Lesson 1 Flashcards
Process of collecting blood
PHLEBOTOMY
the act or practice of bloodletting as a
therapeutic measure
were used to puncture blood vessel
crude tools
Hippocrates
-Greek physician
-Recognized as father of medicine
Hippocrates -Developed an early medical theory that the
body requires
balance
-Believed that disease resulted from excess
substance, and removing excess will restore
health
Hippocrates
Phlebotomy was considered a therapeutic
process
VENESECTION (17th - early 18th Century)
lancet type instrument
• Pierced the vines to bleed
VENESECTION (17th - early 18th Century)
suction through heated glass cup
CUPPING
capillary blood is pulled under the cup area is
bled by blade
CUPPING
transmission of blood-borne pathogen
CUPPING
bloodletting was no longer
considered cure for all illness
19th century
soon emerged as a more modern
method of bleeding
Hirudo medicinalis/LEECHES
Blood collection has changed from being
therapeutic to being
diagnostic
provides accurate and precise test
results
Phlebotomy
Primary role is to collect blood
-Produces accurate and reliable results
-In a quick manner
-Brings least discomfort to patient
PHLEBOTOMIST
PHLEBOTOMIST Trained in various techniques
-Venipuncture
-Capillary Collection
-Patient Care
-Receptionist duty
-Sample processing
-Computer Work
-Professional code of conduct must be used in
treating patients
-Proper treatment of patient
PROFESSIONAL ATTITUDE
What are the professional attitude
Self-confidence
Integrity
Compassion
Self-motivation
dependability
is able to trust his or her
own personal judgment
- Ex. erect posture, professional appearance,
courage, and tactfulness in communication
SELF-CONFIDENCE
displays honesty and consistency of character to
do what is righ regardless of circumstances
INTEGRITY
-being sensitive to a person’s needs and willing to
offer reassurance in a caring and humane way
- Ex. Appreciating and recognizing the fear illness
or the unknown generates
COMPASSION
- finds the workplace stimulating no matter what
the tasks may ent - Ex. makes every effort to provide excellence in all
aspects of patient care in which he or she is
involved
SELF-MOTIVATION
-takes personal responsibility for his or her actions
- Ex. works hard and shows constant, reliable
effort, and perseverance
DEPENDABILITY
means by which information is exchanged or
transmitted
COMMUNICATION
most important processes that takes place in the
healthcare system
COMMUNICATION
Interpersonal Communication Components
- Verbal Communication
- Active Listening
- Nonverbal Communication
types of non-verbal communication
Kinesics
Proxemics
Appearance
Touch
study of nonverbal communication
Kinesics
study of an individual’s concept
and use of space
Proxemics
medicine is a contact profession
Touch
ELEMENTS IN HEALTHCARE COMMUNICATION
• Empathy
• Control
• Trust
• Respect and Confirmation
• Dispatching phlebotomist from the lab to the
units/ OPD areas
-Acquires list of samples to be collected
-Begins early for fasting patients
-Brings samples back to the laboratory
• Collects samples by batches
CENTRALIZED PHLEBOTOMY
• More people are collecting blood samples
• Personnel are multi-skilled
• Patient-focused care
- duties in hospital revolve around the patient
• Personnel are not restricted to one job
description
DECENTRALIZED PHLEBOTOMY
• Instrument is taken into the patient’s room/area
• Blood is collected and testing in the bedside
• Eliminates transport time and waiting time
POINT OF CARE TESTING
LABORATORY SECTIONS
hematology
coagulation
urinalysis
chemistry
microbiology
immunology and serology
immunohematology
cytogenetic
molecular diagnostics
histopathology
Collects samples from patients and processes
samples
PHLEBOTOMY
• Studies in the blood in normal and diseased
states
• Limited to the study of cellular components
HEMATOLOGY
hematology test examples
- Complete Blood Cell Count (CBC)
- Hemoglobin
- Hematocrit
- Platelet Count
- Sedimentation Rate
- Body fluid cell counts
Study of blood clotting mechanisms as an aid in
diagnosis or monitoring of patient therapy
COAGULATION
coagulation examples of tests:
- Prothrombin time (PT)
- Activated Partial Thromboplastin Time (aPTT)
- D-dimer
- Factor VII
- Fibrinogen Assay
- Heparin Level
- Von Willebrand Factor
Study of urine to aid in patient diagnosis
• Routine tests performed: “”
URINALYSIS
URINALYSIS Example of tests
-Physical (Color, clarity and specific gravity)
-Chemical (urine pH, glucose, protein, etc.)
