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MLAB 123 > 1- Lab stuff > Flashcards

1- Lab stuff Flashcards

1
Q

phlebotomist is usually cross trained in

A

 Venipuncture
 Capillary collection
 ECG and Holter Monitor
 Patient care

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2
Q

Competency can be assessed by:

A
  1. Hands on -doing
  2. Direct observation
  3. Videotaping
  4. Reviewing worksheets and log books
  5. Reviewing quality control records
  6. On line courses and assessments
  7. Providing written exams
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3
Q

Ethical Obligations to the Public

A 
Provide exceptional customer service to all 
Respect for the Patient 
Informed Consent
Consideration of Privacy
Confidentiality
Continuity of care
Clinical trials (Drug Studies)
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4
Q

Collaborative practice

A

health care occurs when multiple health workers from different professional backgrounds provide comprehensive services by working with patients, their families, careers and communities to deliver the highest quality of care across settings.

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5
Q

essential component in the phlebotomist communication network

A

TEAMWORK

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6
Q

Bill 168

A

An Act to amend the Occupational Health and Safety Act with respect to violence and harassment in the workplace and other matters, came into effect June 15, 2010. Workplaces in Ontario are now required to have the necessary policies, programs, measures and procedures in place

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7
Q

What is accreditation?

A

Accreditation is a peer review process by which an authoritative body ensures that:
• Clinical laboratories meet explicit quality management criteria, in order to give formal recognition that the laboratory is competent to carry out examinations
• Teaching facility program meet the didactical, practical and professional competencies required by students for entry-level work.

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8
Q

Ontario’s authoritative body for Laboratory accreditation

A

• Ontario Laboratory Accreditation (OLA) is operated by the Quality Management Program – Laboratory Services (QMP–LS), a division of the Ontario Medical Association

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9
Q

Role of Institute of Quality Management in Health Care (IQMH ) formally OLA

A
  • Peer review
  • Created a process to develop and implement a peer-group accreditation program
  • Developing and promoting standards of practice guidelines.
  • Assist laboratories with utilization management.
  • Create and manage a Test Review Committee.
  • Performs laboratory inspections

Pre-Analytical Process

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10
Q

What is quality

A
  • Defined as a degree of excellence

* Doing the right thing, the right way, at the right time, and doing it on time

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11
Q

What is quality Assurance

A
  • Ensuring that the standards of patient care are maintained
  • In the laboratory developing a program to assess the entire department’s operation to identify areas of weakness and strength. (Internal)
  • QMP-LS work to ensure that laboratories meet standards, rules and regulations( External
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12
Q

What is Quality Control

A

• The process of validating final results

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13
Q

What is Continuous Quality Improvement (CQI)?

A

• Consistently searching for ways to improve service, performance or a product.

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14
Q

What is Total Quality Management (TQM)?

A
  • The TQM plan is a management plan that ensures that the quality expected can be met. Looks at the entire system (polices, processed and procedure documents).
  • Documents and records
  • Organization
  • Personnel
  • Equipment
  • Purchasing and inventory
  • Process control
  • Information management
  • Occurrence management
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15
Q

Quality Assurance in Phlebotomy Service

A

 Performing the right type of phlebotomy (venipuncture vs fingerprick)
 Doing the procedure the right way (according to specified laboratory procedure)
 Doing the procedure correctly the first time (puncturing the appropriate vein with one stick, or taking timed specimen)
 Doing the procedure on time ( as soon as requested)
 Monitoring the expiration dates of supplies and reagents
 Positive patient outcome
 Customer satisfaction\

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16
Q

Needle Safety

A

 Regulation 474/07 Needle Safety (enacted in August 2007 under the Occupational Health and Safety Act (OHSA) requires hospitals to use safety-engineered needles and needleless devices to replace conventional hollow-bore needles, beginning September 1, 2008.

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17
Q

Standard Precautions (Standard Practice).

