POC Competency - minimum testing requirement?
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Hello,
Our team of POCC's are considering a statement for competency that would include a "minimum" number of patient testing that an operator would need to perform annually. Since we all train staff, give access to POC testing, perform annual competency to only find that they do not actually perform any.
QUESTION: Do you have a minimum number of patient POC testing that operators MUST perform annually to be considered competent?
Reponses are greatly appreciated.
Thank you,
Mary Jo Merritt
Mary Jo Merritt MT(ASCP)
Point of Care Testing Coordinator
Pathology and Laboratory Medicine
Henry Ford Health System
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Our medical director requests (not a requirement…yet) that anyone trained for a moderately complex test perform at least one test (patient or QC) per month.
We require staff to run a sample quarterly.
We tried to implement one test a year and were resoundingly fought on the issue by management
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No we do not. With the number of operators we have across the system, and the variety of testing performed at the number of testing sites we have... and the process not entirely electronic for tracking competency! It would be a challenge we continue to feel we cannot meet.
Even for moderate testing we do not unless that changed recently.
For annual recertification, operators are required to perform 1 QC & 1 "fake" patient sample correctly, without assistance.
This is a very good question, especially in the realm of Waived Testing. Because you only need two measures of competency, many facilities go with an online learning module + running QC (using glucose on a waived meter here as an example), because it's the easiest thing to do.
Even though it's "beyond" the requirement, I also require at least 1 patient test per period (annual). Running QC doesn't take into account sample collection proficiency, which may be the most challenging aspect of the whole task. And I've seen some otherwise really smart people struggle with doing a patient test because too much time goes by since they've done it. Once a year's not too much to ask. And if they can't fit in once a year, you have to really consider do they need testing privileges at all. But I also get why when your operator list is in the thousands, even adding one simple task becomes monumental.
As far as non-waived, I have always considered the Direct Observation component to be synonymous with performing a test on a patient sample (even if it's a "fake" sample), and therefore a must-do. Perhaps I'm alone in that?
We had written 6 samples /6 months for waived tests in our policy.
But it is impossible to require so many per month since many staff are PRN or part time .
During Skills Fair- most only do glucose meter and gastric PH check off .
We have managers and supervisors do the direct observation.
They do the test in Healthstream .
These satisfy 2 elements: direct observation and written test.
ER has more tests and I have been doing the ER staff one- to- one,
observation and recertification on waived and non-waived.
I come to ER and they come one or two at a time in the ER lab.
No more than 2 so I can really watch what they do.
They like the personal touch, because they can ask questions
and not get lost in the chaos of doing them at Skills Fair.
We used to have that set electronically in Telcor to require X, Y, Z, etc but I turned it off. While I agree that nobody should have privileges but then go a whole year without running a test, what would the solution be? For example, if all ED RNs are required to be able to use the glucometer, how do you manage the few that might be casual and truly do not ever use it but can demonstrate competency yearly that includes running a fake patient test? It became too complicated to enforce as the operator pool became larger. And management would just have me return privileges anyway if they can demonstrate the skill. It's a tough situation.
Most of the nurses we certify can do the test and
can demonstrate the ability to run QC and fake patient at Skills Fair.
WE even have managers and supervisors do them and they can.
In the busiest units CNAs do the most glucose testing. They are the expert on those units.
I cannot dictate that nurses should do them just to comply with the rules we put in place.
Their priority is to take care of the patient.
Waived tests don’t really have CLIA “ must do”.
It is not like non-waived tests that I can show them “ CLIA says” they have to comply.
There is no sense getting on their bad side unless it is a written regulation or TJC says so. .