module 1 ppt

Copyright © 2010 The McGraw-Hill Companies, Inc. Permission required for reproduction or display

Booth, Wallace, and Fitzgerald

PowerPoint PowerPoint ® Presentation to Accompany Presentation to Accompany

Chapter 1


Chapter 1 2

Introduction to Phlebotomy


Chapter 1 3

Learning OutcomesUpon Completion of this chapter, you should be able to:

•Describe the evolution of phlebotomy.

•Describe the roles and responsibilities of the phlebotomist.

•Discuss professionalism, public image, and customer service as they relate to the phlebotomist


Chapter 1 4

Learning Outcomes (cont’d)

•Identify the various settings where phlebotomists are employed.

•List the regulating agencies for phlebotomy.

•Identify safety and infection control practices related to phlebotomy.

•Describe HIPAA, law, and ethics related to phlebotomy.


Chapter 1 5

Phlebotomy means to cut into a vein.

This procedure of cutting or puncturing a vein is performed by a phlebotomist.

The primary role of a phlebotomist is to obtain blood specimens for testing.

Other roles include packaging urine specimens, accepting incoming specimens, and routing specimens to other departments.

Introduction


Chapter 1 6

History of Phlebotomy

History of

Phlebotomy

Phlebotomy

leeches

• Removing blood from veins dates back to about 1400 B.C. when leeches were applied to the skin of sick people.

• In the early 1800’s, medicinal leeches were used for the procedure known as bloodletting.

• Bloodletting was typically performed by barbers or anyone claiming medical training.


Chapter 1 7

Bloodletting

• Performed by a cut into a vein with a sharp instrument to drain blood

• The lancet was the most popularly used instrument

• Aseptic practices were not known, so the lancet was reused for several patients

Then Now

• Profession emerged as a result of technology and expansions in laboratory function

• Performed by trained professionals

• Standards of practice set by the Clinical and Laboratory Standards Institute (CLSI)


Chapter 1 8

Apply your Knowledge

What is the primary role of the phlebotomist?

ANSWERANSWER: To obtain blood specimens for testing

BRAVO!


Chapter 1 9

Apply Your Knowledge

The standards for the practice of phlebotomy are set by which organization?

ANSWER:ANSWER: Clinical and Laboratory Standards Institute

Good Job!


Chapter 1 10

Roles and Responsibilities of the Phlebotomist

PATIENT IDENTIFICATION

• Check armband or ID label in acute care settings

• Check driver’s license or picture ID in outpatient settings

Proper Identification Is a Three-Step Process

ASK COMPARE

VALIDATE


Chapter 1 11

Roles and Responsibilities (cont’d)

Specimen Collection and Handling

Physician orders indicate type of specimen and time of collection

Most Commonly Used Methods

VenipunctureInsertion of a needle into a vein to remove blood

Dermal Puncture

Use of puncture device to obtain capillary blood by pricking the skin


Chapter 1 12


Professionalism

•Be professional

•Apply good interpersonal skills

•Dress professionally

Many institutions require that phlebotomists wear a lab jacket and specified shoes to meet OSHA guidelines.


Chapter 1 13


The phlebotomist must be able to communicate using nonmedical terms.

Verbal and nonverbal communication should be appropriate, such as:

• Avoiding the use of slang• Speaking in a calm, clear voice• Avoiding inappropriate terms• Maintaining eye contact• Neat, well-groomed appearance• Respecting personal space


Chapter 1 14


When providing customer service:• Be empathetic• Observe the patient’s behavior• Listen to the patient’s concerns• Address any situation promptly• Be flexible


Chapter 1 15


What are the two most commonly used methods of blood specimen collection?

ANSWER: Venipuncture and dermal puncture

Great!


Chapter 1 16


True or False: The phlebotomist must be able to communicate using nonmedical terminology.

ANSWER: True. The use of nonmedical terminology is important for patient understanding of the procedure.

