1 phlebotomy: past and present and the healthcare setting

1

Phlebotomy: Past and Present and the Healthcare Setting

OBJECTIVES3. Compare types of healthcare institutions and the

methods used by providers for coverage.

4. List the personnel levels in the clinical analysis areas of the laboratory and the types of laboratory procedures performed in each of the areas.

Study the information in your TEXTBOOK that corresponds to each objective to prepare

yourself for the activities in this chapter.

1. Demonstrate basic knowledge of terminology for healthcare settings including the national healthcare organizations that contributed to the evolution of phlebotomy and the role of the phlebotomist today.

2. Describe the basic concepts of verbal and nonverbal communication as they relate to the professional image and proper telephone protocol in healthcare.

1

Unit I. The Healthcare Setting

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2 Unit I The Healthcare Setting

MATCHINGUse choices only once unless otherwise indicated.

MATCHING 1-1: KEY TERMS AND DESCRIPTIONSMatch the key term with the best description.

Descriptions

A. A system of moral principles that govern conductB. Another name for outpatientC. Biases that are major obstructions to verbal

communicationD. Centers for Medicare and Medicaid ServicesE. Clinical Laboratory Improvement Amendments of

1988F. Conforming to a standard of right and wrong

conductG. Current procedural terminology codesH. Evidence that an individual has mastered

competencies in a technical specialtyI. Healthcare workersJ. Health Insurance Portability and Accountability ActK. Health maintenance organizationsL. International Association for Continuing Education

and TrainingM. International Classification of Diseases, 10th

RevisionN. Laboratory department that typically performs the

most testsO. Laboratory department that performs tests to

identify chromosome deficienciesP. Laboratory department that studies cells to detect

malignant and premalignant conditionsQ. Laboratory department where type and screen tests

are performedR. Laboratory department that performs protime testsS. Organization that published The Patient Care

Partnership brochureT. The study of blood and blood-forming tissuesU. The study of the microscopic structure of the tissueV. Type of test performed in the microbiology

departmentW. Units awarded for participating in continuing

education activitiesX. Verbal and nonverbal messages that do not match

Key Terms

1. ______ AHA

2. ______ Ambulatory

3. ______ Blood bank/immunohematology

4. ______ C&S

5. ______ Certification

6. ______ CEUs

7. ______ Chemistry

8. ______ CLIA ’88

9. ______ CMS

10. ______ Coagulation

11. ______ Communication barriers

12. ______ CPT

13. ______ Cytogenetics

14. ______ Cytology

15. ______ Ethical behavior

16. ______ Ethics

17. ______ HCWs

18. ______ Hematology

19. ______ HIPAA

20. ______ Histology

21. ______ HMOs

22. ______ IACET

23. ______ ICD-10-PCS

24. ______ Kinesic slip



Chapter 1 Phlebotomy: Past and Present and the Healthcare Setting 3

Descriptions

A. A patient’s main source of routine medical careB. An agency that approves phlebotomy programsC. Another name for inpatientD. Care by a specialistE. Entity that pays for healthcare services on behalf of

a patientF. Federal and state health insurance program for

eligible low-income AmericansG. Federal health insurance program for seniors who

are 65 and olderH. Highly specialized careI. Laboratory department that identifies antigens and

antibodiesJ. Laboratory department that performs culture and

sensitivity (C&S) testingK. Laboratory department with the same name as the

most common test it performsL. Large independent laboratories that test specimens

from many different facilitiesM. Managed care organizationsN. Medical laboratory scientistO. Medical laboratory technicianP. Preferred provider organizationsQ. Promotes and administers programs for public

healthR. Protected health informationS. Study of an individual’s concept of and use of

spaceT. Study of nonverbal communicationU. Term with the same meaning as venesectionV. Turnaround time

Key Terms

25. ______ Kinesics

26. ______ MCOs

27. ______ Medicaid

28. ______ Medicare

29. ______ Microbiology

30. ______ MLS

31. ______ MLT

32. ______ NAACLS

33. ______ Nonambulatory

34. ______ PHI

35. ______ PHS

36. ______ Phlebotomy

37. ______ PPOs

38. ______ Primary care

39. ______ Proxemics

40. ______ Reference laboratories

41. ______ Secondary care

42. ______ Serology/immunology

43. ______ TAT

44. ______ Tertiary care

45. ______ Third-party payer

46. ______ UA

MATCHING 1-2: CERTIFICATION AGENCIESMatch the certification agency with the title awarded. A title may be used more than once.

