Elements and Performance Criteria

The range of variables relates to the unit of competency as a whole. It allows for different work environments and situations that will affect performance.
Where reference is made to industry Codes of Practice, and/or Australian/international standards, it is expected the latest version will be used.
This unit of competency describes the work of the technical officer in the transfusion or immunohaematology laboratory.
The unit of competency is based on the assumption that technical personnel would perform tests and procedures under the close supervision of scientific and/or medical staff.
It is understood that the management of any transfusion laboratory would establish for itself, in terms of its own responsibility and purposes, the ability of any worker to work in a transfusion science laboratory, regardless of the education and training record or presumed ability of any worker.

Information sources could include
latest edition of Guidelines for Pretransfusion Testing, published by the Australasian Society of Blood Transfusion Inc
Human Tissue Acts and regulations operable in Australian jurisdictions
guidelines, policies and business rules of the Australian Red Cross Blood Service that are operable from time to time
enterprise procedures, standard operating procedures (SOPs) and operating manuals
test procedures (validated and authorised)
sampling procedures (labelling, preparation, storage, transport and disposal)
safety requirements for equipment, materials or products
cleaning, hygiene, personal hygiene requirements
quality system and continued improvement processes
incident and accident/injury reports
schematics, work flows, laboratory layouts
instructions to comply with new legislation, standards, guidelines and codes
stock records and inventory
waste minimisation and disposal.

Equipment, materials and systems could include
centrifuges, light boxes, calibrated pipettes, waterbaths, incubators, microscopes
laboratory information/management systems, computer databases, record and filing systems
general laboratory glassware and equipment identified with a serology laboratory
antisera and phenotyped red cells and other relevant reagents
gel systems.

Communication may involve
supervisors and managers (laboratory, quality and customer service)
other laboratory or relevant medical or nursing personnel
patients and clients
external auditors, or accreditation agency (for example, NATA)
couriers.

Health, safety and environment
All operations to which this unit applies are subject to stringent health, safety and environmental (HSE) requirements, which may be imposed through State or Federal legislation, and these must not be compromised at any time. Where there is an apparent conflict between performance criteria and HSE requirements, the HSE requirements take precedence.
All operations assume the potentially hazardous nature of samples and require standard precautions to be applied. Users should access and apply current industry understanding of infection control issued by the National Health and Medical Research Council and State and Territory Departments of Health. All operations are performed in accordance with standard operating procedures.

The Evidence Guide describes the underpinning knowledge and skills that must be demonstrated to prove competence.
Critical aspects of competency

Competency must be demonstrated in the ability to perform consistently at the required standard. In particular, assessors should look to see that the candidate:

detects and records accurate evidence of blood group antigen and antibody reactions.

Such reactions will be related to the determination of blood groups and the detection of antibodies of significance in:

transfusion (as laboratory evidence that in
pregnancy and the perinatal period (as evidence of sensitisation of foetal red cells by transplacental maternal antibody)
the investigation of haemolysis or haemolytic episodes.
The tests that the worker will use will be validated and authorised procedures, clearly described in the laboratory's manual of procedures. The parameters of interpretation will be clearly described, indicating for the worker what he or she is permitted to sign off without reference to supervisors or managers.

In particular, the assessor should look to see that the candidate:

recognises problems in systems and documentation
uses enterprise information systems efficiently
critically analyses information/documents
prepares documentation that is accurate, concise and in accordance with enterprise requirements
manages tasks and organises work to ensure the timely release of blood and blood products, as they complete routine tasks
uses samples, reagents and materials economically and disposes of wastes safely
uses equipment safely
maintains equipment, recording and reporting malfunctions appropriately.

Underpinning knowledge

Competency includes the ability to apply and explain enterprise procedures relating to:

selection and application of appropriate testing procedures in terms of the suspected or known nature of the antibody and its documented possible range of testing behaviours
selection, testing and issuance of blood cleared for transfusion
discussion of antigen/antibody reactions with colleagues to elucidate likely causes and to select and apply confirmatory tests as required
selection and issuance of blood products for therapeutic or prophylactic use
relevant health, safety and environment requirements.

Competency includes the ability to correctly use scientific, medical, clinical, technical and workplace terminology relevant to:

normal and abnormal anatomy, physiology, biochemistry and immunology
immunohaematology.

Assessment context and methods
This unit of competency is to be assessed in the workplace or simulated workplace environment.

The following assessment methods are suggested:

review of results/data/records generated by the candidate
feedback from peers and supervisors that enterprise procedures were followed and that work is consistently performed in line with enterprise requirements
oral and/or written tests and paper problems associated with ABO group determination; antibody identification; record keeping
integrated assessment with a case focus, such as the routine pre-transfusion crossmatch; an antenatal antibody detection and preliminary identification; batch of routine ABO and Rh(D) groups to be completed at the same time as completion of a pre-transfusion battery of tests.
Assessment should establish the candidate's ability to perform tests accurately and to organise work so that the needs of all relevant patients and clients are met in a timely fashion.
In all cases, practical assessment should be supported by questions to assess underpinning knowledge and those aspects of competency which are difficult to assess directly. Questioning techniques should suit the language and literacy levels of the candidate.

Interdependent assessment of unit

This unit of competency may be assessed with:

PMLQUAL401B Apply quality system and continuous improvement processes
PMLTEST501B Perform microbiological tests.

Resource implications

Resources may include:

standard transfusion/immunohaematology laboratory with relevant equipment, samples and reagents
enterprise procedures, test methods and equipment manuals.
Under duty of care requirements, off-the-job training providers should ensure that blood samples are known to be antibody free for hepatitis B and C, syphilis and human immunodeficiency viruses, but this does not preclude the use of universal precautions in the use of blood samples.

This competency in practice
A patient's blood sample and request form have been brought to the laboratory. The patient is to undergo elective surgery the next afternoon. The technical officer has been asked by the supervisor to determine the patient's ABO and Rh(D) blood groups, to screen the sample for irregular blood group antibodies and to cross match two units of packed red cells in readiness for possible use during or after surgery. The technical officer checks the records for information on the patient. Finding none, they prepare the required data in the laboratory databases and then perform the required tests. They do not detect any irregular antibody and have had no difficulty in choosing suitable units for crossmatching. They complete the required documentation and labels and then store the compatible blood units for possible later use.

The seven key competencies represent generic skills considered for effective work participation. The bracketed numbering against each of the key competencies indicates the performance level required in this unit. These are stand-alone levels and do not correspond to levels in the Australian Qualifications Framework (AQF).
Level (1) represents the competence to undertake tasks effectively
Level (2) represents the competence to manage tasks
Level (3) represents the competence to use concepts for evaluating and reshaping tasks.
Communicating ideas and information
(2)

Collecting analysing and organising information
(2)

Planning and organising activities
(2)

Working with others and in teams
(2)

Using mathematical ideas and techniques
(2)

Solving problems
(3)

Using technology
(2)