Decentralized WT comp. assessment - WT PT INR that does not include (external) liquid QC

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Howdi all,
I am interested to find out what means, besides passing a quiz, is used for training/competency determination and then annual comp assessment for testing personnel who test patients using a WT PT INR device which does not require external/liquid QC per manufacturer.

FYI my consistent concern is not within our RN-only Anticoag Clinics, it's related to our multiple Fam Med practices. To be validated initially and annually as competent, each operator must be observed for technique (testing a patient and not 'a volunteer') which includes the fingerstick and cleaning/disinfecting the device. 

The lab SOP has never included/added performing liquid controls; liquid QC is not purchased by each clinic. 

Asking others who use this type of device in Fam Med settings if you do/don't include routine QC in your SOP, and/or use liquid QC for anual comp assessment as an option? 

Thanks much!
Peggy

3 Replies

Hi Peggy, 
In our SOP we require liquid QC to be performed during training and we use successful performance of liquid QC as part of annual competency assessment. Our outpatient locations get the revenue for the INR testing they perform, so they purchase their own supplies for the tests.   We are big advocates that staff are not just trained on patient testing, but also always trained on quality control practices as well, for all of our POCTs (waived + nonwaived). 

Hi Kari and thanks so much for your reply. 

I want to be sure I understand - you are using a PT INR device which is waived and the manufacturer does not require in the IFU to perform external liquid QC, correct?

I understand that in your training/comp assessment policy, you require liquid QC be performed. 
In the lab SOP- technical procedure for patient testing - the testing personnel are required to perform QC routinely. What is the frequency you've set for routine performance? 
I'm curious since the device won't lock out related to lack of QC performed if you are requiring day of patient testing or less frequent, such as a new lot# strips.

Thanks much!

We also have waived bedside INR devices (x4), but not fam med (small/med hospital). We do not use external QC at all. Competency includes a quiz and performance of a properly documented test (on a result form) on a volunteer/mock patient (often me, but also coworkers).

We don't have a high enough test/operator ratio for actual patient testing to suffice for annual competency, which could probably create issues for annual competency if we were to move to a moderate complexity INR device. I imagine in family med the ratio would be flipped :)

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Peggy Mann
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