LLU Phlebotomy Questions and Answers

LLU Phlebotomy Questions and Answers Identify and describe three barriers to simple verbal communication Verbal Communication, Language Barriers, Hearing Disabilities Verbal Communication Communication involves both a speaker and a listener. When this process is complete, it is called feedback. Feedback gives both parties the opportunity to clarify any miscommunication caused by barriers or filters. Language Barriers Medical jargon English as a second language Age Hearing Disabilities Especially important in giving collection instructions See if patient understood by: 1) Asking questions (active listening) 2) Writing it down Tone of Voice Calm, soothing, confident tone in voice Avoid sarcasm Avoid sending mixed messages List five behaviors that exhibit positive body language Face to face positioning Relaxed hands, arms, and shoulders Erect posture Eye contact, eye level (avoid looking down on some one) Smiling Appropriate "zone of comfort" List five behaviors that exhibit negative body language Wandering eyes Nervous behaviors Breathing pattern Other distracting behaviors Slouching, shrugged shoulders Staring blankly or at ceiling Rubbing eyes or excessive blinking Squirming or tapping foot or pencil Deep sighing or groaning Crossing arms or clenching fists Wrinkling forehead Thumbing through books or papers Stretching or yawning Peering over eyeglasses Pointing finger at someone List at least three forms of non-verbal communication Kinesics, Proxemics, Types of Personal Space Kinesics The study of non-verbal communication is kinesics. When your verbal and nonverbal communication does not agree, it is called a kinesic slap. As a healthcare professional, it is important to recognize a kinesic slip. Many patients are anxious or fearful of having their blood drawn but may not want the phlebotomist to know this. It is believed that communication is comprised of 20% words and 80% nonverbal cues. These nonverbal cues "body language" can be positive-helpful to understand or negative-prevents communication. Proxemics The study of an individual's concept and use of space is called proxemics. also, referred to as your "personal space". As a phlebotomist, you are working at an intimate distance to collect the blood. You must be careful not to make the patient feel threatened, insecure or out of control. Types of personal space Intimate distance, Personal distance, Social distance, Public distance Factors that determine one's personal space Age Culture Relationship to person (mother/child, student/teacher, etc) Appearance A powerful non-verbal signal is your appearance. A person makes a judgement within the first 30 seconds of meeting you. Each facility will have a dress code that must be adhered to. A professional appearance conveys: Confidence Cleanliness Competence Trustworthiness Touch Because medicine is a contact, profession, touching privileges are granted to and expected for health care workers under certain circumstances. Numerous studies have shown the importance of touch in healing. Whether a patient or healthcare professional is comfortable with touching is based on his/her cultural background. Interact appropriately and professionally with other individuals Describe and demonstrate techniques for dealing with family and visitors during the specimen collection process Family members and friends are often present, so many times it is more than the patient that you must interact with when collecting the blood sample. They must be treated with the same respect and dignity as the patient Their presence may make the patient feel more secure and comfortable Sometimes they can more difficult to deal with than the patient If several visitors are present, you may ask them to wait outside the room while the specimen is being drawn Physicians, priests, and chaplains have the right to visit privately If the test ordered is timed or STAT, apologize for the interruption and explain why you must collect it now Describe the legal and ethical importance of proper patient/sample identification If phlebotomists become inattentive to, careless about, or unaware of their professional roles and duties, they may increase the risk of error in the practice of their profession. Also, increasing the risk of being held legally liable for those errors. Examples of some common errors: Injury to a blood donor Misidentification of a patient Mistake in interpreting a physician's orders Transmission of a disease Define Respondent Superior (Let the master answer) is the legal doctrine that places an employer in a position of responsibility for the acts of its employees Define the _____________________ used in the medicolegal aspect for phlebotomy, and discuss policies and protocol designed to avoid medicolegal problems Different terms Medicolegal Describes the interrelationship of the professions of law and medicine Phlebotomists, as members of the laboratory health care team, are in a unique position in relation to most other laboratory personnel. In many health care settings phlebotomists may be the only laboratorians who: Come into face-to-face contact with patients or blood donors Perform specimen collection procedures on patients or donors Deal with the very real issues of fear of infection, illness, and death and dying from the patient's perspective Phlebotomist's must have: Good training Technically proficient Follow laboratory procedures Be in compliance with government rules and regulations Be good listeners Good public relations representatives If phlebotomists become inattentive to, careless about, or unaware of their professional roles and duties, they may increase the risk of error in the practice of their profession and thus increase the risk of being held legally liable for those errors. Examples of some common errors are: Injury to a blood donor Misidentification of a patient Mistake in interpreting