1. Suction cups, leeches, and barber surgery were used before
2. Currently, phlebotomy has evolved into a fundamental diagnostic tool
Goals of phlebotomy practice
For diagnosis and treatment using blood samples
For transfusion
For removal of blood for polycythemia (excess RBCs) or therapeutic purposes
Ancient Egyptians practiced "bloodletting" as early as 1400 BC and it was used to cure disease and maintain the body in a state of well-being
The primary role of phlebotomy is the collection of blood samples for laboratory analysis to diagnose and monitor medical conditions
Additional Duties of a Phlebotomist
Training other healthcare personnel to perform phlebotomy
Monitoring the quality of samples collected on the units
Evaluation of protocols associated with sample collection
Performing and monitoring point-of-care testing (POC
Hippocrates believed that diseases are caused by an excess of body fluids (blood, bile, and phlegm) and that removal of the excess will cause the body to return or maintain a healthy state
Decentralization is the dispersion, distribution, or delegation of functions and powers from a single authority
Phlebotomy
"phlebos" = vein; "tamnein" = cut
Means "incision to the vein"
One of the oldest medical procedures, dating back to the Stone Age
Phlebotomists are responsible for obtaining samples primarily by venipuncture or microtechniques
Traits that form the Phlebotomist’s Professional Image
Other healthcare services
Ambulatory care
Homebound services
Public health services
Stat labs
Reference laboratory
Education and Certification: Certification or license, Continuing education
Training Programs
1. Designed to incorporate a combination of classroom instruction and clinical practice
2. Follows the guidelines developed by the National Phlebotomy Organizations to ensure the quality of the program
Levels of Healthcare Facilities
PRIMARY: Health units in the rural areas and sub-units operated by DOH
SECONDARY: Non-departmentalized hospitals that attend to patients during the symptomatic stages of an ailment
TERTIARY: Medical centers and large hospitals where services are sophisticated coupled with highly technical facilities that can address serious diseases
Category of Healthcare Facilities: OUTPATIENT (AMBULATORY) Patients are served by secondary care specialists on the same day
Hospital Organizations
EMERGENCY DEPARTMENT (ED/ER): Immediate care is given to patients
INTENSIVE CARE UNIT (ICU): Critically ill patients are treated
CARDIAC CARE UNIT (CCU): Another form of ICU dealing with patients with acute cardiac disorders
PEDIATRICS: Care for children
NURSERY: Care for infants/newborns
NEONATAL INTENSIVE CARE UNIT/NURSERY (NICU): Newborns experiencing difficulties are treated
LABOR & DELIVERY ROOM (LR/DR): Childbirth
OPERATING ROOM (OR): Surgical procedures
RECOVERY ROOM (RR): Post-operative care
PSYCHIATRIC UNIT: Mentally disturbed patients
DIALYSIS UNIT (HEMODIALYSIS UNIT - HD): Patients with severe renal disorders
MEDICAL/SURGICAL UNITS: General patient care
ONCOLOGY CENTER: Cancer treatment
SHORT-STAY UNIT (OUT PATIENT DEPARTMENT - OPD): Outpatient surgery, minor injuries that do not require admission
Characteristics Associated with Professionalism
DEPENDABLE, COOPERATIVE, COMMITTED: Punctuality and awareness, Prepared for emergencies and disruptions
COMPASSIONATE, COURTEOUS, RESPECTFUL: Sensitive and approachable to the concern of the patient
ORGANIZED, RESPONSIBLE, FLEXIBLE: Counter-check equipments, Master of prioritization
APPEARANCE: Look like a professional at all times
COMMUNICATION: Good communication, either verbal or non-verbal
Additional Duties of a Phlebotomist
1. Training other healthcare personnel to perform phlebotomy
2. Monitoring the quality of samples collected on the units
3. Evaluation of protocols associated with sample collection
4. Performing and monitoring point-of-care testing (POCT), near the site of patient care rather than the laboratory
5. Performing electrocardiograms
6. Performing measurement of patient’s vital signs
7. Collection of arterial blood samples
8. Collection of sample from central venous access devices (CVAD)
Skills and Knowledge of a Phlebotomist
Good manual dexterity
Special communication skills
Good organizational skills
Thorough knowledge of laboratory specimen requirements
Trained in phlebotomy skills, coupled with standard practice
Category of Healthcare Facilities: INPATIENT (NON-AMBULATORY) requires patients to stay in the hospital for at least one night to be serviced by tertiary care practitioners
Training Programs
1. Designed to incorporate a combination of classroom instruction and clinical practice
2. Follows the guidelines developed by the National Phlebotomy Organizations to ensure the quality of the program
3. The goal is to meet the accreditation requirements and to prepare graduates for a national certification
Phlebotomist Certifications
Registered Phlebotomy Technician, RPT (AMT)
Phlebotomy Technician, PBT (ASCP)
Certified Phlebotomy Technician, CPT (ASPT)
Certified Phlebotomy Technician, CPT (NPA)
Certified Phlebotomy Technician, CPT (NHA)
Membership in a professional organization enhances the professionalism of a phlebotomist by providing opportunities for continuing education
Components of good communication
Verbal communication
Non-verbal communication
Active listening
Professional organizations present seminars and workshops or published journals containing info on new developments in the field
Non-verbal communication
Observing facialexpressions and other non-verbal communication
Includes dimensions like bodylanguage, gestures, distance, appearance, touch
Professional organizations represent the profession at the state and national levels to influence regulations affecting the professions
Active listening
Building rapport by listening to the patients, then giving feedback to ensure that the message is interpreted correctly
Elements in healthcare communication include empathy, control, respect and confirmation, trust
Outline of the National Accrediting Agency for Clinical Laboratory Science’s Phlebotomy Competencies
Knowledge of the health-care system and medical terminology
Knowledge of infection control
Knowledge of basic anatomy and physiology and anatomic terminology related to the laboratory and the pathology of body systems
Understanding of the importance of sample collection and integrity of patient care
Knowledge of collection equipment, tube additives, special precautions, and interfering substances associated with laboratory tests
Performance of standard operating procedures in collecting samples
Understanding of requisitions, sample transport, and sample processing
Understanding of quality assurance and quality control in phlebotomy
Use of effective and appropriate communication skills
Verbal communication
Expressing ideas through words
Professional Organizations
American Medical Technologists (AMT)
American Society for Clinical Pathology (ASCP)
American Society of PhlebotomyTechnicians (ASPT)
National Phlebotomy Association (NPA)
NationalHealthcareerAssociation (NHA)
Phlebotomists need to have good communication skills which are essential to ensure that the patient feels at ease during the venipuncture procedure