Phlebotomy : A compentency-based approach Flashcards
What is plhebotomy
cut into a vein (phleobs- vein, and tome - to cut)
What percent of medical decisions are based on lab results?
70%
What is the primary role of phlebotomists?
- obtain blood specimens for testing
What do blood specimens test (list)
- levels of glucose, proteins, drugs ot blood cell countrs, atibodies, and infectious diseases
How to obtain blood?
- venipuncture or dermal (capillary) puncture
What are the 2 pairs of interchangelabe terms?
phlebotomy and venipuncture
dermal puncture and capillary puncture
When does the process of removing blood go back to
1400 BC (egyptians used leeches)
hipporates thought bloodletting rid body of impurities
What are barbers history with phlebotomy?
- they performed bloodletting procedures
- barber pole is linked to bloodletting : red = blood and white = bandage, pole = stick pt squeezed to make veins prominent
(Europe have red and white poles and America has RWB (blue = vein or patriotism)
usage of leeches in past?
- prescribed to remove blood that collected at newly transplanted tissue sites and to decrease the swelling following microsurgery (reconstruciton of small tussue structures)
- have anti coagulant and vasodilation properites
- now have medicinal leeches
What is venesection
- vein is pierced with sharp object (lancet) to drain blood
- thought to be effective at removing unwanted diseases from body
George washington and bloodletting
death of George Washington was believed to be the result of
excessive bloodletting in an attempt to treat a throat infection.
What is cupping?
- vacuum effect by pulling blood to capiullaries under heated glass
- then had a spring-loaded blox with multiple blades piercing skin to bleed (scards!)
who drew blood before phlebotomists?
- medical laboratory scientists (MLSs, formerly known as medical technologists) and medical laboratory technicians (MLTs) were responsible for collecting blood specimens
who established the princiupples and techniques phlebotomists must demosntrate mastery of?
- clinical and laboratory standards institute (CLSI)
role of phlebotomist?
- colleciton, processing, and transportation of blood specimes
- known as pre-examination
- removal of blood from donors with polycythemia
- may instruct patient on how to collect urine or fecal speciemn, and package blood, urine, fecal, cultures, and body fluids
- accepting incoming specimens, logging in specimes,routing specimens to proper departments
- quyality control testing and varical clinical and clerical duties
What is patient advocacy
- assist patients who are confused or overwhelmed by their healthcare needs and help them through the helathcare system (schedule appt, directions)
What is Point of care testing (POCT) + example
- performed at pt bedside or work area with portable instruments
- ex: blood glucose monitoring
- allow physician to diagnose quicker, speed up hosptial time
What must a phlebotomist must be familiar with?
- process, equipment, variables in venipuncture and dermal puncture (how to perform procuedres and handle specimen)
Table - duties and responsibilites of the phlebotomist?
Demonstrate professional attire, attitude, and communications
* Observe all safety regulations
* Know and follow the facility’s policies and procedures
* Properly identify patients
* Collect both venous and capillary blood specimens
* Select the correct specimen container for the specified tests
* Properly label, handle, and transport specimens following departmental policies
* Sort specimens received and process specimens for delivery to laboratory departments
* Perform computer operations and/or update log sheets where required
* Perform point-of-care testing and quality control checks
What is phlebotomy training ?
- hs diploma or equivalent
- training programs at hospital, tech and private schools, and community colleges
What agencies establish approved programs standards?
National Accrediting Agency for Clinical
Laboratory Sciences (NAACLS) and American Medical Technologists
(AMT)
What are phlebotomist role in inpt facilities
- hospital, nursing homes, rehab centers
- part of mmedical alb staff or PCTs
- physicians order tests to assist with eval of pt condition and phleb label, collect and transport
What are phlebotomist role in outpt facilities + ex of location
- physician offices, amulatory care centers, blood collection center, home healthcare, vet offices, health maintenance organizations (HMOs), American red corss, insurance companies
- collecting and processing blood specimens (resposiblities can differ)
What is the fastest growing outpatient setting ?
- amublatory care centers : walk-in facilities that patients can go to not only during the day but also after business hours and on weekends, when most physician offices are closed
What do phleb in ambulatory care centers do?
- chemistry, hematolgoy, urinalysis, serology,coagulation studies, and microbiology tests for minor conditions (sore throat, UTI, therapeutic drug monitoring)
- provide instructions to pt on how to collect urine, fecal, etc material
- obtain vital signs and transport pt
Role of phleb in physicians offices
- collecting and labeling variety of speicmen and transport ot reference lab (off site lab)
- pysican office lab may perform only basic lab tests according to certification by Clinical Laboratory Improvement Amendments (tests w/ small amt of erroneous results)
- basic tests include cholestoerl and nasal smears
Who are part of healthcare team
- Anesthesiology (anesthesiologists and nurse anesthetists)
- cardiology
- diagnositc imaging (radiology) (radiologic technicians and technologists)
- electrocardiography (nurses, med assistants, ECG tech)
- EEG (nurses and EEG tech, neurologists)
- emergency department
- endocrinolgoy
- general med (Physician, PA, NP)
- geriatrics (geronotolgists)
- internal med (osteopathic, PA< NP)
- nwonatology
- nephrology (nephrologists or urologists)
- neurology
- nuclear med
- nutrition and dietics
- ob/gyn
occupatoinal therapy - oncology
- orthoipedics
- pathology (medical lab personal often work close with)
- pediatrics
- pharmacy
- physical therapy
- psychiatry
- respiratory therapy
- surgery
- urology
What are hospital lab divided into?
- clinical pathology : lab analysis of body fluids and body tissues
- anatomical pathology : surgical specimens and sometiems autopsy
lab director vs pathologist
- lab director : administrative med lab sciensits
- pathologist : in charge of anatomical or clinical portion of lab
who is the lab director/ administrator clinical pathology in charge oif
- blood bank section supervisor
- clinical chemistry section supervison
- hematologysection supervisor
- microbiology section supervision
- Specimen Procurement Section Supervisor (phlebotomists, specimen processors)
What ar ehte specialties of medical labratory specialities?
- cytologu - look for cancer (main is pap smears)
- histology (human body tissues and cells - surgical specimens)
- cliniical chemistry (chemical constituents - enzymes, glucose, hormones, lipids, proteins, vitaminds, iron + nutrients, drugs, elements)
- hematology - study of blood and blood foring tissues
- immunohematology (blood bank) (donor transfusion)
- immunology and serology - body’s resistance to disease and foreign substances
- medical microbiology - microscopic organism
- molecular diagnostics - classification of diseases usign molecular and DNA testing
- toxicology (chemical on live organisms)
- urinalysis
What does hematolgoy include
complete blood counts, coagulation tests, bone marrow analysis, body fluid cell counts, and special tests for red blood cell and white
blood cell disorders.
What does immunohematolgy include
- screen donors and collect blood
- blood group, type analysis, cross-match, prepare and issue blood products, transfusion reaction investigations