Bravo!


Chapter 1 17

Where Do Phlebotomists Work (Inpatient)

MedicalCenter

Inpatient Facilities

Phlebotomists employed at inpatient facilities work directly with several members of the health care team.

HospitalsNursing HomesRehabilitation Centers


Chapter 1 18

Where Do Phlebotomists Work (Outpatient)

Outpatient FacilitiesPhysician’s OfficesHome Health Care AgenciesAmbulatory Care CentersReference LaboratoriesBlood Banks

Ambulatory care centers are the fastest-growing outpatient facilities.


Chapter 1 19


Give three examples of inpatient care facilities where phlebotomists may work.

ANSWER: Hospitals, nursing homes, and rehabilitation facilities

Good Job!


Chapter 1 20

Regulatory Agencies

Clinical Laboratory Improvement Amendment (CLIA)

• Established in 1988 to ensure that all laboratories receiving federal funds, regardless of size, would meet the same standards

• As of 1992, this legislation became the main regulatory body for all laboratories

• Establishes qualifications for phlebotomists


Chapter 1 21

Regulatory Agencies (cont’d)

• Centers for Disease Control (CDC)

• Occupational Safety and Health Administration (OSHA)

• Clinical and Laboratory Standards Institute (CLSI)

• Healthcare Finance Administration (HCFA)

• Department of Health and Human Services (DHHS)


Chapter 1 22

Regulatory Agencies (cont’d)

The Joint Commission on Accreditation of Healthcare The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the College of American Organizations (JCAHO) and the College of American Pathologists (CAP) help ensure a high standard of Pathologists (CAP) help ensure a high standard of care for patients.care for patients.

JCAHO is the main accrediting agency for hospitals.

Laboratory classifications are based on the complexity of testing.

Waived

Moderately Complex

Highly Complex


Chapter 1 23


Which amendment established qualifications for phlebotomists?

ANSWER: Clinical Laboratory Improvement Amendment (CLIA)

GREAT!


Chapter 1 24

Contact transmission of infectious agents can be caused by either direct or indirect contact.

Direct Contact

Requires transfer of pathogens from reservoir to a susceptible host (person to person)

Indirect Contact

Contaminated item is handled prior to contact with a susceptible host (person to contaminated item to person)

Safety and Infection Control


Chapter 1 25

Safety and Infection Control (cont’d)

Prevention of Nosocomial InfectionsBreaking the Chain of Infection

The Six LinksThe Six Links

Breaking the chain of infection at any of these links will prevent an infection from developing.


Chapter 1 26

STANDARD PRECAUTIONSCombines the good hand hygiene and the use of gloves when workers are exposed to contaminated products

ISOLATION PRECAUTIONS

Based on how the infectious agent is transmitted:

AirborneDropletContact

Centers for Disease Control (CDC) Levels of Protection

for the Prevention of Nosocomial Infections

Always follow Standard Precautions with every patient when performing phlebotomy!!



Chapter 1 27


If performed correctly, will reduce the risk of transmitting infection

Steps to Proper Handwashing

• Remove all rings and jewelry

• Wet hands thoroughly using warm water

• Apply antibacterial soap and work up a good lather

• Interlace fingers using friction to cleanse the hands


Chapter 1 28


Steps to Proper Handwashing Technique (cont’d)

• Use an orange stick or handbrush to clean under fingernails

• Be sure not to lean against the sink area

• Rinse each hand with fingers pointing downward

• Keep fingers pointed downward so water and lather will drain toward fingertips

• Turn water off and dry hands thoroughly with paper towels

• Turn off water with a clean paper towel if needed

• Clean area of the sink without recontamination of your hands if needed


Chapter 1 29


Alcohol-based hand rub

•Make sure there is no visible dirt or contamination.•Apply ½ to 1 teaspoon of alcohol cleanser to one hand. Check the manufacturer’s directions for proper amount.•Rub your hands together vigorously, making sure all surfaces are covered.•Continue rubbing until your hands are dry.


