Managing iSTAT QC
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Right now we only have the POC staff run liquid QC once a month on each iSTAT. I know we need to transition this to the end users but I just can't wrap my head around how to manage this across 2 hospitals.
We use APOC QC so it gives a pass/fail. We plan to only have clinical educators or select people doing this, not everyone.
Do you all let the users just come get what they need? Do you bring it to them and be there while they run it? I'm concerned about troubleshooting - I haven't found the APOC QC to be as reliable as Eurotrol was so then they'd have to get replacement QC, let it equilibrate for another 4 hours, repeat, etc.
I'm just looking for any ideas of what works and what doesn't!
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Julie B. you are in good company, most of the labs I inspect are doing way more liquid QC on the iSTAT than they need to be. I came from an organization that squeezed every penny out of anywhere they could, so we scrutinized waste and where we could reduce it from every possible angle. The iSTAT QC was actually a pretty easy one to cut back on, once we were armed with a solid IQCP.
Like Deanna, we also do Lot to Lot on our New Lot/Shipment QC, and the 6 month CLEW update where we satisfy the requirement to compare all iSTAT's to each other by running one level of LQC on every handheld for the same tests, then calculate precision between them. Doing 1 level on each handheld twice a year, is still a lot less waste than doing 2 levels on each handheld every month. It doesn't seem like a big deal for a location that only has 2 iSTATs in the building, but when we are talking about a big hospital with 65-100 iSTATs then that is a lot of time and money!!
Hi Silka,
This question is a little off topic but since you have a lot of Istat I wanted to know what do you require your operators to do for their mod competency? How many Istat operators do you have? I'm always looking for ways to revamp that
.
Hi Adonica! We have about 850 iSTAT operators. I have two full time POC Coordinators that do the heavy lifting as far as competency assessment goes, but we have a really good thing going here with our nursing leaders. As part of the nursing career ladder, nurses have to engage in certain tasks or projects that go outside of their normal day to day job duties. Lucky for us, one of those things is becoming a site trainer for POCT. We train the designated site trainers (have to be BSN plus 2 years using the iSTAT, or Bachelor Degree in a Life Science for Respiratory, Anesthesia, etc), and they then go out to their units and check of the iSTAT operators in their department. Currently we have 30 iSTAT Site Trainers. Some departments may only have one, and that nurse is also the educator for that unit. Other units may delegate this to other qualified RN's - like our CICU has 4 Site Trainers just for their unit.
Our competency includes an online course with quiz, and the performance of a cartridge with a site trainer. We have a checklist that they go through as part of that direct obs, then the site trainer signs off and emails my team that the person completed it. We are trying to automate this entire process by adding an interface between our online training (Cornerstone) and our data manager (Telcor) but right now we are still manually marrying up those two activities.
We are in the process of trying to separate our ISTAT operators into waived and non-waived so we can set waived to auto-recertify using TELCOR. Do any of you have your ISTAT operators split like this in TELCOR?
We are still in the specimen collection training process for operators to insure that they always collect a green top tube.
Sylvia