Questions and Answers
What does ICD-9CM stand for?
What is the purpose of ICD-9CM?
Billing code used to submit service charges to insurance companies
What are requisitions in a laboratory setting?
Documents generated by laboratory which include patient demographics and test information
What is the most important step in any phlebotomy procedure?
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ID bands are required for outpatients.
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According to the Joint Commission guideline in 2010, how many patient identifiers should be used?
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The first choice for a venipuncture is the ______.
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What should you do when receiving requisitions?
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List the three consequences of improper tourniquet application.
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What techniques should be used to prepare a patient for venipuncture?
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It is safe to draw blood from a standing patient.
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Study Notes
International Classification of Diseases
- ICD-9CM: Billing code essential for submitting service charges to insurance companies.
- Physicians must provide this code for requested tests.
Requisitions
- Generated by the laboratory, often includes labels.
- Contains patient demographics: date of birth, full name, sex, race, physician's code, hospital ID number, room number (if inpatient), and test status (stat, timed, or fasting).
- Essential for accurate patient identification, indicating specimens to collect, and required equipment for collection.
Receiving Requisitions
- Confirm requisition includes necessary information: full name, DOB, physician, and patient location.
- Check for duplicate requisitions; group if more than one for a patient.
- Prioritize requisitions: stat, timed, or routine.
- Gather all required equipment for the blood draw.
Patient Identification
- Crucial step in phlebotomy procedures; must correctly identify the patient to avoid serious consequences.
- Wrong blood draws can lead to incorrect treatment or diagnosis; phlebotomists risk termination for errors.
Joint Commission Guidelines
- Requires at least two patient identifiers for blood drawing; key identifiers are patient's name, DOB, and ID number.
ID Band
- Worn by all inpatients, contains patient’s name, DOB, and ID number.
- ID number on the band must match that on the requisition.
- If not attached, arrange for a nurse to attach a new one.
Outpatients
- Do not require ID bands; verification of identity is done by asking patients to state their name and DOB.
- Avoid asking questions like, "Is your name...?"
Routine Venipuncture Steps
- Follow a comprehensive sequence starting from greeting the patient, to withdrawing the needle, and labeling tubes.
- Ensure appropriate hygiene and equipment is prepared throughout the process.
Greeting and Identifying Patient
- Knock gently, explain purpose of blood collection, and verify patient's full name and DOB against the requisition form.
- Inquire about any medications the patient is taking and set up the phlebotomy tray.
Positioning and Preparing Patient
- Check if the patient has fasted, if required, and verify any pretest preparation.
- Inpatients should not be standing during the procedure; support arm and lower bed rail as needed.
- Obtain consent and ensure the patient is comfortable, explaining the expected sensations during the procedure.
Applying the Tourniquet
- Position the tourniquet 3-4 inches above the puncture site, adjusting for clothing if necessary.
- Monitor for slight pressure without pain; should not cause discoloration or tingling in the fingers.
Consequences of Improper Tourniquet Application
- Hemoconcentration: Increased ratio of formed elements to plasma, potentially affecting test results.
- Hemolysis: Damage to red blood cells caused by tight or prolonged tourniquet application, altering test results.
- Petechiae: Small red spots caused by prolonged tourniquet application.
Vein Selection
- Median cubital vein is the first choice for venipuncture: large, well anchored, and stable during needle insertion.
- Cephalic vein is the second choice, suitable for obese patients but tends to move and is not as well anchored.
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Description
Test your knowledge on key concepts from Chapter 9 of Phlebotomy Essentials, focusing on routine venipuncture and related terminology. This quiz covers important definitions such as ICD-9CM and requisition processes necessary for laboratory proficiency.
