Training activity information
Details
Perform sample identification and acceptance according to current guidelines and laboratory policies
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
- Sample to patient identifiers and pre-transfusion sample acceptance
- Quality assurance procedures and their application including concessionary testing
- Audit trail vein-vein
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 sample identification and acceptance in antenatal serology.
- Review learning outcomes which relate to practising in accordance with antenatal serology standards and guidelines and performing acceptance testing of samples.
- What specific steps or criteria define successful sample identification and acceptance according to these standards and guidelines?
- What are the essential policies and guidelines you must follow for sample receipt in this context?
- Discuss with your training officer to understand their expectations regarding common issues or challenging samples.
What is your prior experience of this activity?
- Think about what you already know about the critical requirements for sample labelling, integrity, and documentation in blood transfusion.
- Consider possible challenges you might face during the activity, such as:
- Mislabelled tubes
- Incorrect sample types
- Haemolysed samples, or
- Delays in transport
- Think about how you might handle these according to policy.
- Recognise the scope of your own practice for this activity, meaning knowing when you might need to seek advice regarding complex sample acceptance issues or deviations from standard protocols.
- Acknowledge how you feel about the responsibility of sample acceptance, knowing its critical importance for patient safety.
What do you anticipate you will learn from the experience?
- Consider the specific skills you want to develop in meticulously checking sample details and applying laboratory policies consistently.
- Identify the specific insights you hope to gain into the link between accurate pre-analytical steps and reliable laboratory results for antenatal patients.
What additional considerations do you need to make?
- Consult actions identified following previous experience with sample handling that could inform your approach.
- Identify important information you need to consider before embarking on the activity, such as specific requirements for antenatal samples e.g., EDTA vs. clotted, turnaround time expectations, or using the laboratory information system for logging samples.
In action
Is anything unexpected occurring?
- Are you noticing anything surprising or different from what you anticipate whilst performing sample identification and acceptance?
- Are you encountering situations such as:
- Illegible labels, insufficient sample volume, or incorrect sample type, requiring immediate scrutiny regarding whether to accept the sample
- A discrepancy between the sample label and the documentation that makes the identification process complex
- A specific type of sample or discrepancy that you are finding unexpectedly difficult to identify or resolve compared to others
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 or the checking process in the moment?
- Consider the steps you are taking in the moment, such as:
- Immediately making decisions about how to handle a non-conforming sample, weighing the safety implications of acceptance.
- Seeking immediate support or clarification from a senior colleague or training officer if you are unsure about whether to accept a complex or borderline non-conforming sample.
- Adapting your checking process based on the type of challenge encountered e.g., focusing on integrity checks for haemolysed samples
- How are you feeling in that moment? For instance, are you finding it difficult to adapt your process to resolve the discrepancy? Is it affecting your confidence in justifying the sample handling decision?
What is the conclusion or outcome?
- Identify how you are working within your scope of practice. For example, are you successfully troubleshooting the acceptance criteria issue, or needing support because the resolution of the discrepancy is outside your scope regarding sample handling decisions?
- What are you learning as a result of the unexpected development? For example, are you learning a more effective technique for dealing with illegible labels, or gaining critical insight into the link between accurate pre-analytical steps and reliable laboratory results?
On action
What happened?
- Begin by summarising the key points of the experience of identifying and accepting samples for antenatal serology. Did the samples meet all the criteria according to current guidelines and laboratory policies?
- Consider specific events, actions, or interactions which felt important during the acceptance process, such as querying a non-conforming sample with a colleague or ward staff.
- Acknowledge your own feelings during the experience, for instance, when making a difficult decision about sample acceptance.
- Include any ‘reflect-in-action’ moments where you adapted to the situation as it unfolded. For instance, describe when you adjusted your sample checking process based on a previous finding or policy reminder.
How has this experience contributed to your developing practice?
- Identify what learning you can take from this experience regarding the critical importance of accurate sample identification and acceptance in antenatal serology. What strengths did you demonstrate e.g., attention to detail? What skills and/or knowledge gaps were evident e.g., unfamiliarity with specific acceptance criteria?
- Compare this experience against previous engagement with similar activities. For instance, did you successfully apply any lessons from previous sample handling issues? Has your attention to detail improved?
- Identify any challenges you experienced e.g., ambiguous labelling, difficult communication with ward staff and how you reacted to these. Did this affect your ability to deal with the situation? Were you able to overcome the challenges?
- Identify anything significant about the activity, such as whether you needed to seek advice or clarification on sample acceptance criteria. Did you ensure you were working within your scope of practice when dealing with complex sample issues?
- Acknowledge any changes in your own feelings now you are looking back on the experience regarding your ability to ensure sample integrity.
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. For example, determining specific steps to improve your knowledge of or adherence to sample acceptance policies.
- What will you do differently next time you encounter a potentially problematic sample?
- Do you need to practise any aspect of the activity further, such as applying specific acceptance criteria or communicating with others about sample issues?
Beyond action
Have you revisited the experiences?
- Looking back at your different experiences with sample identification and acceptance, have you reviewed your past reflections? What specific steps for improvement did you previously identify regarding adhering to guidelines or policies, handling discrepancies, or knowing when to reject a sample? Have you actively worked on these areas? Are you now able to demonstrate improved proficiency in performing sample identification and acceptance?
- Have you engaged in professional storytelling or discussed challenging scenarios involving sample acceptance e.g., mislabelled tubes, delayed samples with peers or senior colleagues? Has hearing their perspectives or approaches changed your own understanding or method for ensuring correct sample identification and acceptance?
How have these experiences impacted upon current practice?
- Consider how the cumulative learning from these experiences and your reflections helps you prepare for observed ‘in-person’ assessments for the module, such as a DOPS where accurate sample handling might be observed, or an OCE where you might need to discuss sample suitability with a healthcare professional?
- How has your ability to perform sample identification and acceptance according to guidelines evolved over time? Have you become more adept at spotting potential issues or knowing when to seek advice before accepting a sample?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Practice in accordance with antenatal serology standards and guidelines. |
| # 2 |
Outcome
Perform acceptance testing of samples requiring antenatal investigation. |