a physician's orders Transmission of a disease General Legal Terms Statutory Law, Administrative Law, Judicial Law, Civil Law, Tort, Assault, Battery, Informed Consent, Implied Consent, Malpractice, Negligence, Invasion of Privacy, Breach of Confidentiality, Defamation of Character, Good Samaritan Law, Statutory Law State law; statues written by the state Administrative Law Implements state law; usually federal U.S. Dept of Health & Human Services is the administrator Judicial Law Handles disputes Civil Law Involves crimes against a person. It involves two private parties such as healthcare organization and a patient. The most common civil actions in healthcare are based on tort. Tort A civil wrong (other than a breach of contract) committed against a person or property for which damages may be awarded in a court of law. It is an act that is committed without just cause either intentionally or unintentionally. Assault The unjustifiable attempt to touch someone or the threat to do so. Assault may be permissible if content is given (e.g. consent to obtain a blood sample). Battery The intentional touching of another person without consent or the unlawful beating of someone. (e.g. someone refuses to have their blood drawn and the phlebotomist holds them down and draws it anyway). Informed Consent Voluntary permission by a patient to allow touching, examination or treatment by healthcare workers after they have been given information about the procedures and potential risks and consequences. Implied Consent When the patient's nonverbal behavior indicates agreement. Immediate action is required to save someone's life or to prevent permanent impairment. The emergency removes the need for consent. Malpractice Professional negligence. Improper or unskillful care of a patient by a healthcare worker or any professional misconduct or unreasonable lack of skill. Negligence Failure to act or to perform duties according to the standards of the profession. Invasion of Privacy The unauthorized release of information about a patient Breach of Confidentiality Unauthorized release of medical information. Failure to keep medical information confidential. Not only is it illegal, it is unethical. Defamation of Character Injury to another person's reputation, name, or character through spoken (slander) or written (libel) words. Good Samaritan Law, Deals with the rendering of first aid by healthcare professionals at the scene of an accident or sudden injury. It encourages them to provide medical care within the scope of their training without fear of being sued for negligence. Describe the conditions that must be met if blood specimens and laboratory tests are to be used as legal evidence Samples may be used as legal evidence in a court of law Including: Blood Urine Other body fluids Tissue samples A ______________________________ protocol is followed to ensure the sample is not tampered with chain-of-custody It involves ____________________________ that tracks the specimen from the time it is collected until the results are reported. documentation Anyone who comes in contact with the specimens must document it with: Name Date Time Location Any breach of documentation may render the ___________ useless as legal evidence Sample Describe and discuss the major points of the Patient's Bill of Rights as it applies to clinical laboratory personnel Heathcare professionals (including phlebotomists) must recognize the needs and rights of patients in healthcare team your first responsibility is to ensure to patient's health, safety, and dignity. These rights have been clearly outlined in a document put together in 1973 and revised in 2003 by the American Hospital Association. The document is called the A Patient's Bill of Rights. The latest revision is titled the Patient Care partnership. They key elements involve patient's rights to the following: Quality health care A clean health care environment The patient's role in his/her own care Privacy rights Availability of assistance when leaving the hospital or with billing issues Describe why it is important to maintain confidentiality Trust must be maintained between the patient and the phyician. Patient's must know that their medical information will not be made public. This is especially true when dealing with drugs of abuse, mental illness, sexually transmitted diseases, and someone's HIV status. Patient lab results are considered confidential and test results should not be shared with anyone other than the patient's physician or the patient himself. Maintain confidentiality of privileged information Confidential materials include: Verbal communication between patients and physicians Written communication including lab results Information on computer terminals Electronic transmissions such as faxes and emails Describe and exhibit appropriate _________________ and _________________. appearance grooming Describe why it is important to maintain confidentiality Facts about patients are to be kept CONFIDENTIAL, and are not a part of non-professional conversation Confidentiality Protects both the patient and the practitioner Patient information is private Privacy of information must always be maintained Unauthorized release of information concerning a patient can lead to a claim of breach of confidentiality or invasion of privacy HIPAA Compliance Describe traits that form the professional image General Appearance and Grooming Conservative clothing, personal hygiene Dress Codes Character Traits/Behavior Communication-verbal/nonverbal Personal accountability Integrity -Don't cover up, admit to mistakes Honesty Sincerity and compassion Work with team members Pride in your work Display _______________________________ and _________________________________ for your actions Personal integrity Individual responsibility List causes of stress in the work environment Stress and Stress Management It is not easy