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                                                         The “Phlebotomist”

                                      Optimized for Performance  

                                                 ………. are we?………                       

         

On the forefront of healthcare is the phlebotomist.  What is happening on the forefront of phlebotomy? Are we keeping abreast of it all? What has changed since the Needle Safety and Prevention Act ?  What happened to the Phlebotomy Coalition?  Does it matter? Are we accessing the correct information?  Are we being the beneficial and responsible phlebotomist’s at our facility? 

We, phlebotomist serve as an ambassador to the laboratory.  Phlebotomy is a crucial component of patient care, since laboratory results are dependent on the quality of collected blood specimen received for analysis. 

We, phlebotomist must ………

  1. “First Do No Harm”
  2. Avoid pre-analytical variables that could affect the quality of a specimen and patient results.
  3. Utilize correct safety measures
  4. Improve patient, staff, and, personal satisfaction for customer service and communication techniques

Updates/revisions    (www.clsi.org) Clinical Laboratory Standards Institute


_ Order of draw (revised/revisions 2007)

_ Blood culture collection

_ Capillary collection

_ Filter paper collection

 

H03-A6—Procedures for the Collection of Diagnostic

Blood Specimens by Venipuncture; Approved

 

Standard—Sixth Edition

H03-A6 QG—Quality Venipuncture Quick Guide

H04-A5—Procedures and Devices for the Collection of

Diagnostic Capillary Blood Specimens; Approved

Standard—Fifth Edition

 

H04-A5 QG—Technique for Skin Puncture

Quick Guide

 

LA04-A5—Blood Collection on Filter Paper for

Newborn Screening Programs; Approved Standard—Fifth Edition

LA04-A5 QG—Set of Two Newborn Screening

Quick Guides

 

M29-A3 QG—Personal Protection in the Laboratory

Quick Guide

 

M47-A—Principles and Procedures for Blood Cultures;

Guidelines

 

Procedure

Has your facility updated venipuncture procedure in their manuals?  As a result, if they have not, it may reflect the standard of care for procedures, putting them at risk of liability.

Furthermore, standards and guidelines should be on every phlebotomist and educator’s agenda, creating well-written phlebotomy and specimen procedures.  All standards and guidelines should be based on the approval of Clinical Laboratory Standards Institute and NAACLS.

 

Legislation

                            …………. Awareness in your state, if any report it……………..

FYI

Texas

Did you know that a study conducted at the University of Texas Southwestern Medical Center in Dallas showed that a comparison of blood cultures contamination rated associated with phlebotomists and non-phlebotomy staff in the ED at Parkland Memorial Hospital?  The comparison showed by utilizing well-trained phlebotomist to collect blood cultures in the ED, the contamination rates were lowered to recommend levels, with projected reductions in patient charges of approximately $4.1 million per year.

Does your have a strategic plan that is employed by law enforcement officers to obtain search warrants for blood when suspected drivers refuse a breathalyzer test.  In Texas, those who refuse a breathalyzer leave the officers with only one option to enforce: a blood draw.   See Texas House Bill 509, which takes effect September 2009.  Along with HB 509 there are five other related DWI bills.  HB 509 is DWI Bill #1.  HB 259 did not pass in 2007. 

HB 509 ……………..Another related House Bill (HB 823)

 

Public Safety Committee

HB 823  Turner/ Sylvester | Rodriguez | Edwards  - Relating to the authority of a peace officer to take a blood specimen from a vehicle operator to test for alcohol concentration or other intoxicating substances.

YES, in Favor:   Restrict a peace officer from taking blood!  Below is the bill analysis by the Texas  Legislative Service

BACKGROUND AND PURPOSE 

Currently in Texas there is an increasing trend of law enforcement agencies implementing "no refusal" policies in an effort to increase conviction rates for suspected DWI violations. 