Title Awarded

A. RPTB. CPTC. PBTD. NCPT

Certification Agency

1. ______ American Society for Clinical Pathology

2. ______ American Medical Technologists

3. ______ National Center for Competency Testing

4. ______ American Certification Agency




MATCHING 1-3: METHODS OF PAYMENT AND DIAGNOSIS CODINGMatch the methods of payment and diagnosis coding with the appropriate definition.

Definitions

A. Begun in 1983 to limit and standardize the Medicare/Medicaid payments made to hospitals

B. Reimburses healthcare facilities a set amount for each patient procedure using established disease categories

C. A classification system implemented in 2000 for determining payment to healthcare facilities for Medicare and Medicaid patients only

D. Traditional payment model of reimbursement for healthcare service after service is rendered

E. A procedural classification system for use in U.S. hospitals with a broad range of codes and greater specificity

Method of Payment and Diagnosis Coding

1. ______ Ambulatory patient classification

2. ______ ICD 10th Revision

3. ______ Fee for service

4. ______ Diagnosis-related groups

5. ______ Prospective payment system

MATCHING 1-4: LABORATORY TESTS AND DEPARTMENTSMatch the laboratory tests with the departments that perform them using the letters shown below. Departments can be used more than once.

Laboratory Departments

B. Blood bankC. ChemistryCo. CoagulationCy. CytologyH. HematologyI. ImmunologyM. MicrobiologyU. Urinalysis

1. ______ BUN

2. ______ PT

3. ______ Hct

4. ______ WBC

5. ______ Nitrites

6. ______ ANA

7. ______ Fibrinogen

8. ______ ALT

9. ______ d-dimer

10. ______ Pap smear

11. ______ Blood culture

12. ______ EBV

13. ______ Type and Rh

14. ______ Gram stain

15. ______ DAT

Laboratory Tests

16. ______ Immunoglobulins

17. ______ Creatinine

18. ______ aPTT

19. ______ Plt ct

20. ______ hs-CRP

21. ______ pH

22. ______ Occult blood

23. ______ Urobilinogen

24. ______ Potassium

25. ______ diff

26. ______ Hgb

27. ______ Electrolyte panel

28. ______ Blood glucose

29. ______ HIV NAAT

30. ______ Specific gravity




MATCHING 1-5: PATIENT CONDITIONS AND MEDICAL SPECIALTIESMatch the specialties with types of patient conditions they serve. One choice will not be used.

Medical Specialties

A. Allergy and immunologyB. AnesthesiologyC. CardiologyD. DermatologyE. Emergency medicineF. EndocrinologyG. Family medicineH. GastroenterologyI. GerontologyJ. HematologyK. Infectious diseasesL. NephrologyM. NeurologyN. OncologyO. OphthalmologyP. PediatricsQ. PsychiatryR. Pulmonary medicineS. RheumatologyT. Sports medicineU. Urologist

Patient Conditions

1. ______ Tumors, benign and malignant

2. ______ Eye examinations

3. ______ Endocrine gland disorders

4. ______ Diseases of the heart

5. ______ Disorders of the brain and spinal cord

6. ______ Well checkups for children

7. ______ Kidney function

8. ______ Urinary tract disease

9. ______ Conditions of the skin

10. ______ Emergency care due to accident

11. ______ Injuries resulting from athletic activities

12. ______ Respiratory system conditions

13. ______ Inflammation and joint diseases

14. ______ Contagious, pathogenic infections

15. ______ Disorders of the blood

16. ______ Disorders causing hypersensitivity

17. ______ Aging and age-related disorders

18. ______ Clinical depression

19. ______ Digestive tract disorders

20. ______ Continuous, comprehensive care




LABELING EXERCISESLABELING EXERCISE 1-1: VERBAL COMMUNICATION BARRIERSUsing the TEXTBOOK, identify six barriers in the communication loop diagram that interrupt the message being sent to the receiver. Write the answers in the “Receiver” column. Identify six communication barriers that interrupt the feedback being sent to the sender. Write the answers in the “Sender” column.

Receiver

1.

2.

3.

4.

5.

6.

