Competency Assessment via RALS e-Quiz

1. Competency Assessment via RALS e-Quiz • Presentation by: Tim Deen, MT(HEW), MLT(ASCP) • Point of Care Testing Manager • tim.deen@hcahealthcare.com As a 20 year old in early 1974, I was transfusing blood, assisting surgeons and anesthesiologists with no real training. Competency assessment, what was that?

2. Medical City Dallas Facilities Map

3. Competency Assessment via RALS e-Quiz JCAHO Standards • Standard PC.16.30 Staff performing tests have adequate, specific training and orientation to perform the tests and demonstrate satisfactory levels of competence. • Rationale for PC.16.30 For waived tests to be performed properly, the staff performing them must be qualified to do so. Staff members who perform waived testing have specific training in each test performed. • Elements of Performance for PC.16.30 • Current competence of testing staff is demonstrated. • Each staff member who performs testing has been trained specifically to each test he or she is authorized to perform. • Each staff member who performs testing has been oriented according to the hospital's specific needs. • Testing that requires the use of an instrument is performed by staff with adequate and specific training on the use and care of that instrument. • Competence is assessed according to hospital policy at defined intervals, but at least at the time of orientation and annually thereafter. • These assessments have considered the following: • The frequency by which staff members perform tests; the technical backgrounds of the staff. • The complexity of the test methodology and the consequences of an inaccurate result • Methods to assess current competency include at least two of the following: • Performing a test on an unknown specimen • Having the supervisor or qualified delegate periodically observe routine work • Monitoring each user's quality control performance • Having written testing that is specific to the method assessed • The hospital evaluates and documents the information listed above. • Note:All staff who perform instrument-based testing, including but not limited to physicians, licensed independent practitioners, contracted staff, and RNs, must participate in training and competence demonstrations.

4. Competency Assessment via RALS e-Quiz CAP Standard POC.06900 Phase II Is there a documented program to ensure that each person performing POCT maintains satisfactory levels of competence? NOTE: The records must make it possible for the Inspector to determine what skills were assessed and how those skills were measured. Some elements of competency assessment include, but are not limited to: Direct observations of routine patient test performance, including patient preparation, if applicable, specimen handling, processing and testing Monitoring the recording and reporting of test results Review of intermediate test results or worksheets, quality control records, proficiency testing results, and preventive maintenance records Direct observation of performance of instrument maintenance and function checks Assessment of test performance through testing previously analyzed specimens, internal blind testing samples or external proficiency testing samples; and Evaluation of problem-solving skills Competency must be reassessed at least annually. During the first year that an individual is performing such patient testing, competency must be assessed every six months. All of the above elements that are applicable to an individual’s duties must be evaluated for that individual. The competency of physicians who perform POC tests may be established and reassessed through the credentialing process of the institution’s medical staff.

5. Competency Assessment via RALS e-Quiz • Limitations of RALS Web 1.2 e-Quiz • Only one quiz can be assigned to a HOME location at one time • Multiple quizzes can not be assigned to a single operator • One can not access certifications other than glucose from e-Quiz • Working around these limitations • Design multiple quizzes that can be assigned to specific HOME location(s) • HOME locations can be for specific skill mix of testing done on that unit • Example: 7S does glucose & Occult Blood, 7SPCA does only glucose • I still know that these staff work on 7S but are two different skill mixes • Recertify staff in either RALS-Plus or RALS Web (I prefer Web)

6. Competency Assessment via RALS e-Quiz • Thinking outside of the box with e-Quiz • Questions can be created to meet facility and regulatory agency • requirements: • Do you know where to locate the Policy & Procedure Manual? • If you are color blind, can you perform color differentiation testing? • What are the two patient identifiers? • What do you do if a POCT refrigerator is outside temp. range? • How are “ready to use” POCT reagents marked? • Can you draw blood above an I.V.? • Can you re-cap needles?

7. Competency Assessment via RALS e-Quiz • Getting Started Building Competency Assessment(s) • Question Management and Quiz Management • e-Quiz comes preloaded with some Accuchek Inform questions (default) • Create your questions by grouping them under a nickname (i.e. GLU, Sig+ etc) • Example Nicknames: BNP, CARD, CG8, CG8/CREAT, CHOL, GLU, HCG, HMSOR, NIT, OccBld, PP, PYLORI, SC, SigACT, SigPTPTT, TCTB, TRIAGE, and UA • Create your quiz, start with the quiz everyone will need (i.e. Glucose) • Quiz questions can be optional or required and multiple choice or T/F. • Once that is done, click on that quiz and click the save as button then rename • Name can be for another HOME location or skill mix. • Now let’s see it with screen shots!

8. Competency Assessment via RALS e-Quiz Create your questions by grouping them under a nickname (i.e. GLU, Sig+ etc). Enter Nickname, enter question, enter correct and incorrect responses and save. Questions can be True/False or multiple choice.

9. Competency Assessment via RALS e-Quiz Create your questions by grouping them under a nickname (i.e. GLU, Sig+ etc). Once you have all your questions then move on to create Quizzes by skill mix or HOME location. When you hover over a question, the full text will pop-up

10. Competency Assessment via RALS e-Quiz Create your quiz, start with the quiz everyone will need (i.e. Glucose). Enter quiz name, enter total questions, enter # correct to pass, enable quiz lockout and how many attempts, enter Hospital name to be printed on certificate, enter memo as you like and assign locations.

11. Competency Assessment via RALS e-Quiz Create your quiz (continued) – Optional additional text to appear on quiz taker’s home page, introductory statement, message of operator passes quiz, message if operator fails quiz.

12. Competency Assessment via RALS e-Quiz Create your quiz (continued) – Assign which questions will be on this quiz and whether they are required or optional. When you hover over a question, the full text will pop-up

13. Competency Assessment via RALS e-Quiz • Create additional quizzes based on skill mix: • Take the quiz that everyone is going to need (i.e. glucose) • Highlight that quiz and click on “save as” button. • Rename the new quiz (i.e. GluOcc = glucose + occult blood). • Change # of question on quiz & # questions to pass. • Assign other HOME locations for this skill mix. • Change any of the additional message or memos to reflect new quiz • Select questions on occult blood as required or optional. • Save new quiz.

14. Competency Assessment via RALS e-Quiz Create quizzes based on skill mix. Once questions or quizzes have been taken you can monitor times taken, % passed and average score.

15. Competency Assessment via RALS e-Quiz Likewise, one can monitor questions for # quizzes using question, # times answered, and % answered correctly. This allows one to root out problematic questions that need fixing.

16. Competency Assessment via RALS e-Quiz Operator reports can be generated by user defined filters using the operands: parenthesis, AND, OR and choosing the attribute and condition.

17. Competency Assessment via RALS e-Quiz User defined operator report: Not taken – exclude students

18. Competency Assessment via RALS e-Quiz Coming soon in North Texas early 2007: North Texas Point of Care (NT-POC) is a premier network supporting cross disciplines and diversities of point-of-care testing (POCT) that include nursing, lab, information technology and ancillary staff. We will provide a forum for the discussion of POCT and the complexities in the care and treatment of our patients.