others might have to put up with.)
Are there any facilities out there that have a successful competency assessment plan that meets the CLIA requirements? (i.e. Assess the six applicable elements of competency, with EVERY test system, for EACH associate, EVERY year)
How are you documenting your competency assessment activities? Are you including copies of result entry/review, copies of worksheets, profiency results, direct observation checklists, copies of problem solving quizzes/scores?
Are you including transfusion service activities that aren't testing into your competency assessment plan? (i.e. receipt/logging in blood products, issuing blood products, component processing, etc.)
How do you handle competency assessment with part timers, zero hour/PRN associates, weekenders, and overnighters?
How are you delegating competency assessment activities among your staff?
We have a plan that I'm pretty happy with but there's a lot of contention with the specifics. I'm hoping to hear from other institutions and have a better understanding how the community as a whole handles this process. My previous experience was with military blood banks and we had a very rigorous training and competency assessment program, which I have been told was unnecessarily rigorous simply because it was military.
I'm also curious if anyone is willing to share any of your assessment plans/checklists/documentation. I need to blank out one of our template cover sheets and maybe include an example of our excel sheet tracking tool.