MLSP PHLEBOTOMY

• Review of Healthcare Facilities:

  1. Hospital Organizations

  2. Physician Office Laboratories

  3. Health Maintenance Organizations

  4. Reference Laboratories

  5. Blood Donor Centers
• Hospital Organizations:

  • 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
• Characteristics of Phlebotomists:

  1. Dependable, cooperative, compassionate, organized

  2. Courteous, respectful, honest, responsible

  3. Competent, flexible, with good communication skills and respect for cultural diversity