Direct observation for non-waived testing

If you have nursing personnel that were serving as technical consultants and performing direct observations as of December 28, 2024, they are grandfathered and can continue in that role as long as there is not a service interruption of 6 months or more. That should help some. However, once someone leaves, you can't have another nurse technical consultant unless their transcript shows the appropriate number of bio and chem courses. If you have someone come in from another organization who was a technical consultant as of Dec 28,2024 and it is within the 6 months, you can use them as long as you have documentation. I'm not sure what that documentation would look like, as we've just started considering this so are developing the tool. You can't just take their word that they were a TC. Another thing we're looking at is during the request for new POCT, if it is mod complex and needs oversight, we might have to also hire additional POC staff, which would add to the cost to the organization. One thing we do know is that our POCT staff can't just keep absorbing tasks like direct observation. We have too many mod complex operators. 

Oh Ashley! You have got to be hyperventilating right now. 
A very important caveat to the new rule is grandfathering. If you have an RN that qualified under the previous rules AND were delegated (signed off) to be a TC (performing competencies) THEN they DO still qualify after the new rules are in place. The new rule prohibits any new RNs from joining your TC delegates.

We also have hundreds of operators that need competencies and direct observations. We hired another POC FTE. That person performs the competencies in the departments that do not have the ability to do them currently and we will absorb those other units that will need a new TC through attrition. 

I am a bit. Haha. We had been having nursing observe each other after initial competencies. In our OR and CATH we had one person that would do all the observations but in our NICU/PICU department, as long as they had 2 years of experience with the device and a BSN, they would observe. Unfortunately, this was all in place before I came in and there was never any delegation of these duties to any particular nurse nor any documentation signed by our Medical director stating this was appropriate. We were just inspected by TJC at one of our sites and the inspector brought this to our attention there so I am trying to come up with some ideas to help remedy this before our CAP inspection this year. 

Thank you for that advice! I will check those out. I was wondering about our RT caregivers as they manage their own devices and have always done the competencies themselves. They are awesome! 

Please note that respiratory degrees have to be bachelors. Associate degree folks in respiratory (which are many) are not qualified to be technical consultants under the new regulations.

Hi Ashley, I hope you get some time to sort through employee degrees to be sure someone who may qualify for grandfathering is not overlooked (Kathleen's post). Doubt you could get that lucky but years ago a BS, MT(ASCP) working in our POC Lab jumped ship to go to nursing school (e.g. career ladder, more money) - he's worth his weight in gold these days. 

Ashley, when you follow Erika's suggestion on watching the Whitehat POC Webinar and pulling documents out of CAP eLab Solution Suite, my suggestion is to pull the 'CAP Personnel Guidance Document' sooner rather than later. Even page 1 is a helpful reminder on following State or local stricter regulations and definitions based on final rule changes.  
Good Fortune to you.