Introduction to Phlebotomy and Laboratory Analysis

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Questions and Answers

What color code represents health hazards in the workplace?

  • Red
  • Yellow
  • White
  • Blue (correct)

Which item is NOT an example of personal protective equipment (PPE)?

  • Lab coats
  • Safety goggles
  • Biological safety cabinet (correct)
  • Gloves

What practice is recommended for handling specimens and hazardous chemicals?

  • Using the same pair of gloves for multiple patients
  • Wearing gloves at all times
  • Gloves should be replaced after each patient (correct)
  • Only using gloves when instructed to do so

Which of the following is a proper housekeeping technique in a laboratory?

<p>Double-bagging properly labeled waste (C)</p> Signup and view all the answers

How should hazardous waste be identified for safe disposal?

<p>With a warning and specific instructions (C)</p> Signup and view all the answers

In terms of hazard levels, what number corresponds to a severe hazard?

<p>3 (C)</p> Signup and view all the answers

What is the primary purpose of personal protective equipment (PPE) in laboratories?

<p>To protect individuals from hazards (A)</p> Signup and view all the answers

What is considered a common pre-analytical error in clinical laboratory testing?

<p>Inaccurate patient identification (D)</p> Signup and view all the answers

What is the primary purpose of bending the knees when lifting heavy objects?

<p>To avoid bending the back too much. (A)</p> Signup and view all the answers

Which type of shoes is recommended for safety in the workplace?

<p>Comfortable, closed-toe shoes with nonskid soles. (B)</p> Signup and view all the answers

What does the NFPA 704 color-coded diamond symbol indicate?

<p>The types of hazardous materials present. (D)</p> Signup and view all the answers

What are universal precautions designed to address?

<p>To treat all body fluids as potentially infectious. (B)</p> Signup and view all the answers

Which action should be taken regarding personal items while working in a healthcare setting?

<p>Keeping long hair tied back. (B)</p> Signup and view all the answers

What is a recommended practice in maintaining a safe workplace environment?

<p>Maintaining a clean and organized work area. (D)</p> Signup and view all the answers

What is a potential issue related to patient preparation that may affect test results?

<p>Collecting a sample from a non-fasting patient (C)</p> Signup and view all the answers

Which of the following best describes OSHA's role in workplace safety?

<p>Establishing guidelines for hazardous materials. (B)</p> Signup and view all the answers

Which error can occur during the analytic phase of testing?

<p>Inadequate mixing causing clots (D)</p> Signup and view all the answers

What precaution is advised to help avoid accidents on wet floors?

<p>Being alert and cautious on wet surfaces. (C)</p> Signup and view all the answers

What mistake might lead to hemolysis of the blood sample?

<p>Forcing blood through a needle (C)</p> Signup and view all the answers

What can result from a short draw or incorrect blood ratio in anticoagulant use?

<p>Inaccurate test results (D)</p> Signup and view all the answers

Which factor is NOT related to sample collection errors?

<p>Incorrect incubation time (A)</p> Signup and view all the answers

What is a common issue associated with inadequate patient preparation?

<p>Clotting in the sample (A)</p> Signup and view all the answers

During which phase is hemoconcentration most likely to occur?

<p>Collection phase (C)</p> Signup and view all the answers

What is a possible consequence of inadequate mixing of samples post-collection?

<p>Formation of clots (B)</p> Signup and view all the answers

What type of specimens does the anatomical area responsible for analysis handle?

<p>Surgical specimens and biopsies (B)</p> Signup and view all the answers

What is not contained in serum obtained from a blood sample allowed to clot?

<p>Fibrinogen (C)</p> Signup and view all the answers

Which section of the anatomical area is specifically involved with chromosome studies?

<p>Cytogenetics Section (A)</p> Signup and view all the answers

Which type of analysis is performed in the Histology Section?

<p>Issues pathology biopsies (C)</p> Signup and view all the answers

What is the main purpose of the Cytology Section?

<p>Conducting PAP smears and cellular studies (C)</p> Signup and view all the answers

Which option represents a type of sample that is specifically analyzed in Cytopathology?

<p>Cerebrospinal fluid (D)</p> Signup and view all the answers

What distinguishes serum from plasma in terms of clotting factors?

