LESSON 2 INTRO TO PHLEB Flashcards
(t or f) Phlebotomists may be scheduled to work at one
of these areas or patients from these areas may
be referred to the laboratory for sample
collection.
TRUE
May range in size (in terms of bed capacity)
50 to more than 300 beds.
Classification of Hospitals (based on DOH)
According to Ownership
o Public hospitals
o Created by law
o May be under: National Government,
LGU, DOH, State Universities and
Colleges (PGH)
GOVERNMENT
Classification of Hospitals (based on DOH)
According to Ownership
Owned, established, and operated with
funds from donation, principal,
investment, or other means by any
individual, corporation, association, or
organization
o Business in healthcare
private
equipped with the service capabilities
supporting board certified/ eligible medical
specialists in, but not limited to the following:
o Clinical Services (family medicine,
pediatrics, specialty clinics)
o Emergency Services
o Outpatient Services (check-up patients)
o Ancillary and Support Services
(laboratory tests, x-rays, physical
therapy sessions)
general
May be devoted to the treatment of
the following:
o Particular illness/condition requiring a
range of treatment.
o Patients suffering from diseases of a
particular organ/group of organs
o Patients belonging to a group such as
children, women, elderly or others
Specialty
According to Functional Capacity: General Hospitals
➢ Clinical Services for in-patients
▪ Consulting specialists in:
Medicine, Pediatrics, OB-GYNE,
Surgery
▪ Emergency and Out-Patient
Services
▪ Isolation Facilities
▪ Surgical/Maternity Services
▪ Dental Clinic
Level 1
According to Functional Capacity: General Hospitals
➢ Clinical Services for in-patients
▪ Departmentalized Clinical
Services
▪ Respiratory Unit
▪ General ICU
▪ High Risk Pregnancy
▪ NICU
LEVEL 2
According to Functional Capacity: General Hospitals
➢ Clinical Services for in-patients
▪ Teaching/ Training with
accredited residency training in
all 4 major clinical services
▪ Physical Medicine with
Rehabilitation Unit
▪ Ambulatory Surgical Clinic
▪ Dialysis
level 3
➢ Ancillary Services
▪ Secondary Clinical Laboratory
▪ Blood Station
▪ 1st Level X-ray
▪ Pharmacy
LEVEL 1
Ancillary Services
▪ Tertiary Clinical Laboratory
▪ Blood Station
▪ 2nd Level X-Ray with mobile unit
level 2
Ancillary Services
▪ Tertiary Lab with Histopathology
▪ Blood Bank
▪ Level X-ray
level 3
Four Traditional Hospital Services
Nursing Services
support services
Fiscal services
professional services
Deals directly with
patient care
Nursing Services
Ex: communications
systems, food, housekeeping
Support Services
Business Aspect
(Accounting, Admitting, Data Collection
and Health Information Management)
Fiscal Services
Assist the
physician in the diagnosis and treatment
of disease
Professional Services
o Radiology and Diagnostic Imaging
o Radiation Therapy
o Respiratory Therapy
o Nuclear Medicine
o Occupational Therapy
o Pharmacy
o Physical Therapy
o Cardiovascular Testing
o Clinical Laboratory
Professional Service Departments
- Provides data to
the healthcare team to aid in
determining the diagnosis, treatment,
and prognosis of a patient; 80% of
patients’ diagnosis comes from the
clinical laboratory
Clinical Laboratory
- Consist of several primary care physicians or may
specialize in a particular medical specialty such
as pediatrics or cardiology. - Made up of a combination of family practice
physicians and specialists. - Stand alone clinics with laboratories
PHYSICIAN OFFICE LABORATORIES
- Managed care group practice centers that
provide a large variety of services. Physicians’
offices, a clinical laboratory, radiology, physical therapy, and outpatient surgery are often
available at one location. - Members are charged a prepaid fee for all
services performed during a designated time
period. (Usually tied with insurance company.
Ex. Philhealth) - Phlebotomists are employed as part of the
clinical laboratory staff
HEALTH MAINTENANCE ORGANIZATIONS (HMO)
- Large, independent reference laboratories
contract with health health-care providers and
institutions to perform both routine and highly
specialized tests. - Phlebotomists are hired to collect samples from
patients referred to the reference laboratory. - Stand-alone lab that perform specific tests
- Offer test to specific diseases
REFERENCE LABORATORIES
- Independent laboratories that are in contact
with healthcare provider - They perform both routine and highly specialized
tests - Stand-alone laboratories that perform specific
tests for specific diseases - Based on the mandate of department order 393
(2000) - They also offer trainings
National Reference Laboratories (NRL) in the
Philippines:
Reference Laboratories
for hematology and blood-banking
National Kidney Transplant Institute (NKTI)
Reference Laboratories
– for emerging diseases and microbiology
Research Institute for Tropical Medicine (RITM)
Reference Laboratories for clinical chemistry (proteins, glucose, etc.)