Message

Feedback

Encoded

Communication loop

Sender

BarriersBarriers

Receiver

Decoded

Sender

1.

2.

3.

4.

5.

6.




LABELING EXERCISE 1-2: NONVERBAL FACIAL CUESLabel each of the sketches below with the correct facial cue from the following list. Answers may be used more than once.

• Surprise

• Fear

• Sadness

• Happiness

• Anger

• Disgust

A. B. C.

D. E. F.

G. H. I.

LABELING EXERCISE 1-3: LABORATORY ORGANIZATIONAL CHARTFill in the names of the major divisions in a typical laboratory organizational chart.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Department of laboratory medicine and pathologyLaboratory Administrator/Director

1. 2. 3.

4. 5. 6. 7.

8. 9. 10.

Histology

Cytology

Surgicalpathology

Outpatientservice

NursingPOCT

Transfusionmedicine

Toxicology

Therapeuticdrugmonitoring

Moleculardiagnostics

Coagulation

Immunology

Urinalysis

Bacteriology

Mycology

Virology

Parasitology

HLA

Stem cellanalysis

Phlebotomy

Centralprocessing




KNOWLEDGE DRILLSKNOWLEDGE DRILL 1-1: CAUTION, FYI AND KEY POINT RECOGNITIONThe following sentences have been taken from caution and key point statements found throughout Chapter 1 of the textbook. Using the TEXTBOOK, fill in the blanks with the missing information.

1. By recognizing and appreciating (A) _________________, the phlebotomist promotes (B) _________________

_________________ and harmonious relationships that directly improve health (C) ________________, the (D)

_______________ of services, and (E) ________________ satisfaction.

2. The (A) _________________ phrase primum non nocere, which means “first do no harm” describes one of the

fundamental (B) __________________ of healthcare. Although it does not include this (C) _________________

_______________, the promise “to abstain from doing harm” is part of the (D) ________________________ oath

taken by new physicians and other (E) __________________ professionals as they begin their practice.

3. To (A) __________________ effectively with someone, establish good (B) _______________ _______________.

A patient or client may be made to feel (C) ___________________ and more like an (D) _____________ rather

than a human being if no eye contact is established.

4. Phlebotomists will find that when dealing with (A) ________________ who are (B) _________________ or

(C) __________________, a confident and professional (D) ____________________ will be most (E)

__________________ to them in doing their job.

5. An important (A) ___________________ in ensuring that the healthcare system as a whole is (B)

___________________ is the (C) ________________ _______________ physician (PCP). It has been shown that

(D) ___________________ primary care results in better health outcomes and lower spending, including

avoidable (E) ________________ _______________ visits and hospital care.




KNOWLEDGE DRILL 1-2: SCRAMBLED WORDSUnscramble the following words using the hints given in parenthese and the letters that have been placed in the correct boxes. Finish writing the correct spelling of the scrambled word in the corresponding boxes.

1. deadmici (healthcare for the poor)

d i

2. enscikis (involves body language)

i s

3. fracitinecito (an indication of competency)

c i i

4. gloomyheat (laboratory area that counts blood cells)

m l

5. irebrar (message obstruction)

r r

6. mexicrops (involves one’s concept of space)

o m

7. ratyitre (highly complex care)

r y

8. shymictre (most laboratory tests are this type)

e m

9. sneeviconte (phlebotomy)

v n

10. troblumaya (describes most outpatients)

b a

11. glutaniocoa (tests that detect clotting problems)

g i

12. scithe (moral standards)

s




KNOWLEDGE DRILL 1-3: TRUE/FALSE ACTIVITYThe following statements are all false. Circle the one or two words that make the statement false and write the correct word(s) that would make the statement true in the space provided.

1. One CEU equals 20 contact hours of participation in an organized experience under responsible sponsorship, capable direction, and qualified instruction.

2. A continued awareness and knowledge of cultural differences by all employees can protect an organization from OSHA and HIPAA violations, promote an inviting workplace, and increase innovation and teamwork.

3. Ethics are centered on an individual’s emotions.

4. All patients in a healthcare setting have rights but do not have to be informed of these rights when care is initiated.

5. Safeguarding the correctness of protected health information (PHI) is one of the primary aims of The Joint Commission’s privacy rule.

6. The Latin phrase primum non nocere, which means “do not ignore the patient” describes one of the fundamental principles of healthcare.

