Techniques for Advanced Monitoring —
Training activity: 1

Details

Perform quality assurance & maintenance for a Point of Care Testing device 

Type

Entrustable training activity (ETA)

Evidence requirements

Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion. ​

Reflection at multiple timepoints on the trainee learning journey for this activity.

Considerations

• POCT accreditation regulations including ISO standards
• Quality and competence requirements
• SOPs
• Manufacturer’s operating guidelines

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

What does success look like?

• Identify what is expected of you in relation to performing quality assurance (QA) and maintenance for a Point of Care Testing (POCT) device.
• Consider how the learning outcomes apply, specifically in relation to applying techniques for preparing POCT devices for safe use and practicing safely according to guidance.
• Discuss with your training officer to gain clarity of what is expected of you in relation to expectations for equipment setup, specific standards defining successful QA, and troubleshooting common issues.

What is your prior experience of this activity?

• Think about what you already know about POCT devices, QA procedures, and general maintenance tasks.
• Consider possible challenges you might face during the activity, such as equipment malfunctions or unexpected results during the QA process.
• Recognise the scope of your own practice for this activity i.e. know when you will need to seek advice or help, and from whom. You will need to seek advice from your Training Officer when required, for example if you encounter equipment malfunctions or unexpected results.
• Acknowledge how you feel about performing the quality assurance of the device. How confident do you feel about implementing the maintenance of the device?

What do you anticipate you will learn from the experience?

• Consider the specific skills you want to develop, such as developing or improving skills related to this training activity, drawing upon previous experiences if any.
• Identify the specific insights you hope to gain into specific device types or troubleshooting common issues.

What additional considerations do you need to make?

• Consult actions identified following previous experiences of this activity or similar tasks.
• Identify important information you need to consider before embarking on the activity, such as specific device protocols, safety procedures, or required documentation.

In action

Is anything unexpected occurring?

• Are you noticing anything surprising or different from what you anticipate whilst performing QA or maintenance?
• Are you encountering situations such as:
  • The device calibration or control samples yield unexpected results?
  • You encounter any alarms or error messages that you didn’t anticipate?
  • The QA/maintenance process compares differently to previous times you’ve done it, or similar tasks on other devices?

How are you reacting to the unexpected development?

• How is this impacting your actions? For example, are you responding to the situation appropriately? Are you adapting or changing your approach to troubleshooting protocols or seeking advice due to unexpected results or errors? Did encountering something unexpected impact your ability to complete the QA/maintenance steps independently?
• Consider the steps you are taking in the moment, such as following troubleshooting protocols or seeking advice to resolve the unexpected results or errors.
• How are you feeling in that moment? For instance, are you finding it difficult to troubleshoot the errors? Is it affecting your confidence in resolving the issue?

What is the conclusion or outcome?

• Identify how you are working within your scope of practice. For example, are you successfully completing the QA/maintenance, ensuring the device is safe for use, while working within your scope? Or are you needing support because the troubleshooting process requires specialist input outside your current technical capacity?
• What are you learning as a result of the unexpected development? For example, are you mastering an immediate troubleshooting technique for this specific device or general POCT QA processes?

On action

What happened?

• Begin by summarising the key steps you took when performing the quality assurance (QA) and maintenance procedure for the specific Point of Care Testing (POCT) device.
• Consider specific events, actions, or interactions which felt important, such as successfully resolving a difficult maintenance task or identifying that the device was out of calibration limits.
• Include any ‘reflect-in-action’ moments where you had to adapt to the situation as it unfolded, for instance, immediately troubleshooting an error code that appeared unexpectedly during the calibration sequence.
• How did you feel during this experience, e.g., did you feel confident in your technical troubleshooting ability or stressed by the persistent error alarm?

How has this experience contributed to your developing practice?

• Identify what learning you can take from this experience regarding performing QA and maintenance on POCT devices. What strengths did you demonstrate, e.g., meticulous adherence to the maintenance checklist and safety procedures?
• What skills and/or knowledge gaps were evident, e.g., unfamiliarity with the governance procedures involved in POCT?
• Compare this experience against previous engagement with similar activities – were any previously identified actions for development achieved? Has your practice improved in efficiently executing the QA procedure or documenting the maintenance steps?
• Identify any challenges you experienced, such as needing to seek advice or clarification on scope of practice regarding resolving a complex technical error that exceeded routine troubleshooting capacity, and how you reacted to this.

What will you take from the experience moving forward?

• Identify the actions or ‘next steps’ you will now take to support the assimilation of what you have learnt, including from any feedback you have received, with regards to improving your understanding of specific POCT device error codes and troubleshooting protocols.
• What will you do differently next time you approach performing QA and maintenance, for instance, by proactively reviewing the manufacturer’s guidelines for unexpected control sample results?
• Do you need to practise any aspect of the activity further, such as diagnosing and resolving common software or hardware faults on the POCT device or key learning outcomes related to preparing POCT devices for safe use?

Beyond action

Have you revisited the experiences?

• How have your subsequent experiences of QA or maintenance activities for other critical care equipment since completing this specific training activity led you to revisit your initial approach or decisions during that activity? For example, having to troubleshoot a persistent error during maintenance for different monitoring equipment forced you to re-evaluate the rigidity of your initial adherence to the technical manual during your first attempt at this training activity.
• Considering what you understand about equipment management, safety protocols, and governance procedures for POCT now, were the actions or considerations you identified after your initial reflection on this training activity sufficient? How have you since implemented or adapted improvements in your protocol adherence or technical checklist for POCT QA/maintenance based on further learning and experiences? For example, how you proactively implemented observable behaviours and practices regarding equipment management and safety assimilated from other activities based on further learning.
• Has discussing unexpected control sample results or the impact of poor governance procedures for POCT with colleagues, peers, or supervisors changed how you now view your initial experience in this training activity? For example, how professional storytelling with a senior colleague about a POCT result that was invalidated due to procedural errors refined your understanding of the critical nature of meticulous QA/maintenance.

How have these experiences impacted upon current practice?

• How has the learning from this initial training activity, in combination with subsequent POCT QA and maintenance experiences, contributed to your overall confidence and ability in efficiently managing equipment functionality and adhering to safety protocols, particularly in preparing for assessments like DOPS or OCEs? For example, how your accumulated attention to detail, systematic troubleshooting skills, and adherence to protocols now enables you to confidently approach procedures and technical troubleshooting during relevant DOPS or OCE assessments.
• How has reflecting back on this specific training activity, combined with everything you’ve learned since, shaped your current approach to POCT management and technical verification? How does this evolved understanding help you identify when something is beyond your scope of practice or requires escalation? For example, how your evolved approach means you now routinely seek advice from the Training Officer or Technical Manager immediately when a major equipment malfunction or complex technical issue falls outside routine maintenance and requires specialist technical review.
• Looking holistically at your training journey, how has this initial POCT QA/maintenance experience, revisited with your current perspective, contributed to your development in meeting the learning outcomes related to preparing POCT devices for safe use and practicing safely? For example, how this foundational experience has supported your development in applying systematic analysis and meticulous procedural checks necessary for other monitoring activities.

Relevant learning outcomes

#	Outcome
# 1	Outcome Prepare point of care testing (POCT) devices for safe use in monitoring critically ill patients.
# 2	Outcome Perform blood gas analysis to monitor critically ill patients.
# 8	Outcome Practice safely in accordance with guidance and legislation to minimise risk in all elements of patient care.