KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

Name of staff:

Job Title:

Scope:

Date of assessment:

Interview and/or directly observe staff perform the procedure as indicated in the SOP. For each step
that conforms to the procedure score each item by scoring on a scale of 0 to 5.

Scor
SPECIMEN RECEPTION AND PROCESSING e Comments
/5
1. Correctly identifies patient and matches samples with
respective request forms
2. Visually inspects sample for clots and/or haemolysis

3. Records correct patient details; path number, name, LHIMS

number
tests, initials, time of reception
4. Wears appropriate PPEs in performing tasks
5. Handles all potentially infectious material according to the
laboratory procedures and the safety manual (observe &
interview)
6. Correctly collects and accession sample on the LHIMS

7.

8.

9.

GEN/FRM/06 Version 2 Page 1 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

10.

COMMENT/EVALUATION (SPECIMEN RECEPTION AND PROCESSING):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

STAINING Scor Comments

e
/5
11. Demonstrates relevant knowledge in the preparation of
giemsa stains (interview)
12. Performs quality control on stain and documents (observe)

13. Performs staining procedure as described in SOP (observe &

interview)

14. Correctly labels slides using the two way patient identifier
(observe)

15. Uses the correct volume of blood for preparing thick and thin
films: (observe)
16. Operates and maintains microscope using appropriate
methods and following laboratory procedure
17. Documents and takes appropriate corrective action for failed
quality control
18.

COMMENT/EVALUATION (STAINING):
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

GEN/FRM/06 Version 2 Page 2 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

FULL BLOOD COUNT (FBC) Scor Comments

e
/5
Name of analyser(s):

19. Assesses FBC specimen acceptability before testing (observe

& interview)
20. Runs start up on analyser including maintenance procedures
(observe)

21. Performs quality control including documentation (observe)

22. Evaluates quality control acceptability (interview)

23. Recognises and documents error codes (interview)

24. Recognises when results may be incorrect, re-runs and

checks before reporting (observe & interview)
25. Recognises and reports critical values (observe & interview)

26. Documents and takes appropriate corrective action for failed

quality control
27. Performs test according to documented procedure

28. .

29. .

30. .

31. .

GEN/FRM/06 Version 2 Page 3 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

COMMENT/EVALUATION (FULL BLOOD COUNT):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

ERYTHROCYTE SEDIMENTATION RATE(ESR) Scor Comments

e
/5
Name of analyser(s):

32. Ensures sample volume is adequate to run test

33. Pours correct volume of blood into citrated tube

34. Performs test according to procedure

35. Properly documents time of start and end of test.

COMMENT/EVALUATION (ERYTHROCYTE SEDIMENTATION RATE):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

GEN/FRM/06 Version 2 Page 4 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

GLUCOSE-6-PHOSPHATE DEHYDROGENASE Scor Comments

e
/5
Name of analyser(s):

36. Assesses specimen for correct volume before testing

(observe & interview)
37. Appropriately documents start and end of test (observe)

38. Performs Positive and Negative quality control (observe)

39. Performs test according to documented procedure

COMMENT/EVALUATION (GLUCOSE-6-PHOSPHATE DEHYDROGENASE):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

SICKLING TEST AND ELECTROPHORESIS Scor Comments

e
/5
Name of analyser(s):

40. Assesses specimen for acceptability before testing (observe

& interview)
41. Prepares sickling reagent as stipulated in the procedure
(observe)
42. Performs Positive and Negative quality control on sickling
test (observe)

43. Ability to detect failed QC and initiate corrective measures

44. Appropriately documents outcome of QC in logbook

45. Performs sickling test test according to procedure (observe

and interview)
46. Prepares tris buffer according to procedure (Interview)

GEN/FRM/06 Version 2 Page 5 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

47. Proper storage and documentation after preparation of the

reagent
48. Ability to operate and maintain electrophoretic chamber
(observe)
49. Performs electrophoresis test according to procedure

COMMENT/EVALUATION (SICKLING/ELECTROPHORESIS TEST):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

MALARIA MICROSCOPY Scor Comments

e
/5
Name of analyser(s):

50. Extensive and proper use of the microscope (interview and

observe)
51. Ability to identify and describe different species of malaria
parasites and their various stages.
52. Ability to detect parasites in films of low parasitemia

53. Performs viewing and count according to the procedure

COMMENT/EVALUATION (MALARIA PARASITE MICROSCOPY):

……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

COAGULATION STUDIES (AUTOMATION) Scor Comments

e

GEN/FRM/06 Version 2 Page 6 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

/5
Name of analyser(s): ACL ELITE

54. Assesses specimen acceptability before testing (observe &

interview)
55. Runs and documents maintenance procedures including
cleaning and priming (observe)

56. Performs quality control and appropriately documents

(observe)

57. Evaluates quality control acceptability (interview)

58. Recognises error codes and their corrective actions

(interview)

59. Recognises when results may be incorrect, re-runs and

checks before reporting (observe & interview)
60. Recognises and reports critical values (observe & interview)

61. Documents and takes appropriate corrective action for failed

quality control
62. Performs test according to documented procedure

63. .