Lung Center of the Philippines
Reference Laboratories for toxicology
(drug testing)
east Avenue Medical Center
Reference Laboratories
for sexually transmitted infections
STD-AIDS Cooperative Central Laboratory
(SACCL)
o “…Without any discrimination and
within the limits of the resources…”
o “…Human dignity, convictions, integrity,
individual needs and culture shall be
respected…”
o “…If any person cannot immediately be
given treatment that is medically
necessary he shall, either be directed to
wait for care, or be referred …elsewhere, where the appropriate care can be
provided…”
Right to Appropriate Medical Care and Humane
Treatment
o “Clear, truthful and substantial
explanation, in a manner and language
understandable to the patient, of all
proposed procedures, whether
diagnostic, preventive, curative,
rehabilitative or therapeutic…”
o “…Person who will perform the said
procedure shall provide his name and
credentials to the patient…”
Right to Informed Consent
o “…The patient has the right to demand
that all information, communication,
and records pertaining to his care be
treated as confidential…“
o Exemptions:
▪ If disclosing the information will
be a public health concern
(elected officials and trials in
court)
▪ The information is disclosed to
the parents or guardian only if
the patient is a minor
▪ Not of sound mine
Right to Privacy and Confidentiality
o “…Right to be informed of the result of
the evaluation of the nature and extent
of his/her disease…”
Right to Information
o “…The patient has the right to discuss his
condition with a consultant specialist, at
the patient’s request and expense…”
o “…He also has the right to seek for a
second opinion… from another health
care provider…”
The Right to Choose Health Care Provider and
Facility
o “…The patient has the right to avail
himself/herself of any recommended
diagnostic and treatment procedures
o “…Any person of legal age and of sound
mind may make an advance written
directive for physicians to administer
terminal care when he/she suffers…
terminal illness…”
Right to Self-Determination
o “…The patient has the right to refuse
medical treatment or procedures which
may be contrary to his religious beliefs…
Provided, that such a right shall not be
imposed by parents upon their children
who have not reached the legal age in a
life-threatening situation as determined
by the attending physician or the medical
director of the facility…”
Right to Religious Belief
o “…Provided, That, an institutional review
board or ethical review board in
accordance with the guidelines set in the
Declaration of Helsinki be established for
research involving human
experimentation…”
Right to Refuse Participation in Medical
Research.
A wrongful act committed by one person
against another that causes harm to the person
or his or her property
Tort Law
Intentional Tort
Assault, Battery, Defamation
– threat to touch
another person without his or
her consent and with the
intention of causing fear of
harm.
Assault
actual harmful
touching of a person without his
or her consent.
Battery
– spoken or written
words that can injure a person’s
reputation. Ex. Releasing or are
overheard saying any
confidential information
Defamation
types of defamation
libel and slander
2 types of Unintentional Tort
Negligence and Medical Malpractice
false defamatory
writing that is published
libel
false and
malicious spoken word
slander
– as failure to give
reasonable care by the health
care provider, must be proven in
a malpractice suit
• Duty
• Breach of Duty
• Causation
• Damages
Negligence
misconduct or lack of skill by a
health care professional that
results in injury to the patient
Medical Malpractice
is the violation of the
patient’s right to be left alone and the right to be
free from unwanted exposure to public view. Ex.
Unwanted releasing of confidential information
and entering a patient’s room without asking
permission
Invasion of Privacy
➢ Cytology Section
➢ Histopathology/Histology Section
➢ Cytogenetics
Anatomical Area
process and examine
tissue and body fluids for the presence
of abnormal cells, such as cancer cells.
o The Papanicolaou (Pap) smear –
common test performed for women
Cytology Section
process and stain tissue from biopsies, surgery, autopsies, and frozen sections
o A pathologist then examines the tissue
Histopathology/Histology Section
o Chromosome studies are performed to
detect genetic disorders
Cytogenetics
➢ Hematology ➢ Coagulation ➢ Clinical Chemistry ➢ Blood Bank (Immunohematology)
Clinical Area
o Cellular elements, red blood cells (RBCs),
white blood cells WBCs), and platelets
Plts) are enumerated and classified in all
body fluids and in the bone marrow.