<p>Plasma contains clotting factors (B)</p> Signup and view all the answers

Which section is NOT involved in histopathological analysis?

<p>Cytogenetics Section (D)</p> Signup and view all the answers

What is the approximate time recommended for scrubbing hands?

<p>20 seconds (D)</p> Signup and view all the answers

When should hands be washed after handling gloves?

<p>After gloves are removed (A)</p> Signup and view all the answers

Which of the following is a precaution taken when dealing with highly infectious patients?

<p>Placing them in private isolation rooms (A)</p> Signup and view all the answers

What is the correct order of donning PPE?

<p>Gown, Mask, Goggles, Face Shield, Gloves (D)</p> Signup and view all the answers

What is the first step in the doffing process of PPE?

<p>Removing the gloves (C)</p> Signup and view all the answers

What color coding is used for containers for disposing of contaminated phlebotomy equipment?

<p>Red or yellow (C)</p> Signup and view all the answers

What should be done before going to designated break areas?

<p>Wash hands (A)</p> Signup and view all the answers

Which of the following is essential to control infection transmission in healthcare settings?

<p>Use of private isolation rooms for certain patients (D)</p> Signup and view all the answers

Which of the following goals focuses on enhancing communication among healthcare providers?

<p>Improving the Effectiveness of Communication among Healthcare Givers (A)</p> Signup and view all the answers

What is one of the patient's rights regarding treatment decisions?

<p>Patients can refuse treatment (C)</p> Signup and view all the answers

What should phlebotomists maintain regarding patient information?

<p>The confidentiality of patient information (D)</p> Signup and view all the answers

Which of the following statements is true about diagnosing patients?

<p>Doctors are responsible for diagnosing patients (B)</p> Signup and view all the answers

What strategy involves patients being actively involved in their healthcare?

<p>Encouraging Patients Active Involvement (A)</p> Signup and view all the answers

Which of the following is NOT a part of the Joint Commission's Patient Safety Goals?

<p>Increasing Hospital Revenues (D)</p> Signup and view all the answers

Why is it crucial for healthcare providers to improve patient identification?

<p>To ensure proper patient care (A)</p> Signup and view all the answers

What role does the phlebotomist play in patient care as per the Patient's Bill of Rights?

<p>Be respectful to their patients (D)</p> Signup and view all the answers

Flashcards

Cytology Section

This section analyzes cells collected from various body fluids, like PAP smears.

Histology Section

This section examines tissues for abnormalities, like cancer.

Cytogenetics Section

This section analyzes chromosomes for abnormalities.

Serum

The liquid portion of blood obtained after it clots.

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Plain Red Top Tube

A blood tube without anticoagulant, used for serum analysis.

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Plasma

The liquid portion of blood that contains clotting factors.

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Microscopic Examination

A test where cells are examined under a microscope.

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Pathology

The study of disease within tissues.

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Standard Precautions

The practice of using protective barriers, like gloves, masks, and gowns, to prevent the spread of infections.

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Transmission-Based Precautions

A type of infection control practice used for patients with highly contagious diseases.

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Donning PPE

The process of putting on personal protective equipment (PPE) in a specific order to minimize contamination.

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Doffing PPE

The process of taking off personal protective equipment (PPE) in a specific order to avoid self-contamination.

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Handwashing Duration

The time needed to effectively wash your hands, typically 20 seconds.

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Biological Waste Disposal

Items contaminated with blood or bodily fluids should be disposed of in containers clearly marked with biohazard symbols.

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Personal Protective Equipment (PPE)

Wearing gloves, gowns, masks, and goggles to prevent the spread of infections.

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Handwashing Practices

The practice of washing hands before and after patient contact, after glove removal, and before leaving the work area.

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Universal Precautions

A policy that treats all blood, body fluids, and OPIM (other potentially infectious materials) as infectious, regardless of the individual's known infection status.

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NFPA Fire Classification System

A system that classifies fires based on the type of material burning, guiding the appropriate fire extinguisher to use.

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NFPA 704 Diamond

A color-coded diamond symbol used to communicate the hazards of materials to firefighters, aiding in their response.

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OSHA Pathogen Regulation

A set of workplace safety regulations implemented by the Occupational Safety and Health Administration (OSHA) to protect workers from exposure to potentially infectious materials (OPIM).

