IM-6 | 1 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Solution Manual For Phlebotomy A Competency Based Approach 6e By Kathryn A. Booth, Lillian Mundt Chapter 1 -16 Chapter 1: Phlebotomy and Healthcare Preface/Introduction Professionals called phlebotomists perform an invasive procedure called phlebotomy that involves an incision into the skin and blood vessels. Phlebotomists work in various healthcare settings and interact with many other healthcare professionals inside and outside of the medical laboratory. At all times during their professional practice, phlebotomists must demonstrate a mastery o f the principles and techniques established by the Clinical and Laboratory Standards Institute (CLSI) and comply with all other governmental regulations concerning medical laboratories. Learning Outcomes 1.1 Summarize the definition and history of phlebotomy. 1.2 Explain the role of the phlebotomist in the various healthcare facilities where he or she may be employed. 1.3 Describe inpatient and outpatient healthcare facilities and their relationship to the practice of phlebotomy. 1.4 Identify the healthcare providers and o ther members of the healthcare team with whom the phlebotomist will interact in inpatient and outpatient facilities. 1.5 Outline the organization of the medical laboratory. 1.6 Recognize the agencies that regulate hospitals and medical laboratories. 1.7 List the quali ties and characteristics of a phlebotomist. Extended Outline Outline PowerPoint® Slides I. Phlebotomy (LO 1.1) Slides 9 –13 A. History of Phlebotomy Slides 12 –13 II. Phlebotomist’s Role (LO 1.2) Slides 14 –18 A. Phlebotomy Training Slide 18 III. Healthcare Facilities (LO 1.3) Slides 19 –22 IM-6 | 2 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Outline PowerPoint® Slides A. Inpatient Facilities Slide 20 B. Outpatient Facilities Slide 21 IV. The Healthcare Team (LO 1.4) Slides 23 –25 V. The Medical Laboratory (LO 1.5) Slides 26 –38 A. Medical Laboratory Specialties Slides 28 -37 B. Medical Laboratory Personnel Slide 38 VI. Regulatory Agencies (LO 1.6) Slides 39 –42 VII. Qualities of a Phlebotomist (LO 1.7) Slides 43 –51 A. Professionalism Slide 44 B. Public Image Slide 45 C. Customer Service and Communication Slide 47 –51 Appendix Slides Hierarchy in the Medical Laboratory Slide 53 Lecture Outline Phlebotomy (LO 1.1) o Phlebotomy simply means to cut into a vein. The term comes from phlebos , which is Greek for “vein,” and tome, which means “to cut.” o The primary role of a phlebotomist is to obtain blood specimens for diagnostic testing, either by phlebotomy/venipuncture (puncturing the vein) or capillary ( dermal ) puncture (puncturing the skin). o The process of removing blood from the veins may date back as far as 1400 BC. During the time of Hippocrates, bloodletting was thought to return the body to a balanced state. o In the early 1800s, the popularity of bloodletting created demand for leeches. The use of leeches has resurfaced in medicine today. o Bloodle tting also used a process called venesection , in which the vein was pierced with a sharp object, called a lancet , to drain blood. o Due to advances in technology and expanding duties of laboratory staff, phlebotomy emerged as a separate profession in the 198 0s to 1990s. Phlebotomist’s Role (LO 1.2) o The phlebotomist is responsible for the collection, processing, and transport of blood specimens to the laboratory for testing. This responsibility consists of the pre -
examination phase of laboratory testing , inclu ding interpretation of provider orders for laboratory testing . In the performance of these duties, the phlebotomist may also act as a patient advocate ; and assist other healthcare professionals with specimen collection , and provide results to providers . o The phlebotomist may also be responsible for performing point -of-care testing (POCT), such as blood glucose monitoring. o Entry into phlebotomy training programs usually requires a high school diploma or its equivalent. Training programs are offered in a var iety of settings. IM-6 | 3 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. o Programmatic accreditation such as that offered by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) ensures that students completing the training program are qualified to take a certification examination. o Various healthcare professionals may be trained to perform phlebotomy. Healthcare Facilities (LO 1.3) o Phlebotomists employed at inpatient facilities work directly with several members of the healthcare team. o Outpatient settings that employ phlebotomists include ph ysician offices, ambulatory care