Waived glucometer competency
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What does annual competencies for waived glucometers under CAP look like for your facility?
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CAP only requires one element of competency for waived testing, and I chose performance of QC. I do strongly suggest at my sites that department leaders assign the online learning module as well, and most do complete that, but it's more of a backup/reinforcement.
Then provide training around and design a 5-10 question quiz that addresses those specific issues.
Automating recertification in your data management system is convenient, but may not be enough. If you aren't having any issues and your meters are almost never "broken" and you almost never get calls about results that don't match the lab, then sure - just successful completion of one QC pair per year may cut it. But from my experience I've never seen POC Utopia myself, usually there are some quality struggles with glucometers that should be addressed at least annually.
We use NOVA StatStrip Meters & RALs with the eQuiz component. Staff have to run both levels of QC within 120 days of the exam in RALS. Auto recertification. I adapt the quiz each year based on any quality issues from the previous year.
We have a two set process:
1. Required initial/annual eLearning completion which includes a instructional video created by the manufacturer on its use, a powerpoint with specific details of its use within our system, quiz and attestation. This eLearning is updated yearly to address common issues found on the floors.
2. A review of the glucometer and its use which includes performing a passing QC with the SuperUser. This forces staff to actually come together and discuss its use. We are too large and don't have enough POC coordinators to do this so these SuperUsers are designated staff on the floors.
2. Complete QC and a patient test at Comp Fair. We also use this time to highlight and teach on the issues from the past year. Sometimes (ok, always) it's critical comment compliance. One year it was reviewing the appropriate lancets to use (we had lab lancets going missing and being used for POC glucoses because it gives a nice big sample!)
I do have elearn only for a couple of my waived tests but glucose meter is something that I'll always require hands on for.
The last thing I heard at a local POCC group meeting from a CAP inspector (had on the slide) was that the lab director determined what the criteria was, how their competency assessments could look - for waived testing.
Thanks!
You were informed correctly. This is why there is more variation in some of the above responces than you might think there would be. I know that JHACO as a slightly higher standard in that it requires two of the non-waived components to be certified.
CAP standard:
POC.06875 Competency Assessment - Waived Testing Phase II
The competency of personnel performing waived testing is assessed for each test system
at the required frequency.
NOTE: Competency assessment evaluates an individual's ongoing ability to apply knowledge
and skills to achieve intended results.
Competency must be assessed at the following frequency:
● After an individual has performed his/her duties for one year and at least annually
thereafter*
● When problems are identified with an individual's performance.
*The annual assessment of competency can be performed throughout the entire year to minimize
impact on workload.
If more stringent state or local regulations are in place for competency assessment for
waived testing (eg, California), they must be followed.
Records of competency assessment may be retained centrally within a healthcare system, but
must be available upon request. The laboratory director may determine how competency will
be assessed for personnel performing waived testing at multiple test sites (same CAP/CLIA
number) or laboratories within the healthcare system (different CAP/CLIA numbers). If there are
variations on how a test is performed at different test sites or laboratories, those variations must
be included in the competency assessment specific to the site or laboratory.
For waived test systems, it is not necessary to assess all six elements listed below at each
assessment event. The POCT program may select which elements to assess. Elements of
competency assessment include, but are not limited to:
1. Direct observations of routine patient test performance, including, as applicable,
patient identification and preparation; and specimen collection, handling, processing
and testing
2. Monitoring the recording and reporting of test results, including, as applicable,
reporting critical results
3. Review of intermediate test results or worksheets, quality control records, proficiency
testing results, and preventive maintenance records
4. Direct observation of performance of instrument maintenance and function checks,
as applicable
5. Assessment of test performance through testing previously analyzed specimens,
internal blind testing specimens (eg, de-identified patient specimens) or external
proficiency testing specimens
6. Evaluation of problem-solving skills.
The competency procedure must outline the practices and procedures used to evaluate
competency. Assessment of the elements of competency may be coordinated with routine
practices and procedures. Laboratories often use a checklist to record and track elements
assessed. Records supporting the assessment must be retained (copies of worksheets,
maintenance logs, etc. or information traceable to the original record).
Evidence of Compliance:
✓ Records of competency assessment for new and existing testing personnel reflecting the
specific skills assessed and the method of evaluation at the required frequency
Peggy
We suggest QC or a mock/patient sample using an auto-recertification barcode. We use Accuchek and RALS. The quiz is pushed through our mandatory education system and not through RALS.