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Engineering and Work Practice Control

Measures implemented to control hazards in the workplace, typically through engineering controls (modifying equipment or processes) or changes in work practices.

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Precautions

Protective measures taken by healthcare workers to prevent contamination and transmission of infectious agents during patient care.

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Class A Fire

A type of fire that involves ordinary combustible materials, such as wood, paper, and cloth.

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Incorrect test order

An error in the order for a laboratory test, which can lead to delays or incorrect results.

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Errors During sample collection

Errors occurring during the collection of the sample that can result in inaccurate test results. Examples include improper fasting, wrong blood container, or hemoconcentration.

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Sample Collection

The process of collecting a blood sample from a patient.

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Sample Transport

The process of transporting the collected sample to the laboratory for analysis.

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Sample Preparation

The process of sorting and preparing the collected samples for analysis. This may include centrifuging the samples, separating serum/plasma, and preparing aliquots.

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Analytic Phase

The analysis of the sample using laboratory instruments and techniques.

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Inadequate Patient Preparation

A pre-analytical error that occurs when a patient is not properly prepared for the test. This can involve not fasting, recent heavy meal, or not taking the right medication.

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Errors After Sample Collection

Errors that occur during the post-collection phase of laboratory testing. These can involve problems with sample handling, storage, or documentation.

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Hazard Identification System

A system used to identify and manage potential hazards in the workplace. It uses colored labels to indicate different types of risks, like health hazards, flammability, reactivity, and specific hazards.

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Sharps Container

A container used to safely dispose of sharp medical instruments, like needles and scalpels. It prevents accidental punctures and infections.

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Biological Safety Cabinet

A specialized cabinet designed to minimize contamination by providing HEPA filtration and a controlled airflow for handling dangerous biological agents.

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Laboratory Fume Hood

A specialized hood with a ventilation system that removes potentially hazardous fumes from a laboratory workspace, protecting workers and the environment.

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Proper Hand Washing

A vital hygiene practice in a laboratory setting. It involves washing hands thoroughly with soap and water to remove any contaminants that may have been picked up while handling specimens or using equipment.

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Banning of Eating, Smoking, and Drinking

Prohibiting activities like eating, smoking, and drinking while working in a laboratory is crucial in minimizing the risk of contamination and accidental ingestion of hazardous materials.

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Personal Protective Equipment (Gloves)

Personal protective equipment (PPE) safeguards individuals working with potentially hazardous materials like specimens and chemicals. Gloves are essential for protecting hands from contamination.

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Protective Body Clothing

A combination of clothing and accessories designed to prevent contamination of a laboratory worker's body. This includes lab gowns, aprons, lab coats, surgical caps, scrubs, shoe covers, and disposable arm sleeves.

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Joint Commission

This agency focuses on promoting patient safety by setting standards for hospitals and healthcare organizations. They have specific goals to minimize errors and improve communication in medical settings.

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Patient's Bill of Rights

A patient's right to be informed about treatments, make choices, and refuse care. It also includes the right to confidentiality and respectful treatment.

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Regulatory Agencies

This type of agency sets rules and regulations for specific industries, including healthcare. They ensure safe and ethical practices in laboratories.

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Phlebotomist's Responsibilities

Phlebotomists should always be courteous and respect their patients' choices. They should guide patients to their doctor for information about their tests and conditions.

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Phlebotomist's Role

Phlebotomists should never diagnose patients. This task belongs to healthcare providers who are qualified to interpret test results.

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Study Notes

Introduction to Phlebotomy: The Clinical Laboratory

  • The clinical laboratory is organized into divisions, including clinical, anatomical, and cytology, histology, cytogenetics, hematology, coagulation, chemistry, blood bank, serology (immunology), and microbiology.
  • Whole blood is a mixture of cells and plasma.
  • Plasma is the liquid portion of blood with anticoagulant, containing fibrinogen.
  • Serum is the liquid portion of blood after clotting, devoid of fibrinogen.
  • Common hematology tests include Complete Blood Count (CBC), differential, hematocrit (Hct), hemoglobin (Hgb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), reticulocyte count and red cell distribution width (RDW).

