Training/proficiency

For waived testing, we do initial training, quiz and second form of competency (usually QC) for initial certification. Annually, we do quiz and second form of competency. We are CAP accredited. (We have also moved all quizzes to e-learning platform Workday this year, so we just observe QC or PT if the manager is not available to do so).

Jill,

Since we started our POC Program we have used a quiz for both waived and nonwaived, training staff knowledge check and annual assessment purposes. In talking to a lot of POCCs over the years, I think many of us use a quiz for both because frankly, it's using an easy option for both the trainer and the trainee who is able to take the quiz related to their schedule. The quiz also serves as a sort of documentation on training points covered in case the operator comes back after making an error and says they were not trained properly - I've seen that happen after an operator has gone through several rounds of annual assessment.

It is much easier for me to oversee a training/competency assessment program across 400 miles if waived testing assessment includes electronic options such as a quiz and using QC logs from routine performance of POCT (the QC performance is used as the 2nd element of assessment for waived testing in a lot of cases if observation of patient testing is cumbersome as an assessment, untimely for the observer, patient cancels etc.)

Thanks for your question. Good Luck!

Thanks everyone for your great feedback! I like the idea of the online option for the quiz - tracking paperwork is so cumbersome.

Jill, unsolicited suggestion. Don’t hesitate to ask nursing leader in clinic how CBO or other nursing competency documentation is handled. Or if the nurses and medical assistants use an online system for any other “compliance” tests.

Sent via Groupsite Mobile.

Jill,

I am in a system that is similar to yours (in WA state too).

I have around 84 clinic with no inpatient sites and we are not accredited.

We only perform waived testing in our clinics and I have them do initial training and then annual training in their birth month.

Initial Training is completed by someone in the clinic who is trained and comfortable with the testing or me. They complete a competency for each test and it's kept in the employee file.  I will audit them when I round annual on all the clinics.

Annual Training is completed in their birth month and by someone in the clinic (I have made "reviewers tip sheets") for all the tests so the staff member who is watching knows what they need to look for. The employee will also complete a quiz for each test. The completed competency is kept onsite in the employee file and I audit for those also when I round annually.

Feel free to email me with any questions you have.

Anastasiaaugustine@chifranciscan.org

Hi Jill,

We don't use a quiz for our competencies, we have them assigned a "course" in our learning system.  The course includes a link to the procedure, which they have to indicate they read and a part where the POCT superuser for the sight indicates they watched them perform their competency.  Once both parts are signed off we get an automated report from our system with the names and dates of completion.  We then manually update them in our QML.

We do the same process for initial and annual training.

That's nice to have, Adonica. Our hospital online system also refers to 'courses' but the lab POC Program so far has not developed doing 'courses', only online quiz. The front cover has a link to pull up the SOP, and at the end of the quiz there is a link to pull up the validation form (blank - no dates of passing quiz, no score). Worse yet it's not an electronic reporting. Plus each quiz is self-enrolled so a constant 'how do I get the glucose quiz?' question/walk through. The quiz does not automatically load once self-enrolled. Our trainers have to manually handle paperwork to complete validation process.

Your system sure would make 'just-in-time' training & competency assessment so much easier for times like 'here'sssssssssssss the next novel emerging infectious disease/pathogen'!

Adonica thanks for posting (maybe I will continue to not lose hope on my end we all will end up with a better electronic solution although so far it's been a funding issue). Enjoy your advanced learning system and how someone set it up!

Happy Friday and hang in there for the next POC adventure.

Thanks Peggy!  It's sorta a home grown system that we have here but because we are smaller than a lot of systems I guess that is an advantage.  I met with our Learning system person and together we created the process.  It's not perfect by far but I really really hate dealing with paper so we make it work lol.

Kudos for finding a way out of the box! And in my opinion, you were wise capitalizing on any advantage you have. 

To those who jumped in on the training and initial competency questions, I’ve asked this before (due to my own angst!). Waived testing only this time but I think I asked this after 2019 AACC annual scientific meeting due to a session that raised some questions. We bogged down with ‘no good answer’.

Let’s pretend Adonica doesn’t have the advantage of a smaller health system (ha, sorry kiddo). I don’t know about COLA, but the little I know about CLIA inspected and then for TJC and CAP, I know ‘training’ is not conscripted. We have to show someone was trained properly. But there is leeway in how that is accomplished. Annual competency - we seem to have that down as well on what is required.

Initial competency! By any accreditor or speaker I’ve heard on initial competency, to be competent is after someone has done the task/work and is proficient. That isn’t someone who got trained on Thursday at 3pm and the paperwork was signed off for initial competency on Thursday after the training class at 4pm. Right?

When do you do initial competency in your POC Program?

For waived testing we have a general introduction of POCT during their orientation. We have POCT mentors in each of our Ambulatory clinics observe and deem them competent. The mentors have attended a training session that goes into depth each test performed in their clinic. Since most of the kit testing states that  QC must be performed with each new operator, the mentor will check them off to perform patient testing once they are observed performing QC. We also use an online quiz of True/False. 

Ours is somewhat similar to Jennifer's method. We have New Employee Orientation and I teach the CLIA (POC) part of it (I'm the only one who calls it POC, everyone else calls all lab testing stuff CLIA). I do a hands on overview of our 5 most used waived tests (Flu, Strep, UA, UPG, Glucose), everyone takes a written test, then they get actual patient testing training in whatever department they are in. Their department trainer is the one who will sign them off. For the rest of our test menu it is super users in the department who train and sign off on competencies and I will competency all of the super users (for everything but the main 5 tests - I have help from clinical training for those tests).