7. Most phlebotomists’ work is in the personal zone as they search and palpate to find a vein and perform venipuncture.

8. Today, assisted living centers are a way to decrease the overcrowded emergency rooms and provide significant savings to patients and insurers.

9. An important component in ensuring that the healthcare system is sustainable is the specialist physician.

10. Certification is a required process by which a hospital grants recognition to an individual who has met certain prerequisites in a specific technical area.

11. Histology is defined as the study of the microscopic structure of cells.

12. Virology is a subsection of immunology.

13. A white blood cell count (WBC) is an example of a cytology test.

14. A risk panel for cardiovascular assessment would be performed in the coagulation department.

15. Histology is part of the clinical analysis division of a traditional laboratory.

KNOWLEDGE DRILL 1-4: HISTORICAL PHLEBOTOMY EVENTSNumber the following events in chronological order from 1 to 5, with 1 being the earliest recorded event.

A. _____ Leeching was widely practiced in Europe, especially France.

B. _____ “Short robe” surgeons used cupping and leeching to extract blood.

C. _____ Microsurgeons use leeching to lessen the complications of surgery.

D. _____ Hippocrates used bloodletting to cleanse the body of impurities.

E. _____ Physicians used a procedure called venesection to treat George Washington.




KNOWLEDGE DRILL 1-5: INPATIENT/OUTPATIENT FACILITYWrite the correct category (outpatient or inpatient) of healthcare facility in the line provided before the statement description.

1. __________________ Principal source of healthcare services for most people

2. __________________ Highly complex services

3. __________________ Requires that patients stay overnight or longer

4. __________________ Center of the American healthcare system

5. __________________ Same-day surgical procedures

6. __________________ Physician’s office care

KNOWLEDGE DRILL 1-6: MEDICARE/MEDICAID PROGRAMSWrite the correct program name (Medicare or Medicaid) in the line provided before the statement description.

1. __________________ Funds come from federal grants

2. __________________ An entitlement program

3. __________________ Provides medical assistance to the poor

4. __________________ Program administered by the state

5. __________________ Coverage includes choices called Part A and Part B

6. __________________ Financed through social security deductions

KNOWLEDGE DRILL 1-7: PROFESSIONAL ATTITUDEAfter each characteristic listed below, define and describe how this quality contributes to your professional attitude:

1. Self-confidence __________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

2. Self-motivation __________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

3. Compassion _____________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

4. Dependability ___________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

5. Ethical behavior _________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

6. Integrity ________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________




SKILLS DRILLSSKILLS DRILL 1-1: REQUISITION ACTIVITYA test requisition contains the following test abbreviations. Write the complete name of the test and the department that will perform the test on the corresponding line next to the abbreviation.

Any Hospital USA1123 West Physician Drive

Any Town USA

Laboratory Test Requisition

PATIENT INFORMATION:

Name: Smith Jane R

Identification Number: 09365784 Birth Date:

Referring Physician: Coleman

Date to be Collected: 08/11/19 Time to be Collected: 0600

Special Instructions: line draw only

TEST(S) REQUIRED:

(last) (first) (MI)

06/21/67

TESTABBREVIATION

1. RBC

2. Hgb

3. FDP

4. BUN

5. PT

6. CBC

7. AST

8. RF

9. UA

10. C&S

TEST NAME DEPARTMENT




SKILLS DRILL 1-2: WORD BUILDING (See Chapter 4, Medical Terminology)Divide each of the words below into its elements (parts): prefix (P), word root (WR), combining vowel (CV), and suffix (S). Write the word element and its definition on the corresponding lines. Write the general meaning of the word in the space provided. If the word does not have a certain element, write “NA” (not applicable) in its place. (See Chapter 4 of the TEXTBOOK for word element definitions and examples.)

Example: pathology Elements NA / path / o / logy

P WR CV S

Definitions / disease / / study of

Meaning: study of disease

1. nephrology

Elements / / / P WR CV S

Definitions / / /

Meaning:

2. phlebotomy


Definitions / / /

Meaning:

3. polycythemia

Elements / / / / P WR CV WR S

Definitions / / / /

Meaning:

4. hematology


Definitions / / /

Meaning:

5. erythrocyte


Definitions / / /

Meaning:

6. dermatologist


Definitions / / /

Meaning:




SKILLS DRILL 1-3: PROPER TELEPHONE ETIQUETTEFill in the blanks of the following table with the missing information.

