MLSP WEEK 1

• Different healthcare facilities associated with the clinical laboratory include: Hospital Organizations, Physician Office Laboratories, Health Maintenance Organizations, Reference Laboratories, and Blood Donor Centers
• Hospital Organizations:

  • Phlebotomists may work at these areas or patients may be referred to the laboratory for sample collection
  • Range in size from 50 to more than 300 beds
  • Vary in extent of services provided
  • Classified by ownership (Government or Private) and scope of services (General or Specialty)
• Four Traditional Hospital Services:

  • Nursing Services
  • Support Services
  • Fiscal Services
  • Professional Services
  • Professional Service Departments include Radiology and Diagnostic Imaging, Radiation Therapy, Respiratory Therapy, Nuclear Medicine, Occupational Therapy, Pharmacy, Physical Therapy, Cardiovascular Testing, and Clinical Laboratory
• Physician Office Laboratories consist of primary care physicians or specialists and may include family practice physicians and specialists

  • Phlebotomists employed here may be responsible for processing and packaging samples to be sent to the hospital laboratory
• Health Maintenance Organizations (HMOs) are managed care group practice centers that provide various services

  • Phlebotomists are employed as part of the clinical laboratory staff
• Reference Laboratories contract with healthcare providers to perform routine and specialized tests

  • Phlebotomists are hired to collect samples from patients referred to the reference laboratory
• Blood Donor Centers:

  • Phlebotomists collect, label, and prepare blood, plasma, and other components for transfusions
  • Interact with the public, conduct interviews, and test samples to screen potential donors
• Patient's Rights include:

  • Right to Appropriate Medical Care and Humane Treatment
  • Right to Informed Consent
  • Right to Privacy and Confidentiality
  • Right to Information
  • Right to Choose Health Care Provider and Facility
  • Right to Self-Determination
  • Right to Religious Belief
  • Right to Medical Records
  • Right to Leave
  • Right to Refuse Participation in Medical Research
  • Right to Correspondence and to Receive Visitors
  • Right to Express Grievances
  • Right to be informed of Rights and Obligations as a Patient
• Tort Law includes:

  • Intentional Torts: Assault, Battery, Defamation
  • Unintentional Torts: Negligence, Malpractice
• Assault: Threat to touch another person without consent with the intention of causing fear of harm

  • Battery: Actual harmful touching of a person without consent
  • Defamation: Spoken or written words that can injure a person's reputation, including Libel and Slander
  • Invasion of Privacy: Violation of the patient's right to be left alone and free from unwanted exposure to public view
  • Medical Malpractice: Misconduct or lack of skill by a healthcare provider
• Medical Malpractice is misconduct or lack of skill by a health-care professional that results in injury to the patient
• Negligence is the failure to give reasonable care by the health-care provider, which must be proven in a malpractice suit
• Four factors must be proven to claim negligence:

  • Duty
  • Breach of Duty
  • Causation
  • Damages
• In phlebotomy, be wary of the following that may cause the patient to file a case of malpractice/negligence against you:

  • Nerve Injury
  • Hemorrhage:
  • From accidental arterial puncture
  • From inadequate pressure to the vein
  • Drawing from inappropriate locations (ex. Same side as mastectomy)
  • Injuries occurring when a patient faints
  • Death of a Patient caused by misidentification of a patient or sample
• The Clinical Laboratory is divided into two areas: Anatomical and Clinical
• Anatomical Area responsibilities include the analysis of surgical specimens, frozen sections, biopsies, cytological specimens, and autopsies
• Anatomical Area specialized sections:

  • Cytology Section: Cytologists process and examine tissue and body fluids for the presence of abnormal cells, such as cancer cells. Common tests include the Papanicolaou (Pap) smear
  • Histopathology/Histology Section: Histology technicians and technologists process and stain tissue from biopsies, surgery, autopsies, and frozen sections. A pathologist then examines the tissue
  • Cytogenetics: Chromosome studies are performed to detect genetic disorders
• Clinical Area specialized sections:

  • Hematology: Enumerates and classifies cellular elements, red blood cells (RBCs), white blood cells (WBCs), and platelets (Plts) in all body fluids and in the bone marrow
  • Coagulation: Evaluates the overall process of hemostasis, including platelets, blood vessels, coagulation factors, fibrinolysis, inhibitors, and anticoagulant therapy (heparin and Coumadin)
• • Serology (Immunology): Performs tests to evaluate the body's immune response, including the production of antibodies (immunoglobulins) and cellular activation
  • Microbiology: Identifies pathogenic microorganisms and manages hospital infection control. Common tests include Culture and Sensitivity and Gram Staining
  • Urinalysis: Routine screening procedure to detect kidney disorders, infections, and metabolic disorders through physical, chemical, and microscopic examination of urine
• • Clinical Chemistry: Most automated area that may perform electrophoresis, therapeutic drug monitoring, and enzyme immunoassays to measure substances such as proteins, carbohydrates, enzymes, hormones, and toxicology
  • Blood Bank (Immunohematology): Collects, stores, and prepares blood for transfusion. Tests involve RBC antigens (Ag) and antibodies (Ab), blood group (ABO) and Rh type, compatibility (crossmatch), and detection and identification of abnormal antibodies
• • Medical Laboratory Scientist: Performs laboratory procedures with independent judgment and responsibility, maintains equipment and records, and ensures quality assurance
  • Medical Laboratory Technician: Performs routine laboratory procedures under supervision, collects and processes samples, recognizes and reports abnormal results, and demonstrates skills to new employees and students
  • Phlebotomist: Collects blood from patients for laboratory analysis, trained to identify patients properly and obtain blood samples
• Laboratory Personnel roles:

  • Laboratory Director (Pathologist): Specialist in the study of disease, acts as a consultant to physicians, and has direct responsibility for all areas of the laboratory
  • Laboratory Manager (Administrator) or Chief-Medical Technologist: Responsible for overall technical and administrative management of the laboratory
  • Technical Supervisor or Section Head: Oversees specific laboratory sections, often with specialty certifications
• History of Phlebotomy:

  • Phlebotomy, meaning "to cut a vein," has roots in ancient Egyptian, Greek, and Roman cultures where bloodletting was a common practice
  • Barbers took over bloodletting from clergyman, using lancet tools for the procedure
• Duties and Characteristics of a Phlebotomist:

  • Traditional Duties and Responsibilities include correct identification and preparation of the patient, collection of blood samples, selection of appropriate containers, labeling samples, transportation to the laboratory, interaction with patients and hospital personnel, sample processing, computer operations, safety regulations, quality control checks, and attendance at continuing education programs
• • Additional Duties may involve training other healthcare personnel, monitoring sample quality, evaluating protocols, performing point-of-care testing, electrocardiograms, vital sign measurements, arterial blood sample collection, and samples from central venous access devices
  • Characteristics of Phlebotomists include being dependable, cooperative, compassionate, organized, having good communication skills, respecting cultural diversity, and maintaining integrity and honesty