-Microscopic (cells, bacteria, crystals and other
substances
• Performs biochemical analysis of blood and body
fluids
• Presence of highly automated computerized
instruments
• Individualized or panels can be performed
CHEMISTRY
Chemistry example of tests
- Metabolic panel
- Iron studies
- Renal panel (Blood Urea Nitrogen [BUN],
creatinine) - Carcinoembryonic Antigen (CEA)
- Glucose (Fasting Blood Sugar (FBS), Random
Blood Sugar [RBS] - Alanine Aminotransferase (ALT)
- Aspartate aminotransferase (AST)
- Lipid Panel (Cholesterol, Triglyceride, High
Density, Cholesterol, Low-Density Cholesterol)
• Cultures samples to determine pathogenic
organisms are present in a sample
• Determines the organisms’ sensitivity to
antibiotics (culture and sensitivity)
MICROBIOLOGY
MICROBIOLOGY example of tests
- Blood cultures
- Stool and urine cultures
- Other body Fluid cultures
- Mycobacterial (Tuberculosis) culture
- Virus and fungal culture
- Antibiotic Susceptibility Testing
Studies antigens and antibodies to determine
immunity to certain disease or presence of disease
IMMUNOLOGY & SEROLOGY
study of the immune system
Immunology
tests used to identify antibodies and
antigens
Serology
IMMUNOLOGY & SEROLOGY example of tests
- Human immunodeficiency virus (HIV) testing
- Rubella
- Syphilis (Rapid Plasma Reagin)
- Hepatitis Testing
- Rheumatoid Factor (RF)
Determines compatibility of blood and blood
products that are to be administered to patients
• Blood samples from all donors and the recipient
mut be carefully tested before transfusion
IMMUNOHEMATOLOGY (BLOOD BANK)
IMMUNOHEMATOLOGY (BLOOD BANK) example of tests
- Compatibility testing
- Antibody screening
- ABO typing
- Rh Determination
Study of deficiencies related to genetic diseases
CYTOGENETICS
CYTOGENETICS tests
- Chromosome analysis
- Prenatal chromosome screening
Using polymerase chain reaction (PCR)
technologies to study the presence of various
diseases or infections
MOLECULAR DIAGNOSTICS
MOLECULAR DIAGNOSTICS tests
- Detection of Covid-19
- MethicillinO-resistant Staphylococcus aureus
(MRSA) - HIV
• Study of the microscopic structure of tissues
• Evaluation of sample tissues for pathological
diagnosis
HISTOPATHOLOGY
HISTOPATHOLOGY tests
- Biopsy
- Frozen section
- Tissue cutting
- Tissue processing
3 PHASES SAMPLE TESTING
a. Pre-Examination
b. Examination
c. Post- Examination
• All steps that involves collection of samples until
testing of sample
-Clinician’s request
PRE-EXAMINATION
Critical step to ensure remaining phases produce
accurate results
- Patient identification and information
- Correct sample collection
- Correct primary sample identification
- Correct use of all equipment
- Sample preparation or centrifugation
- Proper preparation of sample aliquots
- Maintaining sample integrity
PRE-EXAMINATION
• Set of operations to determine the value
characteristics of a property
• Involves processes done in order to perform the
test
- Sample testing
- Maintaining equipment and reagents
EXAMINATION
•Involves processes whereby results of the testing
are communicated or presented
- Reporting of results
-Ensuring accuracy and reliability of delivery of
results
-Follow-up to repeat testing or address physician
concerns
-Storage of samples after the examination
POST-EXAMINATION
Laboratory Staff
Pathologist
Laboratory manager
medical laboratory scientist
medicsl laboratory technician
phlebotomist
histotechnologist
• Licensed physician with residency in pathology
•Specializes in diagnosing disease using
laboratory results
• Assigned to direct laboratory services
• Manages the laboratory
• “Laboratory Director”
PATHOLOGIST
• Oversees laboratory staff
• Responsible for monthly schedule and proper
staffing
• Prepares necessary documents
• “Chief Medical Technologist”
LABORATORY MANAGER
Holds a baccalaureate degree
•Responsible for performing full range of
laboratory tests
• Able to work in major areas of the laboratory
• Other task:
- Reports results
- Performs quality control