Proper Etiquette Communication Tips Rationale

Answer

(1) ______________.

• If the phone is allowed to ring too many

times, the caller may assume that the people

working in the laboratory are inefficient or

(2) ______________.

State your name and

department.

• The caller has the right to know to whom he or

she is speaking.

Be helpful. Ask how you can be of help to the

(3) ______________, and facilitate

the conversation.

Keep your statements and answers

simple and to the point to avoid

confusion.

• When a phone rings, it is because someone

needs something. Because of the nature of

the healthcare business, the caller may be (4)

______________ and may benefit from hearing a

calm, pleasant voice at the other end.

(5) _____________

calls.

Inform a caller if he or she is

interrupting a call from

someone else.

Always ask permission before

putting a caller on hold in case

it is a(n) (8) ______________ that

must be handled immediately.

• It takes a(n) (6) ______________ person to

coordinate several calls. Being able to triage is

an important (7) ______________ that takes a

knowledgeable and experienced person to handle

well.

• The caller needs to know where he or she is

in the queue. Handling an important call or an

emergency (9) ______________ will save the

laboratory from problems in the future.

Transfer and

put callers (10)

____________

properly.

Tell a caller when you are going to

transfer the call or put it on hold,

and learn how to do this properly.

Note: Do not leave the line open,

and do not keep the caller waiting

too long.

• Disconnecting callers while transferring or

putting them on hold (11) ______________ them.

• Leaving the line open, so that other conversations

can be heard by the person on hold is discourteous

and can compromise (12) ______________.

• (13) ______________ back with a caller when on

hold for longer than expected; this keeps him or

her informed of the circumstance.

• If a caller is waiting on hold too long, ask if he or

she would like to leave a(n) (14) ______________.




Be prepared to

record information.

Have a pencil and paper close to

the phone.

Listen (15) ______________, which

means clarifying,

(17) ______________, and

summarizing the information

received.

• Documentation is necessary when answering the

phone at work to ensure that

(16) ______________ information is transmitted

to the necessary person.

• Reading back the information when complete is

one of best ways to

(18) ______________ it is correct.

Know the

laboratory’s

policies.

Make answers consistent by

learning the laboratory’s policies.

• People who answer the telephone must know the

laboratory (19) ______________ to avoid giving

the wrong information. Misinformation given to

the caller can result in unnecessary worry and

additional expense.

• (20) ______________ answers help establish

the laboratory’s credibility because a caller’s

perception of the laboratory involves more than

just accurate test results.

Defuse

(21) ____________

situations.

When a caller is hostile, you might

say, “I can see why you are upset.

Let me see what I can do.”

• Some callers become angry because of lost

results or errors in billing.

• (22) ______________ a hostile caller’s

(23) ______________ will often defuse the

situation.

• After the caller has calmed down, the issue can

be addressed.

Try to assist

everyone.

If you are uncertain, refer the

caller to someone who can

address the caller’s issue.

Remind yourself to keep your

attention on (25) ______________

______________ at a time.

• It is possible to assist callers and

(24) ______________ ______________ even if you

are not actually answering their questions.

• Validate callers’ requests by giving a response

that tells them something

(26) ______________ ______________ done.

• (27) ______________ interest in the caller will

enhance communication and contribute to the

good (28) ______________ of the laboratory.




SKILLS DRILL 1-4: TWO CATEGORIES OF HEALTHCARE FACILITIES

Outpatient Inpatient

• (1) ______________ source of healthcare services

for most people.

• Offers (3) ______________ care in the physician’s

office to (4) ______________ care in a freestanding

ambulatory setting.

• Serves (6) ______________ care physicians who

assume (7) ______________ responsibility for

maintaining patients’ health.

• Serve (8) ______________ care physicians

(specialists) who perform routine surgery,

(12) ______________ treatments, therapeutic

radiology, and so on in same-day service centers.

• The key resource and (2) ______________ of the

American healthcare system.

• Offer specialized instrumentation and technology to

assist in unusual diagnoses and treatments.

• Serves (5) ______________ care (highly complex

services and therapy) practitioners. Usually requires

that patients stay overnight or longer.