Chapter 1 30


OSHA is the federal organization responsible for preventing or minimizing employee exposure to bloodborne pathogens such as hepatitis and HIV.• OSHA mandates that health

care facilities provide annual training on preventing exposure to bloodborne pathogens.

• OSHA requires that health care facilities provide the necessary Personal Protective Equipment to prevent exposure.

Occupational Safety and Health Administration


Chapter 1 31

Needlestick Safety and Prevention Act of 2001

• Established through the recommendation of the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA)

• Mandated the use of safety devices on needles for the prevention of exposure to bloodborne pathogens

• All devices for phlebotomy should be equipped with needlestick prevention features



Chapter 1 32


Name the two levels of protection developed by the CDC for the prevention of nosocomial infections.

ANSWER: Standard and Isolation Precautions

GREAT!


Chapter 1 33


Which agency has the responsibility of minimizing or preventing exposure to bloodborne pathogens?

ANSWER: Occupational Safety and Health Administration (OSHA)

GOOD JOB!


Chapter 1 34

Health Insurance Portability and Accountability Act (HIPAA)

•Developed in response to medical information transactions

•In 2003, established a national standard for electronic health care transactions

•Protects the privacy and confidentiality of patient information

•Patient information can be shared only for treatment purposes

HIPAA, Ethics, and Law


Chapter 1 35

HIPAA – Protect Patient Information!

• Close patients’ room doors when discussing their health

• Do not talk about patients in public places

• Log off computers when finished

• Turn computer screens so passersby cannot see patient information

• Do not walk away from patient medical records; close them when leaving

HIPAA, Ethics, and Law (cont’d)


Chapter 1 36


Code of Ethics

Ethics consist of a set of written rules, procedures, or guidelines that aid in determining right from wrong.

Remember the Golden Rule!!!

Treat others the way you would want to be treated.

All Information Concerning a Patient’s Care Must Remain Confidential!


Chapter 1 37


A phlebotomist must have clear consent from the patient before performing any blood collection procedure!

Patients have the right to:

• Refuse care• Be treated with respect• Have all records and information kept confidential• Be informed about the purpose and expected

results of treatments• Have access to their medical records


Chapter 1 38


What act was established in 2003 to protect the privacy and confidentiality of patient information?

ANSWER: Health Insurance Portability and Accountability Act (HIPAA)

BRAVO!


Chapter 1 39


A patient’s right to refuse care, be treated with respect, have all records kept confidential, and be informed regarding the purpose and outcome of treatment is known as:

ANSWER: The Patient’s Bill of Rights

GREAT!


Chapter 1 40

CHAPTER 1 SUMMARY The art of phlebotomy has evolved from the use of

leeches to modern-day certified phlebotomists.

Phlebotomists are responsible for collecting, processing, and transporting blood specimens.

Professionalism involves a positive attitude and appearance, proper communication to the patient, and providing quality customer service.

Phlebotomists are employed at hospitals, rehabilitation centers, nursing homes, clinics, physician’s offices, ambulatory care centers, blood banks, and reference labs.


Chapter 1 41

CHAPTER 1 SUMMARY (cont’d)

There are many regulating agencies for phlebotomy including CLSI, JCAHO, HCFA, CDC and OSHA.

Infection control and safety practices include hand hygiene and Standard and Isolation Precautions.

HIPAA provides protection of health care information. Ethics is used to help determine right from wrong. The law includes following your scope of practice and obtaining consent for procedures.


END OF CHAPTER 1

Always bear in mind that your own resolution to succeed is more important than any one thing.

--Abraham Lincoln

module 1 ppt

Health & Medicine

mcgrawhill companies

blood specimens

practice of phlebotomy

evolution of phlebotomy

capillary blood

learning outcomes contd

incoming specimens

routing specimens