A

Standard precautions basically combines universal precautions with isolation techniques
• Standard Precautions refers to an infection control method that uses hand hygiene, barrier protection (gloves) and work control practices to prevent direct skin contact with blood and other body fluids, and tissues from all persons.
• The concept is based on the inability to identify infected individuals, who could be carriers, or with the health care worker may be in contact during an incubation period.
• Health care workers are to consider all fluids whether blood is visible or not.

o Blood
o All body fluids
o Non-intact skin
o Mucous membranes

• CDC advice: Artificial nail not to be worn by health care workers because they may harbour gram negative pathogens

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18
Q

Airborne Infection Isolation Room (AIIR):

A

A room that is designed, constructed and ventilated to limit the spread of airborne microorganisms from an infected occupant to the surrounding areas of
the health care setting. This is also known as a negative pressure room. NOTE: The Canadian Standards Association uses the term Airborne Isolation Room, abbreviated AIR

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19
Q

Strict Isolation:

A
  • A patient with a contagious disease such as chicken pox, SARS or pneumonia is placed in strict isolation.
  • The patient stays in a private room, and anyone entering that room is required to wear a mask, gown, gloves and sometimes boots.
  • Only the phlebotomy equipment and labels needed for that patient is to be taken into the room.
  • The disposable equipment used to draw the blood sample including the needle, gauze, needle holder and tourniquet, must be left in the sharps container in the room.
  • The only items to leave the room are the labeled tubes that contain the blood.
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20
Q

Contact Isolation

A

A disease that is transmitted by direct contact with the patient’s skin (infectious agent and the susceptible host )

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21
Q

Indirect contact

A

transmission involves contact between a susceptible host and a contaminated intermediate object such as a needle, instrument or other equipment.
E.g.: Scabies caused by infestation with a mite, is an example of this type of disease.
• Gowns and gloves are worn when entering the room and removed when leaving

22
Q

Respiratory Isolation

A

• A patient with a disease transmitted through the air, such as mumps or pertussis.

  • Required mucous membrane protection
  • This isolation requires a private room with a closed door.
  • Anyone entering the room must wear a mask or goggles; discard the mask as you leave the room.
  • A fresh mask must be used every twenty minutes and once a mask has become moist from normal breathing it is no longer effective.
23
Q

Droplet transmission involves

A

contact of the conjunctiva or mucous membranes of the nose or mouth of a susceptible host with large particle droplets (larger than five microns) that contain an infectious agent. Droplets are released through talking, coughing or sneezing, and during procedures such as suctioning and bronchoscopy.

24
Q

Tuberculosis Isolation:

A
  • Tuberculosis isolation, sometimes called AFB (acid-fast bacillus) isolation, is the isolation of the patient with tuberculosis.
  • The isolation techniques are similar to respiratory isolation.( mask or goggles)
25
Q

Airborne Precaution:

A
  • Requires special air handling and ventilation and respiratory protection
  • HEPA filter mask and N95 respirators
26
Q

Enteric Precautions:

A
  • Enteric precautions are for patients with sever diarrhea due to contagious bacteria such as Salmonella.
  • Transmitted by contact with the infected patient’s feces.
  • Gown , mask and gloves are required as in most other isolations, and only the equipment needed is to be taken into the room.
27
Q

Reverse Isolation

A
  • Reverse isolation is protecting the patient form the health care professional. e.g. a bone marrow transplant patient, burn patients, and a patient receiving chemotherapy have compromised immune system,
  • A mask, gown and gloves are required.
  • The tray must stay outside the room so not to contaminate the patient.
  • A clean evacuated tube holder and a new tourniquet must be used each time
  • Since the patient is not contagious all equipment taken into the room can be removed
28
Q

• Gloves

A

are the last to be put on and the first to be taken off.

29
Q

• Masks

A

are no longer effective once they become moist from breathing, so they should never be used longer than 15-20 minutes.

30
Q

Going into Isolation: Putting On -donning

A

Step One: Gown
Step Two: Mask or respirator
Step Three: Goggles or face shield
Step Four: Gloves

31
Q

Leaving Isolation: Taking off (doffing)

A

Step One: Gloves
Step Two: Gown
Step Three: Goggles
Step Four: Mask or respirator

32
Q

What is an N95 respirator/mask

A

• The “N” means “Not resistant to oil”.
• The “95” refers to a 95% filter efficiency.
• NIOSH certified N95 respirators/masks are designed to help provide respiratory protection for the wearer.
• The N95 mask is a High Efficiency Particulate Air (HEPA) filter mask
• The N95 respirator/mask is has 95% or greater
effectiveness against 0.3 micron particles.
• It is fluid resistant, disposable and may be worn in surgery.