• Examples are acute care hospitals, nursing

homes, (9) ______________ care facilities,

(10) ______________, and (11) ______________

centers.




ACROSS 1. Federal healthcare program for persons 65 years of

age and older 6. Occupational Safety and Health Administration

(abbrev.) 8. Personalized filters or biases 10. Internationally recognized standard formula for PT

results 11. Electroencephalogram (abbrev.) 12. Protected health information (abbrev.) 14. State of being varied or different 17. Cervical smear for cancer cells 18. Complete blood counts (abbrev.) 19. Continuing education unit (abbrev.) 20. Centers for Medicare and Medicaid (abbrev.) 22. Identifying with the feelings of another person 23. Therapeutic _____, nonverbal communication 26. Prepaid managed care group practice 27. Disseminated intravascular coagulation (abbrev.) 29. Intensive care unit (abbrev.) 31. Coagulation test used to detect heparin 34. Hemoglobin (abbrev.) 35. Urinalysis (abbrev.) 36. “Blood ________” to rid body of evil spirits 38. Health maintenance organization (abbrev.) 39. Word meaning “immediate” 41. Emotion brought on by feeling out of control 42. Alanine aminotransferase (abbrev.)

DOWN 1. Hemoglobin concentration in RBCs (abbrev.) 2. Standard or requirement for a technical specialty 3. Registered nurses (abbrev.) 4. Wrongful act committed against one’s person 5. Study of nonverbal communication 7. Condition of decreased RBCs in blood 8. Basic metabolic panel (abbrev.) 9. Standards of right or wrong conduct 13. Federal HC program for the indigent 15. Unquestioning belief in the HCW’s ability 16. ________ stain for bacteria 21. American Hospital Association (abbrev.) 22. Complete removal of all blood 24. Occupation therapy (abbrev.) 25. Organization that offers continuing education 26. Federal law that protects patient confidentiality 28. Personal standard of honesty 30. __________ medicinalis 32. Stool sample may show this stage of a parasite 33. To confirm specific qualifications have been met 36. Laboratory information system (abbrev.) 37. Phlebotomy certifying agency that united with ASCP 38. Hematocrit (abbrev.) 40. Turnaround time (abbrev.)

CROSSWORD1

22

25

26

36

41

37 38

39 40

42

33

34 35

27 28

31 32

23 24

2

18 19

20 21

3 4

65

1098

12

16

13

14

29 30

15

17

7

11




1. In the 17th century, the name given to the bloodletting tool or lancet wasa. cup. c. fleam.b. hemostat. d. leech.

2. A factor that contributes to the overall professional impression made by the phlebotomist isa. compassion. c. dependability.b. self-confidence. d. all of the above.

3. After successful completion of the American Medical Technologists phlebotomy examination, the initials for the title granted area. CPT. c. PBT.b. CLT. d. RPT.

4. Understanding the ____________ of a diverse population is important in providing healthcare.a. history c. traditionsb. motivation d. All the above

5. The evidence that an individual has mastered fundamental competencies in his or her technical area is calleda. certification. c. ethics.b. esteem. d. tort.

6. Which was developed by AMA to provide a terminology and coding system for physician billing?a. APC c. DRGb. CPT d. Medicare

7. Which of the following is the responsibility of a phlebotomist?a. Analyze specimensb. Dispatch samplesc. Obtain vital signsd. Transport patients

8. Which of the following is an example of proxemics?a. Eye contactb. Facial expressionsc. Personal hygiened. Zone of comfort

9. Which of the following is improper telephone technique?a. Listening and restating informationb. Putting an irritated caller on holdc. Referring the caller elsewhere if uncertaind. Taking notes as the caller is talking

10. A healthcare facility that provides ambulatory services is a(n)a. acute care hospital.b. assisted living home.c. rehabilitation center.d. urgent care center.

11. The name of a federal entitlement program isa. IDN. c. managed care.b. HIPAA. d. Medicare.

12. The specialty that treats disorders of the brain is calleda. cardiology. c. neurology.b. gerontology. d. pathology.

13. The department in the hospital that treats lung deficiencies isa. clinical laboratory.b. diagnostic imaging.c. electroneurodiagnostics.d. respiratory therapy.

14. The histology department in the laboratory performsa. blood culture testing.b. compatibility testing.c. electrolyte monitoring.d. tissue processing.