centers, reference laboratories, blood collection centers, home healthcare agencies, veterinary offices, health maintenance organizations, and blood donor centers. The Healthcare Team (LO 1.4) o Departments in a typical hospi tal include anesthesiology, cardiology, diagnostic imaging, electrocardiography, electroencephalography, emergency department, endocrinology, general medicine, geriatrics, internal medicine, neonatology, nephrology, neurology, nuclear medicine, nutrition a nd dietetics, obstetrics/gynecology, occupational therapy, oncology, orthopedics, pathology, pharmacy, physical therapy, psychiatry, respiratory therapy, surgery, and urology. The Medical Laboratory (LO 1.5) o Most hospitals have their own laboratories, which are referred to as “medical” or “clinical” laboratories because they perform a wide range of tests in several specialties. o Each laboratory is organized based on its size and the need s of the facility. Several layers of management may exist. All labor atories must have a director or administrator who is ultimately responsible for the test results reported by laboratory personnel. o Clinical pathology is the laboratory analysis of body fluids and bodily tissue for the diagnosis of disease. Anatomical patho logy involves the examination of surgical specimens to investigate disease and/or cause of death. o Medical laboratory specialties include cytology, histology, clinical chemistry, hematology, immunohematology, immunology and serology, medical microbiology, molecular diagnostics, toxicology, and urine and body fluid analysis . o Medical laboratory personnel may include medical office staff, medical transcriptionists, medical laboratory assistants, medical laboratory technicians, medical laboratory scientists, his tologic technicians, histologists, cytologists, pathologists, and pathologists’ assistants. Regulatory Agencies (LO 1.6) o The 1988 Clinical Laboratory Improvement Amendment (CLIA’88) was established to ensure that all laboratories receiving federal funds, r egardless of size, type, or location, would meet the same standards and be certified by the federal government. o Classifications of laboratories are based on the complexity of testing performed and the associated patient risks if the tests are not performed properly. IM-6 | 4 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. o The Joint Commission (TJC) accredits hospitals; the College of American Pathologists (CAP) accredits clinical laboratories; the Commission on Office Laboratory Accreditation (COLA) accredits physician office laboratories (POLs); and the Clinical Laboratory Standards Institute (CLSI) develops and publishes national and international standards for clinical laboratory testing procedures. o CLSI standards are categorized into the phases of laboratory testing: pre -examination, examination, and post -exam ination. Qualities of a Phlebotomist (LO 1.7) o Professionalism and good interpersonal skills are critical for phlebotomists. o Phlebotomists are the “face of the lab” to the patient and must portray an acceptable public image, which includes cleanliness, good grooming, and appropriate dress for the work setting. o Communication skills are key to providing good customer service. Th is includes both verbal and non verbal communication. o Phlebotomists should be aware of the barriers to communication that may affect customer satisfaction. Teaching Strategies Curriculum Hours 0 to 2.0 Total Time 2.0 hours Activities & Instructions Materials Learning Outcomes Introduction 5 min Introduce self and give an overview of the course and expectations. Have students briefly introduce themselves. Lecture 80 min Use lecture outline and PowerPoint® presentations. Ask students what they think a phlebotomist’s role is in the delivery of healthcare. Introduction Discuss the history of phlebotomy. Discuss the phlebotomist’s role. Describe facilities where phlebotomists work. Chapter 1 lecture outline PowerPoint® slides: 1-1 to 1-6 1-7 to 1 -11 1-12 to 1 -15 1-16 to 1 -18 LO 1.1 LO 1.2 LO 1.3
