MODULE 3: UNDERSTANDING PHLEBOTOMY

• Techniques of Phlebotomy

  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
  • INTEGRITY, HONESTY, COMPETENCE: Confidentiality, morality, confidence, humility
  • 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 facial expressions and other non-verbal communication
  • Includes dimensions like body language, 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 Phlebotomy Technicians (ASPT)
  • National Phlebotomy Association (NPA)
  • National Healthcareer Association (NHA)
• Phlebotomists need to have good communication skills which are essential to ensure that the patient feels at ease during the venipuncture procedure