Proficiency Testing

[Candace Schiele 2]

We missed one sample on proficiency testing for compatibility testing.  Any suggestions on what to do to prove that the tech is competent and something I can show that we did to show JC when they come for inspection.  First one we have ever missed. 

[mollyredone 318]

We have a form to fill out and usually have the tech repeat the test and comment on anything that might have caused the problem.

PROFICIENCY REVIEW.docx

 

This is a copy of our form.

[Candace Schiele 2]

Thank you for the information.

[Gnapplec 15]

I would agree I think a form just as mollyredone attached.  This is similar to the form we use to document CLIA competencies.  There are several requirements that our facility expects to be documented:

1. Observe tech perform testing

2. Observe tech perform PMs on equipment

3. Document that tech can: Report results

4. Review results

5. Troubleshoot (answer problem solving questions)

Hope this helps.

[AMcCord 1,164]

We use a CAP form that we've added our ID to. See attached.

ID Stripped Clinical Laboratory Pathology PT Exception Investigation Checklist.docx

[John C. Staley 1,032]

16 hours ago, Candace Schiele said:

We missed one sample on proficiency testing for compatibility testing.  Any suggestions on what to do to prove that the tech is competent and something I can show that we did to show JC when they come for inspection.  First one we have ever missed. 

I'm curious, have you identified the root cause, (I really hate that term but it was in vogue a few years ago) of the erroneous result?  Was it really the tech or could the sample have gone bad or some other problem?  Just wondering.

 

[Candace Schiele 2]

Tech repeated and got the correct result.  I do not know if maybe she picked the wrong thing on the sheet.  She can not remember and did not save the cards that she used.  I just want to make sure I have a corrective action in place for JC that is sufficient.  Any suggestions?

[sgrassley 11]

We've seen this problem in the past. It can easily happen if the tech uses the 'patient' bottle instead of the 'crossmatch' bottle. There is no barcoding to help 'catch' this as there would be if it was an actual crossmatch of the unit of blood in the computer.

[jalomahe 117]

17 hours ago, sgrassley said:

We've seen this problem in the past. It can easily happen if the tech uses the 'patient' bottle instead of the 'crossmatch' bottle. There is no barcoding to help 'catch' this as there would be if it was an actual crossmatch of the unit of blood in the computer.

I may go to the extreme but when we receive surveys all of the "patients" are registered in the computer and the appropriate tests ordered. The vials can then be labeled with barcoded patient/test labels and can be scanned. I also enter the "donor unit" into our inventory and print donor unit label for the specimen and place the DIN label on the vial. This way everything is done in the computer just as it is with a real patient. When the tech has completed testing they can print their results from the LIS and if need be I can always go back and look at the results.

Edited January 25, 2018 by jalomahe
add info

[Gnapplec 15]

We do the same. Barcodes!

[Gnapplec 15]

On 1/25/2018 at 6:20 AM, jalomahe said:

I may go to the extreme but when we receive surveys all of the "patients" are registered in the computer and the appropriate tests ordered. The vials can then be labeled with barcoded patient/test labels and can be scanned. I also enter the "donor unit" into our inventory and print donor unit label for the specimen and place the DIN label on the vial. This way everything is done in the computer just as it is with a real patient. When the tech has completed testing they can print their results from the LIS and if need be I can always go back and look at the results.

We do the same. Barcodes!

[Eagle Eye 202]

We do the same. Register all CAP specimens as patients and donor as blood unit and just treat like actual patient.

You might want to think about using your LIS as corrective action to prevent the error in future.

Do you have second tech verifying your gel card readings?

All our manual gel results are co-signed by second tech.

Edited January 28, 2018 by Eagle Eye

[Eman 34]

On ‎1‎/‎25‎/‎2018 at 7:20 AM, jalomahe said:

I may go to the extreme but when we receive surveys all of the "patients" are registered in the computer and the appropriate tests ordered. The vials can then be labeled with barcoded patient/test labels and can be scanned. I also enter the "donor unit" into our inventory and print donor unit label for the specimen and place the DIN label on the vial. This way everything is done in the computer just as it is with a real patient. When the tech has completed testing they can print their results from the LIS and if need be I can always go back and look at the results.

Doesn't seem extreme to us at all, we also enter PT specimens into our LIS, although we use the validation environment to keep fake patients out of the live side, which also means we don't get billing issues with these. By managing the PT specimens in the LIS we are truly treating them like real patient specimens.

[Darren 13]

I order all tests for all blood bank CAP specimens in our LIS and label them for the techs doing the testing. I've always been told that QC and CAPs are supposed to be ran exactly the same as patients. With that in mind I order everything for the tech and present it to them as if it were any other patient. It really cuts down on flubs and clerical problems and you get so much less complaints about having to do a survey specimen.

[AMcCord 1,164]

I order all of our surveys in the LIS as well. Makes the paperwork easier and as Darren says, it is how we see our patients, so that's how we should see our survey samples.

[Eagle Eye 202]

On 1/29/2018 at 1:04 PM, Eman said:

Doesn't seem extreme to us at all, we also enter PT specimens into our LIS, although we use the validation environment to keep fake patients out of the live side, which also means we don't get billing issues with these. By managing the PT specimens in the LIS we are truly treating them like real patient specimens.

We use production as we wanted to mimic real patient. Only difference...the order is not coming from EPIC. we record specimen in safetrace.

We use same last name all the time and we have it blocked at interface level so billing is not generated.

[Eman 34]

I guess I could clarify that our validation environment (and training environment) is identical to the live production environment, except the "other" two environments don't interface to billing.

[Eagle Eye 202]

On 2/22/2018 at 2:20 PM, Eman said:

I guess I could clarify that our validation environment (and training environment) is identical to the live production environment, except the "other" two environments don't interface to billing.

We have the same BUT we decided to use production as what if!...

It is very easy to block billing by just creating a code at interface level.

We also use teo patient to stock in ER and OR and again we hav eit blocked at interface so it does not generate any transactions.