33
Q

chain of custody

A

An unbroken documented chain of events from the time of sample collection until it is processed and completed.
The police on site will have evidence seals that can be placed over the stopper of the vacutainer. This procedure dictates that each person handling the specimen must sign a form.

34
Q

Chain of custody documents

A

The forms (documents) should include:
• name or initials of the individual collecting the specimen
• each person or entity subsequently having custody of it
• the length of time the person handled the specimen
• the date the specimen was collected or transferred
• employer or agency information
• specimen number
• patient’s name
• employee’s name (collected by)
• a brief description of the specimen/container.
• lock box seal number

35
Q

Transportation of Chain of custody specimen

A

sealed box to prevent the possibility of switching or tampering with it.

A law enforcement agency legal seal to the Legal Sample such that the sample cannot be opened without breaking the seal .

36
Q

Liability

A

The state of being responsible for something, especially by law.

37
Q

Assault and Battery

A

section 265 of the Canadian Criminal Code. The sections from 266 to 272 define various types of assault like:
• Assault with a weapon (266),
• Assault causing bodily harm (267),
• Assaulting a peace officer (268),
• Sexual assault (270),
• Sexual assault with a weapon or threats or causing bodily harm (271),
• Aggravated sexual assault (272).

38
Q

Application of force

A

An assault is the intentional application of force, directly or indirectly, to another person without that person’s consent.

39
Q

• Threat to apply force

A

Assault - Threat to harm causing fear

An assault may also take the form of an attempt or threat, by an act or gesture, to apply force to another person
The threat must cause apprehension of immediate personal violence;

40
Q

Battery

A

Actual harm
defined as use of force against another with intent of causing physical harm without his/her consent. Assault and battery usually go together

FOR PHLEBOTOMIST
• Lack of or improper consent to blood collection

41
Q

Duty of care

A

requirement that a person act toward others and the public with watchfulness, attention, caution and prudence that a reasonable person in the circumstances would.
If a person’s actions do not meet this standard of care, then the acts are considered negligent, and any damages resulting may be claimed in a lawsuit for negligence.

42
Q

Negligence

A

Conduct that falls below the standards of behavior established by law for the protection of others against unreasonable risk of harm

FOR PHLEBOTOMIST:
• Performing in a manner expected by the profession
• A violation of a duty to exercise reasonable skill or care in performing a task.
• Perform duty within scope of practice

43
Q

Professional Competency

A

The ability to do something well or efficiently

A competency is a set of defined behaviours

44
Q

Informed Consent

A

Consent: Permission for something to happen or agreement to do something:

Informed consent is a voluntary permission given by a patient to allow touching, examination or treatment by health care providers.

45
Q

Worker’s Rights

A
  1. The Right to Know
  2. The Right to Participate
  3. The Right to Refuse Dangerous Work
46
Q

Phlebotomist and Profession Liability Insurance

A

The health care worker who deals with the public could be liable. Phlebotomist should consider purchasing professional liability insurance from a personal standpoint. Included in the OSMT and CSMLS membership is liability insurance coverage.

Phlebotomists working in a health care facility such as hospitals are usually on the hospitals professional liability policy. The phlebotomist should be diligent in enquiring if their employer has liability insurance policy

Possible lawsuits resulting from improper technique and negligence
• Patient falling
• Hematoma/hemorrhage- from inadequate pressure to vein
• Infection after venipuncture
• Injuries from fainting

47
Q

if on blood thinners what to do when needle comes out

A

Make sure you put pressure on longer than regular

48
Q

what to not say to a patient

A

oh its going to be okay

49
Q

if a patient refuses

A

explain it to the patient and tell them the doctor needs the blood to do further tests
and then ask the nurse to help as well

50
Q

standing order

A

when the doctor orders tests that they have regularly

51
Q

if patient it dead

A

write it down

52
Q

if the patient is blind

A

you have to describe all that your are doing and what the procedure is

MLAB 123 (11 decks)

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