A "no refusal" policy results in an arresting officer obtaining a search warrant to obtain a blood specimen when a suspect refuses to give a breath specimen. Often these search warrants contain pre-drafted, boilerplate language so that the officer can obtain a blood specimen as close to the time of arrest as possible.  

The current law states that only a physician, qualified technician, chemist, registered professional nurse, or licensed vocational nurse may take a blood specimen. One method law enforcement agencies who have implemented "no refusal" policies have used is taking suspects to local hospitals and having nurses draw the blood specimens. Many hospitals have expressed concerns with liability, lack of resources, and inappropriate use of emergency room facilities and staff, and in some instances have asked the law enforcement agencies to stop bringing suspects to their emergency rooms. This has led some law enforcement agencies to train their officers in phlebotomy, or the practice of drawing blood. Sometimes all that is needed for such training is a 20-hour course. Once this training is complete, the agencies are claiming that their officers are qualified technicians under the current law.  

A law enforcement agency's goal is to protect and serve. This task is often accomplished with little resources. Asking officers to draw blood keeps them from performing their primary duties.   Police officers are not properly trained in medicine even if they complete phlebotomy training.   This policy undermines public safety, diminishes community trust in law enforcement, and could expose police departments to increased liability. 

 

H.B. 823 prohibits a peace officer from taking a blood specimen from a motor vehicle operator to test for alcohol concentration or other intoxicating substances regardless of whether the officer is a member of the medical profession a chemist, or a qualified technician authorized to take a  blood specimen in such a situation.   The bill passed out of committee by vote 7-0 and was referred favorably to Calendars Committee!

 

the above information was Posted by TxGreen-Lege at on May 8. 2009                                                                                                                              

 

                                          The “Results begin with the Phlebotomist”

                                                The Phlebotomy Coalition Update

 What is a coalition?

A coalition is a diverse group of individuals and organizations that work together to reach a common goal. The goals might be a number of things, but often includes one of the following:

bullet Adapting, creating, or developing public policy
bullet Influencing people's behavior/habits
bullet Building a healthy community

Why develop a coalition?

bullet To bring about more effective and efficient delivery of programs and use of resources and eliminate any duplication of services
bullet To increase communication between groups and break down stereotypes
bullet To revitalize energies of members of diverse groups who are trying to do too much alone, those being the movers and shakers in the health care arena

The Phlebotomy Coalition is dormant, at least for now per the Director of the Center for Phlebotomy Education and Chair of the Phlebotomy Coalition, Dennis Ernst, MT (ASCP).  Mr. Ernst is a renowned speaker both internationally and nationally.  In addition, to these accolades, Mr. Ernst has authored books, created video’s, and, has lectured around the globe, to include at our AMT Meeting both at a state and national level.  As I see it, he is the Leader of Phlebotomy Education. 

In addition, Mr. Ernst has identified people in thirty-five states who expressed an interest in getting active within their states, in order to bring about minimum training standards to phlebotomy programs.

Since its formation in 2003, the Coalition has worked to introduce bills establishing professional standards for phlebotomists and other specimen-collection personnel in Kentucky, Connecticut, Massachusetts, and Missouri. It is currently working on draft legislation in Utah and Michigan. Even though the Connecticut and Kentucky bills did not make it out of committee, the Coalition has encouraged sponsors and supporters to reintroduce revised bills in the next legislative session.  California is currently the only state that mandates training for specimen-collection personnel.

Remember poorly trained specimen blood collection personnel, often commit pre-analytical errors that affect the performance of blood collection systems, cause laboratory instrumentation problems, and, lead to erroneous results, putting the patient in jeopardy.   Discover ways to sharpen your phlebotomy skills.

Furthermore, “let us not forget” that we are the Registered Phlebotomist of the American Medical Technologists, the “Pride of the Profession.”

Linda M. Raven, AAS, AS, RMA, RPT, CLMA (AMT)

 

WEBMASTER rpolasky@familyplace.com        PRESIDENT Annaseals@aol.com  Last Edited:06/21/2009