Introduction to Phlebotomy

Chapter 1
Objectives

• Explain why blood is collected by the

phlebotomist.
• Outline the phlebotomist’s responsibilities to
the patient.
• Explain why the phlebotomist has a special
responsibility to present a neat, pleasant,
and competent demeanor.
Objectives (cont.)
• Identify departments within the hospital and
explain their function.
• Identify each section of the laboratory and
give examples of tests that would be
performed in that section.
• Identify members of the laboratory staff;
describe the duties of each of these staff
members and their education level.
Objectives (cont.)
• Describe the importance of
communication within the laboratory and
that with other departments of the
hospital.
• List five patient rights and tell how they
would affect a phlebotomist’s job.
• Explain advance directives and how they
can direct a patient’s care.
History of Phlebotomy

• Was a cure for disease

– Bleeding removed “bad” blood
History of Phlebotomy (cont.)

• Methods of bleeding:
– Venesection
– Cupping
– Leeches
• Discovery of microorganisms as causative
agent of disease started to change thinking
of how to treat diseases
History of Phlebotomy (cont.)

• Leeches
– Limited uses today
• Bleeding in form of therapeutic phlebotomy
done today for disease polycythemia vera
and hereditary hemochromatosis
 Phlebotomy in Health Care
• Phlebotomist
– Multiskilled
– Known as laboratory representative
Phlebotomy in Health Care (cont.)

• Centralized
– Phlebotomist is part of laboratory team and
dispatched to hospital units to collect blood
samples
• Decentralized
– All members of the health care team share
responsibility to collect blood samples.
 Areas of the Hospital
• Electroencephalography • Nursing
(EEG) • Laboratory
• Electrocardiology (EKG) • Environmental
• Radiology services
• Pharmacy • Administration
• Physical therapy • Food service
• Occupational therapy • Medical records
 Areas of Nursing
• Neonatal • Intensive care
• Obstetrics • Coronary care
• Oncology • Emergency
• Orthopedics • Nephrology
• Pediatrics • Geriatrics
Patient-Focused Care Concept

• Takes laboratory out of physical location

– Brings laboratory to patient
 Areas of the Laboratory

• Phlebotomy • Microbiology
• Chemistry • Immunology
• Hematology • Immunohematology
• Coagulation (blood bank)
• Histology • Cytology
• Urinalysis • Molecular Diagnostics
Phases of Sample Testing

• Preexamination
• Examination
• Postexamination
Phases of Sample Testing (cont.)
• Preexamination
– Previously know as preanalytical phase
– Includes all processes from collecting the
sample to having it ready for testing
Phases of Sample Testing (cont.)
• Examination
– Previously known as analytical phase
– Includes all processes done to sample to
achieve result
Phases of Sample Testing (cont.)
• Postexamination
– Previously known as postanalytical phase
– Process in which the results of the testing
are communicated to the health care
provider
Managed Care
• Coordinates providing health services and
health benefits
• Health maintenance organization (HMO)
• Preferred provider organization (PPO)
Affordable Health Care Act

• Enacted to help those who could not afford

insurance
• Requires all people to have health insurance
Laboratory Staff

• Pathologist
• Medical laboratory scientist
• Medical laboratory technician
• Phlebotomy technician
• Cytotechnologist
• Histotechnologist
Patient Rights

• Patient has right to considerate and

respectful care
• Patient has right to receive understandable
information
• Patient has right to make decisions about
plan of care and refuse treatment
• Patient has right to have an advance
directive
Patient Rights (cont.)

• Patient has the right to privacy

• Patient has the right to confidentiality of his
or her medical records
• Patient has the right to review records
• Patient has right to expect that within its
capacity and policies, a hospital will make
reasonable response to the request of a
patient for appropriate and medically
indicated care and services
Patient Rights (cont.)

• Patient has the right to information regarding

hospital business relationships that might
impact his or her care
• Patient has the right to consent or decline to
participate in proposed research studies
Patient Rights (cont.)

• Patient has the right to expect continuity of

care
• Patient has the right to be informed of
hospital policies and practices that relate to
patient care, treatment, and responsibilities
Professional Attitude

• Everyone must follow professional code of

conduct in treatment of patients
– Includes professional approach to all
aspects of job and professional grooming
and dress
Advance Directives

• Documents written before incapacitating

illness that give instructions about a persons’
health care, if in the future, they cannot
speak for themselves
Regulatory Agencies

• The Joint Commission

• CAP
• State Board of Health
• CLSI
• CLIA
• OSHA
• NAACLS
Quality Assurance

• Quality is phlebotomist’s responsibility

• Result of test sent to physician depends on
quality of sample obtained
• Laboratories must have certain levels of
patient satisfaction to continue receiving
payments from insurance companies
Quality Assurance (cont.)

• Must have quality assurance program, total

quality management program, and
continuous quality improvement program