- Evaluate procedures
-Conduct preventive maintenance
- Troubleshoots instruments
MEDICAL LABORATORY SCIENTIST
•Under the supervision of the medical technologist
• Assists medical technologist in general tasks
MEDICAL LABORATORY TECHNICIAN
Collects blood samples to be used in many
laboratory tests
• Acquires training in phlebotomy
PHLEBOTOMIST
Prepares body tissue samples for microscopic
examination by pathologist
• Must hold baccalaureate degrees and have
special training
HISTOTECHNOLOGIST
Implies voluntary and competent permission
• Patient should be given adequate information
regarding method, risks and consequences
• Information should be given in nontechnical
terms
INFORMED CONSENT
variation of informed consent
•Involved in surgery, experimental drugs, genetic
testing or high-risk procedures
•May be given verbally or in writing
EXPRESSED CONSENT
patient’s actions or circumstances imply consent
without a verbal or written expression of consent
• Necessary in emergency procedures
IMPLIED CONSENT
•Minor cannot give consent for the administration
of medical treatment
• Parental or guardian consent is required
CONSENT FOR MINORS
Individual has a constitutional right to refuse a
medical procedure
• Patient who refuses medical treatment is
normally required to verify the refusal in writing on
a special form
REFUSAL OF CONSENT
Result of the test heavily depends on
quality of
sample
Most common error is
clerical
errors in phlebotomy
-name spelled wrongly
-Mislabeled sample
-Incorrect sample tube
• Highest failure is when it causes harm to the
patient
•Methods of monitoring processes that are
providing patient care
QUALITY ASSURANCE
Quality assurance
- Equipment maintenance
- Calibration of equipment
- Phlebotomy Standards
DUTIES AND RESPONSIBILITIES OF A
PHLEBOTOMIST
• Prepare patients and site for specimen collection
• Collect venipuncture and capillary specimens
• Prepare specimens for proper transport
• Transport and dispatch samples efficiently by
prioritizing specimens to ensure desired
turnaround times
• Comply with safety rules, policies, and guidelines
for the area, department, and institution
• Provide quality customer service for all
ADDITIONAL DUTIES AS REQUIRED
• Assist in collecting and documenting monthly
data
• Perform quality-control protocols
• Collect and perform POCT
• Perform appropriate laboratory computer
information operations
• Provide proper instruction to patients/customers
for container specimen collection
• Perform front office duties required by institution
• Train new technicians and students in duties and
responsibilities
PROPER APPEARANCE
•Should communicate cleanliness and
confidence
• Lab coats, when worn, should completely cover
the clothing underneath
• Shoes should be conservative and polished
• Personal hygiene should be observed.
• Strong perfumes or colognes should not be worn.
•Hair and nails should be clean and natural-
looking.
•Fingernails kept short
TELEPHONE ETIQUETTE
1) Answer promptly
2) State your name and department
3) Be helpful
4) Prioritize calls
5) Transfer callers properly
6) Be prepared to record information
7) Know the laboratory’s policies
8) Defuse situations
9) Try to assist everyone
can be exercised on patient’s
behalf by a designated surrogate or proxy
Patient Rights
Patient rights can be exercised on patient’s
behalf by a designated surrogate or proxy when:
-Patient lacks decision-making capacity
-Legally incompetent
-Minor
PATIENT RIGHTS
1) Right to considerate and respectful care
2)Right to obtain information concerning
diagnosis, treatment and prognosis
3) Right to make decisions for plan of care or
course of treatment
4) Right to information for advance directive of well
being
5) Right to privacy
6) Right to review medical records
7) Right to ask and be informed
8) Right to consent of participation or decline to
any pro research/experimentation
9) Right to continuity of care
10) Right to examine and receive explanation of bill
