Point of Care Competency Testing at Lancaster General Hospital

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Point of Care Competency Testing at Lancaster
General Hospital

• By Karen Espey, MT (ASCP)
• Lab Supervisor - POCT and Phlebotomy

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LGH Highlights

• Bed size greater than 580
• Number of POC sites 10 sites
• Number of POC users 3025 plus
• Number of POC methods 17 - includes waived and
  moderate complex testing
• Two POC computer systems
• MAS/RALS
• Abbott
• POCT Personnel 1.5 FTEs

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LGH Highlights

• LGH is state, JCAHO and CAP accredited
• POC users are trained during orientation by the
  POC department or validated trainer from the
  Education Department
• Competency is assessed annually by the POC
  department for waived and moderate complex
  testing
• Unit validators and the Education Department
  validate ONLY visual glucometer testing

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Competency Assessment Requirements

• CAP/JCAHO Requirements
• Elements of competency assessment include but
  are not limited to
• Direct observation (patients, qc, and
  maintenance)
• Monitoring of test results
• Review of records
• Blind or proficiency testing
• Evaluation of problem solving skills

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Annual Assessment of POCT at LGH

• UA dipstick testing
• Written exam (procedure manual highlights and
  problem solving questions)
• Visual (performance of an unknown)
• Monitoring of quality of control
• Specific Gravity by Refractometer
• Written exam (procedure manual highlights and
  problem solving questions)
• Visual (performance of an unknown)
• Monitoring of quality of control
• Urine Pregnancy
• Written exam which includes a positive/negative
  test
• Unknown Proficiency Testing
• Problem solving questions included in written exam

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Annual Assessment of POCT at LGH

• Hemoccult/Gastroccult
• Written exam which includes a positive/negative
  test
• Unknown proficiency testing
• Problem solving questions included in written
  exam
• DCA 2000/Glycohemoglobin
• Written exam (procedure manual highlights and
  problem solving questions)
• Visual observation of patient testing
• Proficiency testing

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Annual Assessment of POCT at LGH

• ACT Testing (Response and Sig)
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Monitoring of quality control
• i-STAT
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Explanation/observation of patient preparation
  and specimen collection

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Annual Assessment of POCT at LGH

• Coaguchek
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Explanation/observation of patient preparation
  and specimen collection
• Monitoring of quality control
• Glucometer
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Explanation/observation of patient preparation
  and specimen collection
• Monitoring of quality control bi-annually

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Annual Assessment of POCT at LGH

• Cholesterol
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Explanation/observation of patient preparation
  and specimen collection
• Amnioswabs
• Written exam which includes a positive/negative
  test
• Unknown Proficiency Testing
• Problem solving questions included in written
  exam

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Annual Assessment of POCT at LGH

• Strep Testing
• Written exam (procedure manual highlights and
  problem solving questions)
• Unknown proficiency testing
• Monitoring of quality control

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Tools for Annual Competency documentation

• Netlearning program (procedure manual highlights,
  written competency tests, and used for procedural
  changes)
• Net Manager (summarizes completed tests and
  provides grades for each individual)
• Excel spreadsheet

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Managing Annual POC Competency at LGH

• Test specific written exam appears in Netlearning
  for each individual to perform
• Written exam requires gt 80 to pass
• Net Manager tallies all passing tests and
  generates a report
• Visual competency logs completed by POC
  department, Education Department and validators

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Managing Annual POC Competency at LGH contd

• Visual competency logs managed by POC department
• Competencies are managed by using an Excel
  spreadsheet
• Bi-monthly, validators and the Education
  Department are updated with a list of incomplete
  competencies
• All competencies are to be completed by April 1st

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???Questions???
Thank You