Clinical Areas

  • Clinical sections analyze blood, bone marrow, microbiology samples, urine, and other body fluids.
  • Laboratory Information System (LIS) manages lab computer operations, records, and compliance with accrediting regulations.

Hematology Section

  • Study of formed elements in blood (RBCs, WBCs, and platelets).
  • RBCs (erythrocytes) carry oxygen.
  • WBCs (leukocytes) are part of the immune system.
  • Platelets (thrombocytes) aid in blood clotting.

Chemistry Section

  • Analyzes blood components (electrolytes, hormones, chemicals, and poisons).
  • Tests are performed on serum, plasma, urine, and other body fluids.
  • Common tests include electrolytes, lipid panel, total protein, enzyme immunoassays, fasting blood sugars, blood gas analyses, and therapeutic drug monitoring.

Coagulation Section

  • Evaluates hemostasis (blood clotting process), which involves platelets, blood vessels, coagulation factors, fibrinolysis and inhibitors, and anticoagulant therapy (e.g., heparin and coumadin).
  • Key tests include prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT).

Immunohematology/Blood Bank Section

  • Blood collection, storage, and preparation for transfusions.
  • Bloodborne pathogens (Hepatitis, HIV) are tested for in donated blood.
  • Blood components like packed cells, platelets, fresh frozen plasma, and cryoprecipitate are separated. Blood transfusions are performed by doctors.
  • Common tests include blood typing (ABO and Rh), and crossmatching.

Serology/Immunology Section

  • Evaluates immune response by detecting antibodies to bacteria, fungi, parasites, viruses, and autoantibodies.

Microbiology Section

  • Identifies pathogenic microorganisms.
  • Tests include culture and sensitivity, gram stain, blood culture, acid-fast bacillus (AFB) culture, fungal culture, and ova and parasite analysis.

Urinalysis Section

  • Analyzes urine for physical, chemical, and microscopic characteristics.
  • Tests performed include physical examination (color, volume, clarity), chemical examination (pH, protein, glucose, ketones, blood, bilirubin, urobilinogen, specific gravity, nitrite, and leukocyte esterase), and microscopic examination.

Clinical Lab Personnel

  • Personnel includes Laboratory Director (pathologist), Laboratory Manager, Technical Supervisor, Medical Laboratory Scientists, Medical Laboratory Technicians, and Laboratory Assistants/Phlebotomists.
  • Their roles and responsibilities vary with their respective education and certifications.

Safety and Infection Control

  • Important to break the chain of infection to prevent transmission of pathogens.
  • Steps include hand hygiene, standard precautions, personal protective equipment (PPE) and proper cleaning of contaminated surfaces.
  • Infectious agents, reservoirs, portals of exit, portals of entry, mode of transmission and susceptible hosts are important components of the infection chain.

Preanalytical Factors

  • Factors influencing test results before analysis, including patient preparation, proper collection techniques, handling, and labeling of specimens.
  • Common errors to avoid include improper specimen collection, labeling, transportation, storage, and handling errors.

Patient Care Areas

  • Common hospital patient care areas include emergency departments, intensive care units (ICUs), cardiac care units (CCUs), pediatrics, nurseries, labor and delivery, operating rooms, recovery rooms, psychiatric units, dialysis units, medical/surgical units, oncology centers, and short-stay units.
  • Legal issues include compliance, regulatory standards, and patient rights (e.g., consent).
  • Ethical issues include patient confidentiality and responsible practice.

Medical Terminologies

  • Medical terminology uses Greek and Latin roots, prefixes, suffixes to create complex terms.
  • Understanding word parts is essential for deciphering and using medical terms accurately.

Blood Collection Overview

  • Different collection tubes are used for various tests.
  • Proper collection, labeling, and transport is essential to avoid errors.
  • Anticoagulants prevent clotting, while clot activators encourage clotting.

Specimen Transport

  • Proper specimen transport is important to preserve the specimen and prevent deterioration.
  • Transport containers must be appropriately labeled.

Regulatory and Ethical Issues

  • Understand and observe regulatory standards set by agencies such as CLIA and The Joint Commission (JC) in the handling of patient samples..
  • Understand ethical considerations, such as patient confidentiality, and responsible practices in the laboratory environment.

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