for the phlebotomist to face disease and suffering everyday, as wel as the demands of physicians, nurses, supervisors, co-workers, etc. The pressure to perform efficiently and effectively can cause one to feel stressed. Stress is defined as a condition or feeling experienced when a person perceives that "demands" exceed the personal and social resources the individual is able to mobilize Stress initiates the "fight or flight" response Hormones released Increased heart rate and blood pressure Increased sweating Cold clammy hands __________________________ events trigger this reaction, anything unexpected or frustrating can cuase a stress response Not only life-threatening Effects of stress at work: Reduces ability to work effectively with other people Become excitable, anxious, jumpy, or irritable Interferes with ability to make fine judgements Accident-prone Need to keep _________________________________ under control to be effective in your job as well as to avoid problems of poor health and burnout. These are ___________________________________ you can learn to help you remain calm in ______________________________ and to avoid the problems of ____________________________. fight-or-flight response stress management skills high-pressure situations long-term stress Discuss ______________________ used to deal with stress in the work environment coping skills Stress management techniques Imagery-mental stress management Imagine you are somewhere else: the beach, the woods, your favorite place Deep breathing Exercise Progressive muscular relaxation-tense up one set of muscles, then relax, move onto another muscle group Positive thinking Adequate sleep/rest The mission of LLU is "To Make Man Whole". It addresses looking at the whole person: physically, emotionally, mentally, and spiritually. It is important to find balance in your life. You will have much less stress in your life if you spend time in each of these areas Discuss how __________________________________ is achieved in the clinical laboratory professional regulation Professional Regulation The professional image is derived from the public recognition of the educational level that the individual has achieved as well as from the assumption that the profession is regulated. National accrediting and certifying agencies ensure that each profession adheres to predetermined professional standards. The field of clinical laboratory science has several levels of professional recognition: Phlebotomist or Certified Phlebotomy Technician (CPT), Medical Laboratory Assistant (MLA), Medical Laboratory Technician (MLT) or Clinical Laboratory Technician (CLT), Medical Technologist (MT) or Clinical Laboratory Scientist (CLS), Bioanalyst, Clinical Pathologist (MD) Phlebotomist or Certified Phlebotomy Technician (CPT) Educational Level- High school diploma or equivalent with additional phlebotomy training Medical Laboratory Assistant (MLA) Educational level- High school diploma or equivalent with additional training in basic laboratory procedures and specimen processing Medical Laboratory Technician (MLT) or Clinical Laboratory Technician (CLT) Educational level- Associate in science degree with emphasis in introductory chemical and biological science. Specialized clinical training, usually for 3-6 months. Medical Technologist (MT) or Clinical Laboratory Scientist (CLS) Educational level- Bachelor of science degree with emphasis in advanced chemistry and biological science. Specialized clinical training, usually for 9-12 months. Bioanalyst Educational level- Master's degree in a field relevant to clinical laboratory science, with supervisory or management training and experience. Requires general laboratory experience in all areas of the laboratory in the last three years. Recognized in the state of California. Clinical Pathologist (MD) Educational level- Doctorate in Medicine Residency in clinical and anatomic pathology, usually for 2-4 years. Certification Completion of defined academic and training requirements. Includes the attainment of a satisfactory score on a national examination. Most certification is provided through professional regulatory agencies of institutions, not government agencies. Agencies that certify include: National Healthcareer Association (NHA) American Society of Clinical Pathologists (ASCP) American Society for Phlebotomy Technology (ASPT) Licensure Licensure is defined as a process similar to certification, but is controlled by a government agency, either federal, state, county, or city. A license to practice as specific trade is granted through examination to a person who can meet the requirements for education and experience in that field. California State: Licensure Examination required for Phlebotomist (CPT), Clincal Laboratory Scientist (CLS), & for Bioanalyst 6 units of continuing education required every 2 years to maintain state license for CPT, 12 units per year for a CLS. Program Accreditation/Approval Health care training programs and institutions are regulated by an accreditation process which requires external peer review. On-site surveys determine if the program meets certain established qualifications or educational standards referred to as "Essentials". Examples of approval agencies include: The National Accrediting Agency for Clincal Laboratory Sciences (NAACLS) Continuing Education (CEU) To remain current in the field of laboratory medicine, one must participate in workshops and seminars to continually upgrade skills and knowledge. Organizations that offer CEU American Society for Phlebotomy Technology (ASPT) American Society for Clinical Laboratory Science (ASCLS) California Society for Clinical Laboratory Science (CSCLS) American Society of Phlebotomy Technicians (ASPT) American Society of Clinical Pathologists (ASCP) California Association for Medical Laboratory Technologists (AMLT) Clinical Laboratory Managers Association (CMLA)