Epoc QC Testing Question
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We have Epocs in our Anesthesia department and testing is performed by CRNAs and anesthesiologist. They have been complaining about performing the weekly liquid QC. They are trying to say that is the only equipment within their scope where they are assigned responsibility for ongoing quality assurance. But they are using the excuse that they do not ensure things like the ultrasound or other equipment they use are working properly. But those aren't testing devices. They are stating they have "staffing" challenges which makes it difficult for them to perform the QC. I know we have offered to change the day QC is required. They even wanted to train Anesthesia techs, which I know would only be to have them run the QC and not the patient tests, so they wouldn't have to perform the QC testing.
They want us (lab/POCT staff) to perform the weekly QC. We are Joint Commission inspected. We used to be CAP, but are now only Joint Commission accredited. I know with CAP there was a specific requirement that QC testing was performed by testing personnel, which would mean it is a requirement for them to perform the testing, not us. Is this still true for Joint Commission? Or am I missing something? And if so, can someone please provide me where to look for this documentation so I can present it? Knowing how to perform QC is part of the 6 elements of competency, so if they aren't running it, they won't know how to perform during their competency assessment. Can someone please tell me I'm not going crazy and missing something?
They want us (lab/POCT staff) to perform the weekly QC. We are Joint Commission inspected. We used to be CAP, but are now only Joint Commission accredited. I know with CAP there was a specific requirement that QC testing was performed by testing personnel, which would mean it is a requirement for them to perform the testing, not us. Is this still true for Joint Commission? Or am I missing something? And if so, can someone please provide me where to look for this documentation so I can present it? Knowing how to perform QC is part of the 6 elements of competency, so if they aren't running it, they won't know how to perform during their competency assessment. Can someone please tell me I'm not going crazy and missing something?
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Show them the regulation that states that the staff that perform thes testing are the same staff that must perform the QC. I would also include the regulation that states this same QC must be rotated through the testing personal. Then give them the option (politely and professionally): do the QC as required *OR* they can stop doing the testing and it will be shifted to another group.
If you expect more resistance, I would also include your laboratory MD in this for additional weight on it. It's their license that is on the line for this being completed correctly.
Hope this helps,
Matt T
I know of a friend who was a supervisor for the Point of Care department and he was cited by the Joint Commission for running the QC for the epocs. His rationale was that the regulation was silly and believe the surveyor would just be satisfied that QC was run; unfortunately the assumption was wrong.
For CAP and the Joint Commission, the ones who run the test are responsible for running the QCs.
My advice would be to talk to your lab director and see if you could update your IQCP to have you only required to run QCs monthly. We used eurotrol GAS ISE 1,2,3 and hematocrit A, and B. I believe the minimum is running a high and low so it would be GAS ISE 1,3 and hematocrit A, and B.
You can also incorporate the QC runs in their competency which would count as well.
The Joint Commission also informed us that their expectation of Quality controlling the epoc is that the current lot of the epoc cards are to be QCed as the card is the testing apparatus and not the reader. The reader, just reads the cards which matches Siemen's theory of operation.
So if you were to take my advice above, the minimum that the Joint Commission would be for you to run the 4 levels of controls monthly if you can convince your lab director to change your IQCP. I'm assuming you have a weekly IQCP for the epoc. With this change, you can definitely convince them to run the QC