Hematology
o Overall process of hemostasis is
evaluated this includes platelets, blood
vessels, coagulation factors (bleeding
and clotting time), fibrinolysis,
inhibitors, and anticoagulant therapy
(heparin and Coumadin)
Coagulation
o Most automated area in the laboratory
o May perform electrophoresis (uses gel
media for analytes), therapeutic drug
monitoring (antibiotics) and enzyme
immunoassays to measure substances
such as proteins, carbohydrates,
enzymes and hormones and toxicology.
Clinical Chemistry
o Where blood may be collected, stored,
and prepared for transfusion.
o Testing procedures involve RBC antigens
(Ag) and antibodies (Ab).
o Blood from patients and donors is tested
for its blood group (ABO) and Rh type.
Also tests compatibility (crossmatch)
between patient and donor
o Detect and identification of abnormal
antibodies
Blood Bank (Immunohematology)
o Performs tests to evaluate the body’s
immune response; that is, the
production of antibodies
(immunoglobulins) and cellular
activation
Serology (Immunology)
o Responsible for the identification of
pathogenic microorganisms and for
hospital infection control In large
laboratories, the section may be divided
into bacteriology, mycology,
parasitology, and virology
o Common Tests include Culture and
Sensitivity and Gram Staining
Microbiology
may be a separate laboratory
section or a part of the hematology or
chemistry sections
o Routine screening procedure to detect
disorders and infections of the kidney
and to detect metabolic disorders
o Consists of physical, chemical, and
microscopic examination of the urine
Urinalysis
specialist in the study
of disease and works in both clinical
pathology and anatomical pathology.
o Acts as a consultant to physicians
o Has direct responsibility all areas of the
laboratory
o Responsibilities include working with the
laboratory administrator to establish
laboratory policies, interpret test
results, perform bone marrow biopsies
and autopsies, and diagnose disease
from tissue specimens or cell
preparations
Laboratory Director (Pathologist)
o Responsible for overall technical and
administrative management of the
laboratory o Usually a medical laboratory scientist
(MLS) with a master’s degree and 5 or
more years of laboratory experience.
Laboratory Manager (Administrator) or Chief
Medical Technologist
MLS with experience and expertise
related to the particular laboratory
section or sections often have specialty
certifications on each section
o Responsibilities of the technical
supervisor include:
▪ Reviewing all laboratory test
results
▪ Consulting with the pathologist
on abnormal test results
▪ Scheduling personnel
▪ Maintaining automated
instruments
▪ Preparing budget
▪ Maintaining reagents and
supplies
▪ Orienting, evaluating, and
teaching personnel
▪ Providing protocols for new test
procedures.
Technical Supervisor or Section Head
o Has a bachelor’s degree in medical
technology and 1 year of training in an
accredited medical technology / clinical
laboratory science program.
o Performs laboratory procedures that
require independent judgment and
responsibility with minimal technical
supervision
o Maintains equipment and records
performs quality assurance and
preventive maintenance activities
related to test performance setting
Medical Laboratory Scientist
o Performs routine laboratory procedures
according to established protocol under
the supervision of a technologist,
supervisor, or laboratory director
o Duties
▪ Collecting and processing
biological samples
▪ Performing routine analytic
tests,
▪ Recognizing factors that affect
test results
▪ Recognizing and reporting
abnormal results
▪ Recognizing and reporting
equipment malfunctions
▪ Demonstrating skills to new
employees and students
Medical Laboratory Technician
o Collects blood from patients for
laboratory analysis.
o Usually has completed a structured
phlebotomy training program.
o Trained to identify the patient properly,
obtain the correct amount of blood by
venipuncture or microtechnique
Phlebotomist
to cut a vein”
- Greek “Phelb” (vein) and “tomia” (to cut
Phlebotomy
t or f
The earliest forms of phlebotomy can be traced
all the way back to the ancient Egyptian, ancient
Greek and Roman cultures
TRUE
Phlebotomy was called
“Bloodletting”
t or f
Draining blood, in ancient times, was considered
one way to effectively cure the body of most ills
(often described as “bad spirits”) and was often
performed using a lancet tool
true
prohibited clergyman
from performing these bloodlettings
1163 – Pope Alexander III
• Speak loudly and clearly Look directly at patient to
facilitate lip-reading
• Communicate in writing
Hearing
Impairment
Speak calmly and slowly
• Do not appear rushed or disinterested
Patient
Emotions
• Avoid medical jargon, you are collecting a blood sample
rather than performing a phlebotomy
• Use age-appropriate phrases
Age and
Education
Levels
• Locate a hospital-based interpreter
• Use hand signals, show equipment, etc.
• Remain calm, smiling, and reassuring
Non-English- speaking
