Phlebotomists may work in these areas or patients may be referred to the laboratory for sample collection
Hospitals may vary in size from 50 to over 300 beds
Classification of Hospitals by DOH:
Government: Created by law, may be under National Government, LGU, DOH, State Universities and Colleges
Private: Owned, established, and operated with funds from various sources
Hospital Services and Departments:
Nursing Services: Direct patient care
Support Services: Communications systems, food, housekeeping
Fiscal Services: Business aspect like accounting, admitting, data collection
Professional Services: Assist physicians in diagnosis and treatment
Professional Service Departments include Radiology, Pharmacy, Physical Therapy, and Clinical Laboratory
Physician Office Laboratories:
Consist of primary care physicians or specialists
Phlebotomists may process and package samples to be sent to hospital laboratories
Health Maintenance Organizations (HMOs):
Managed care centers providing various services
Phlebotomists are part of the clinical laboratory staff
Reference Laboratories:
Independent labs that perform routine and specialized tests
Phlebotomists collect samples from patients referred to the reference lab
Blood Donor Centers:
Phlebotomists collect, label, and prepare blood and other components for transfusions
They interact with the public, conducting interviews and testing samples to screen potential donors
Patient Rights (DOH):
Right to appropriate medical care and humane treatment
Right to informed consent
Right to privacy and confidentiality
Right to information about their health
Right to choose healthcare 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 receive visitors
Right to express grievances
Right to be informed of their rights and obligations as a patient
Tort Law:
Tort: A wrongful act causing harm to a person or property
Intentional torts: Assault, Battery, Defamation
Unintentional torts: Negligence, Malpractice
Practice in healthcare refers to misconduct or lack of skill by a health-care professional that results in injury to the patient
Negligence in healthcare is defined as the failure to give reasonable care by the health-care provider and must be proven in a malpractice suit
Four factors must be proven to claim negligence:
1. Duty
2. Breach of Duty
3. Causation
4. Damages
In phlebotomy, potential causes for patients to file cases of malpractice/negligence include:
a. Nerve Injury
b. Hemorrhage from accidental arterial puncture or inadequate pressure to the vein
c. Drawing from inappropriate locations (e.g., same side as mastectomy)
d. Injuries occurring when a patient faints
e. 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:
a. Cytology Section: Processes and examines tissue and body fluids for abnormal cells like cancer cells. Common test: Papanicolaou (Pap) smear
Anatomical Area specialized sections:
b. Histopathology/Histology Section: Processes and stains tissue from biopsies, surgery, autopsies, and frozen sections. A pathologist then examines the tissue
Anatomical Area specialized sections:
c. Cytogenetics: Performs chromosome studies to detect genetic disorders
Clinical Area specialized sections:
a. Hematology: Enumerates and classifies cellular elements like red blood cells (RBCs), white blood cells (WBCs), and platelets (Plts) in body fluids and bone marrow
Clinical Area specialized sections:
b. Coagulation: Evaluates the overall process of hemostasis, including platelets, blood vessels, coagulation factors, fibrinolysis, inhibitors, and anticoagulant therapy
Clinical Area specialized sections:
c. Clinical Chemistry: Performs electrophoresis, therapeutic drug monitoring, and enzyme immunoassays to measure substances like proteins, carbohydrates, enzymes, hormones, and toxicology
Clinical Area specialized sections:
d. 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 identification of abnormal antibodies
Clinical Area specialized sections:
e. Serology (Immunology): Performs tests to evaluate the body's immune response, including the production of antibodies (immunoglobulins) and cellular activation
Clinical Area specialized sections:
f. Microbiology: Identifies pathogenic microorganisms and handles hospital infection control. Common tests include Culture and Sensitivity and Gram Staining
Clinical Area specialized sections:
g. Urinalysis: Screens for kidney disorders, infections, and metabolic disorders through physical, chemical, and microscopic examination of urine
Laboratory personnel roles:
1. Laboratory Director (Pathologist): Specialist in disease study, works in clinical and anatomical pathology, consults with physicians, establishes lab policies, interprets test results, performs biopsies, autopsies, and diagnoses diseases
Laboratory personnel roles:
2. Laboratory Manager (Administrator) or Chief-Medical Technologist: Manages technical and administrative aspects of the lab, usually a medical laboratory scientist with a master's degree and experience
Laboratory personnel roles:
3. Technical Supervisor or Section Head: Manages specific lab sections, reviews test results, consults with pathologists, schedules personnel, maintains instruments, prepares budgets, and provides protocols for new test procedures
Laboratory personnel roles:
4. Medical Laboratory Scientist: Has a bachelor's degree in medical technology, performs lab procedures with independent judgment, maintains equipment and records, and ensures quality assurance
Laboratory personnel roles:
5. Medical Laboratory Technician: Performs routine lab procedures under supervision, collects and processes samples, recognizes abnormal results, and demonstrates skills to new employees and students
Laboratory personnel roles:
6. Phlebotomist: Collects blood for lab analysis, completes phlebotomy training, identifies patients correctly, and obtains blood samples
History of Phlebotomy:
Phlebotomy, meaning "to cut a vein," has roots in ancient Egyptian, Greek, and Roman cultures
Bloodletting was a common practice to cure illnesses, often performed using a lancet tool
In 1163, Pope Alexander III prohibited clergy from performing bloodlettings, leading barbers to take over as skilled practitioners (Barber-Surgeons)
Duties and characteristics of a Phlebotomist:
Traditional duties include patient preparation, blood collection, sample container selection, labeling, transportation, interaction with patients and staff, sample processing, record-keeping, and adherence to safety regulations
Additional duties of Phlebotomists:
1. Training other healthcare personnel in phlebotomy
2. Monitoring sample quality and associated protocols
3. Performing point-of-care testing, electrocardiograms, vital sign measurements, arterial blood sample collection, and central venous access device sample collection