15. The abbreviation for a serology test that indicates the presence of hepatitis C is calleda. HBsAg. c. HIV-1ab.b. HCV-ab. d. hs-CRP.

16. Which of the following laboratory professionals is specified by CLIA as responsible for evaluating new procedures?a. Laboratory managerb. Medical laboratory scientistc. Medical laboratory techniciand. Technical supervisor

Chapter Review Questions




17. An important component in ensuring that the healthcare system is sustainable in the future is thea. administration of drug abuse programs.b. consistent use of primary care physicians.c. elimination of ambulatory services.d. increased use of emergency medicine.

18. Managed care systems’ attempts to control costs includea. allowing patients to choose their own

providers.b. discouraging preventative medicine.c. permitting patient unlimited healthcare service.d. using case managers to monitor patients.

19. The serology department in a clinical laboratory performs tests thata. assess blood clotting problems.b. detect antigens and antibodies.c. identify bacteria in body fluids.d. recognize cancer in tissue cells.

20. Healthcare providers who do not recognize diversity area. increasing innovation and teamwork.b. promoting interpersonal relations.c. risking a civil rights violation.d. supporting greater job satisfaction.




CASE STUDY 1-1: MORE EDUCATION FOR THE OJT PHLEBOTOMISTThe phlebotomist, Sam, has been trained on the job (OJT) and since that is how everyone else currently in the physician’s office was trained, he doesn’t see it as a problem. One thing bothers him, however, and it is that no one seems to be able to answer questions that come up daily about the rationale for doing phlebotomy procedures a certain way. The answer is always the same: “I don’t know. It has always been done that way.” When the physician’s office was notified of a pending visit from CLIA inspectors, it was decided that all the phlebotomists should get credentials, if possible, and in that way, every phlebotomist would better understand his or her job responsibilities.

Questions

1. What does “getting credentialed” mean as far as phlebotomists are concerned?

2. How can Sam become officially recognized as a phlebotomist?

3. Where can Sam go to receive a standardized educational curriculum that incorporates classroom instruction and clinical practice in phlebotomy?

4. How can Sam keep current after he becomes credentialed?

CASE STUDY 1-2: NONVERBAL CUES SPEAK LOUDLYThe patient did not understand English, but this was not unusual in the County Hospital. Donna, the phlebotomist, spoke only English and could not tell the patient why she was there or what was going to happen. She had learned that the best way to handle this situation was to continue preparing her equipment, nodding her head often to affirm the patient’s comments but never really looking the patient in the eye. This particular time the patient continued to talk nervously and did not offer his arm. As Donna glanced up to see why he hadn’t, she saw an intense frown on his face and that his eyes were narrowed. His hand was actually clenched, and he was leaning back in his bed as far as he could. Donna

proceeded by grasping his arm and forcefully moving it toward her. She quickly tied the tourniquet, cleaned the area, and prepared to stick the median cubital vein. Just as she got the needle through the skin, the patient yelled and pulled the needle out of his arm.

Questions

1. What did Donna’s nonverbal cues say to the patient?

2. What nonverbal signals was the patient offering to Donna?

3. What should the facial and hand cues from the patient have told Donna?

4. How could this situation have been handled differently?

Case Studies

CASE STUDY 1-3: A PATIENT HEALTHCARE ENCOUNTERA patient went to her primary care doctor’s office in a nearby clinic for an annual complete examination. While there, she mentioned some health problems she had been having. The doctor sent her to a drawing station in the clinic to have some blood test specimens collected. The young man who collected the blood specimens was polite, nicely groomed, and had the letters PBT (ASCP) after his name on his identification badge. She asked him what they meant and he replied that it meant he was nationally certified. Even though she had started out a little nervous about having her blood drawn, she was impressed by the phlebotomist’s professionalism and

that he was nationally certified, even though she was not sure what that meant. They made small talk while he collected the specimens, she barely felt the needle go in, and it was over before she knew it. The next day, the doctor’s nurse called and told her that the doctor was referring her to an endocrinologist.

Questions

1. What do the letters PBT (ASCP) stand for?

2. What does certification mean?

3. How did the phlebotomist play a role in easing the patient’s nervousness about having her blood drawn?

4. What is an endocrinologist’s specialty?



1 phlebotomy: past and present and the healthcare setting

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