examination phase of laboratory testing , inclu ding interpretation of provider orders for laboratory testing . In the performance of these duties, the phlebotomist may also act as a patient advocate ; and assist other healthcare professionals with specimen collection , and provide results to providers . o The phlebotomist may also be responsible for performing point -of-care testing (POCT), such as blood glucose monitoring. o Entry into phlebotomy training programs usually requires a high school diploma or its equivalent. Training programs are offered in a var iety of settings. IM-6 | 3 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. o Programmatic accreditation such as that offered by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) ensures that students completing the training program are qualified to take a certification examination. o Various healthcare professionals may be trained to perform phlebotomy. Healthcare Facilities (LO 1.3) o Phlebotomists employed at inpatient facilities work directly with several members of the healthcare team. o Outpatient settings that employ phlebotomists include ph ysician offices, ambulatory care centers, reference laboratories, blood collection centers, home healthcare agencies, veterinary offices, health maintenance organizations, and blood donor centers. The Healthcare Team (LO 1.4) o Departments in a typical hospi tal include anesthesiology, cardiology, diagnostic imaging, electrocardiography, electroencephalography, emergency department, endocrinology, general medicine, geriatrics, internal medicine, neonatology, nephrology, neurology, nuclear medicine, nutrition a nd dietetics, obstetrics/gynecology, occupational therapy, oncology, orthopedics, pathology, pharmacy, physical therapy, psychiatry, respiratory therapy, surgery, and urology. The Medical Laboratory (LO 1.5) o Most hospitals have their own laboratories, which are referred to as “medical” or “clinical” laboratories because they perform a wide range of tests in several specialties. o Each laboratory is organized based on its size and the need s of the facility. Several layers of management may exist. All labor atories must have a director or administrator who is ultimately responsible for the test results reported by laboratory personnel. o Clinical pathology is the laboratory analysis of body fluids and bodily tissue for the diagnosis of disease. Anatomical patho logy involves the examination of surgical specimens to investigate disease and/or cause of death. o Medical laboratory specialties include cytology, histology, clinical chemistry, hematology, immunohematology, immunology and serology, medical microbiology, molecular diagnostics, toxicology, and urine and body fluid analysis . o Medical laboratory personnel may include medical office staff, medical transcriptionists, medical laboratory assistants, medical laboratory technicians, medical laboratory scientists, his tologic technicians, histologists, cytologists, pathologists, and pathologists’ assistants. Regulatory Agencies (LO 1.6) o The 1988 Clinical Laboratory Improvement Amendment (CLIA’88) was established to ensure that all laboratories receiving federal funds, r egardless of size, type, or location, would meet the same standards and be certified by the federal government. o Classifications of laboratories are based on the complexity of testing performed and the associated patient risks if the tests are not performed properly. IM-6 | 4 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. o The Joint Commission (TJC) accredits hospitals; the College of American Pathologists (CAP) accredits clinical laboratories; the Commission on Office Laboratory Accreditation (COLA) accredits physician office laboratories (POLs); and the Clinical Laboratory Standards Institute (CLSI) develops and publishes national and international standards for clinical laboratory testing procedures. o CLSI standards are categorized into the phases of laboratory testing: pre -examination, examination, and post -exam ination. Qualities of a Phlebotomist (LO 1.7) o Professionalism and good interpersonal skills are critical for phlebotomists. o Phlebotomists are the “face of the lab” to the patient and must portray an acceptable public image, which includes cleanliness, good grooming, and appropriate dress for the work setting. o Communication skills are key to providing good customer service. Th is includes both verbal and non verbal communication. o Phlebotomists should be aware of the barriers to communication that may affect customer satisfaction. Teaching Strategies Curriculum Hours 0 to 2.0 Total Time 2.0 hours Activities & Instructions Materials Learning Outcomes Introduction 5 min Introduce self and give an overview of the course and expectations. Have students briefly introduce themselves. Lecture 80 min Use lecture outline and PowerPoint® presentations. Ask students what they think a phlebotomist’s role is in the delivery of healthcare. Introduction Discuss the history of phlebotomy. Discuss the phlebotomist’s role. Describe facilities where phlebotomists work. Chapter 1 lecture outline PowerPoint® slides: 1-1 to 1-6 1-7 to 1 -11 1-12 to 1 -15 1-16 to 1 -18 LO 1.1 LO 1.2 LO 1.3