64. .

65. .

66. .

MANUAL COAGULATION STUDIES (PT & APTT) Scor Comments

e
/5
Name of analyser(s): N/A

67. Assesses specimen acceptability before testing (observe &

interview)
68. Demonstates proper handling and use of the pippette

GEN/FRM/06 Version 2 Page 7 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

69. Performs quality control for manual PT and APTT and

documents appropriately (observe)

70. Ability to detect earliest formation of clot

71. Performs test according to procedure

FOR SUPERVISORS ONLY.

QUALITY ASSURANCE Score Comments

/5
72. Appropriately undertakes resolution of technical laboratory
problems and manages situations which may otherwise result
in service delivery failure (interview & review records)
73. Performs and supervises laboratory investigations (observe)

74. Ensures that reagents are prepared, stored and used in a

manner suitable for patient investigation (observe & interview)
75. Measures and monitors accuracy and precision of laboratory
investigations using appropriate quality control procedures
(interview & review records)
76. Manages quality control failures or loss of performance of
laboratory instruments or methods (interview and review
records)
77. Interprets laboratory results and takes appropriate actions
including (interview):
a. Validation of results
b. Requesting relevant follow-up laboratory procedures
c. Advise the clinical care team where necessary
HUMAN RESOURCE MANAGEMENT
78. Trains staff and students on laboratory testing and equipment
maintenance procedures (interview)
79. Conducts staff meetings to address staff and technical issues
(interview and review records)
80. Provides supervision to less experienced staff and students of
the laboratory (observe)
HEALTH AND SAFETY RESPONSIBILITIES
81. Assures the safety of all staff in the department (interview &

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 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

observe)
82. Takes appropriate action if there are laboratory accident or
spillage of hazardous substances in the department (interview)
83. Demonstrates sufficient knowledge in PEP (interview)

A- MAINTENANCE AND EQUIPMENT OPERATION PROCEDURES

EQUIPMENT NAME: SYSMEX XN 2000 EQUIPMENT ID: …………………

VALIDATION OF COMPETENCE

PROCEDURES UNDER ASSESSNENT Score

COMMENT
/5

Routine preventive maintenance

Starting up the analyzer

Changing of Reagents on the analyzer

Waste disposal

Shutting down

Documentation and filing of maintenance

procedures

EQUIPMENT NAME: ACL ELITE EQUIPMENT ID: …………………

VALIDATION OF COMPETENCE

PROCEDURES UNDER ASSESSNENT Score

COMMENT
/5

Routine preventive maintenance

Starting up the analyzer

Changing of Reagents on the analyzer

GEN/FRM/06 Version 2 Page 9 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

Waste disposal

Shutting down

Documentation and filing of maintenance

procedures

B- ANALYTICAL
(run selected levels of quality control. Keep the acceptable value as supervisor until staff has run the
same sample and recorded results)

QC LEVEL: ……………. LOT NO: ……………….. EXPIRY DATE: ………….

QC LEVEL: ……………. LOT NO: ……………….. EXPIRY DATE: ………….
QC LEVEL: ……………. LOT NO: ……………….. EXPIRY DATE: ………….
DATE PERFORMED: ……………………… EQUIPMENT ID: …………………

MEASURED
VALUE ACCEPTABLE Acceptable/Not
TEST
(for staff under VALUE acceptable
assessment) (for supervisor)
CONTROL
LOW
CONTROL
NORMAL
CONTROL
HIGH

GEN/FRM/06 Version 2 Page 10 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

C- REPEATABILITY AND REPRODUCIBILITY

SamplMeasure Expecte Scor Measure Expected Scor Measure Expected Scor
e d Value d Value d Value Value d Value Value
ID
e e e
………. ………. ……….
/5 /5 /5

1
2
3
4
5
6
7
8
9
10

MEAN
SD
%CV
TOTAL SCORE TOTAL SCORE TOTAL SCORE

ACCEPTABLE TOTAL SCORE:

GRADES
Total Score
Total Expected
Score
Percentage score

Work without supervision Work without supervision Work under Fails to meet minimum
and can train others but cannot train others supervision requirement and requires
re-training
(80 – 100)% (60 – 79)% (50 – 59)%
Less than 50%

GEN/FRM/06 Version 2 Page 11 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

COMMENT/EVALUATION:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
FOLLOW-UP ACTION

COMPETENCY ACTION ITEM TIMELINE FOLLOW UP ACTION

NAME OF STAFF ASSESSED: ……………………………………………………………………….

SIGNATURE: ……………………………… DATE: …………………………….

GEN/FRM/06 Version 2 Page 12 of 13

 KATH HAEMATOLOGY LABORATORY

Prepared by: KWAME O. ODAME Effective date: 01/07/2022

Approved by: DR DAVID SACKEY Revised date:

Title: COMPETENCY ASSESSMENT CHECKLIST (STAFF)

NAME OF COMPETENCY ASSESSOR: …………………………………………………………….

SIGNATURE: ……………………………… DATE: …………………………….

NAME OF QUALITY MANAGER: ……………………………………………………………

SIGNATURE: ……………………………… DATE: …………………………….

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