c-1 Professional.docx

CHAPTER 1 ========= Phlebotomy Fundamentals ======================= OVERVIEW -------- During phlebotomy, most patients don\'t think about the many ways the phlebotomist keeps them safe. They focus on how long it will take, how much it will hurt, whether it will leave a bruise, and if there will b...

CHAPTER 1 ========= Phlebotomy Fundamentals ======================= OVERVIEW -------- During phlebotomy, most patients don\'t think about the many ways the phlebotomist keeps them safe. They focus on how long it will take, how much it will hurt, whether it will leave a bruise, and if there will be more than one puncture. Phlebotomists must understand the anatomy and physiology of the cardiovascular system, then apply it to collect a blood sample. Collect only the amount necessary for the testing so that blood loss is minimal. Pain is a subjective experience, so it is important to know how to minimize it during the procedure. Learn various factors that affect blood clotting and be ready to handle unexpected situations. Additionally, phlebotomists must communicate professionally and therapeutically with patients. Verify each patient\'s identity and make sure the specimens collected have proper and accurate labeling to avoid laboratory errors or rejection. Determine if anything about the patient\'s history requires extra safety precautions or procedures. Know how to proceed when there are challenges to communication, such as a language barrier or hearing or speaking difficulties. The time spent with most patients is very brief, so it is crucial to be adept at getting the most important information quickly, while helping patients feel comfortable and confident in the phlebotomist\'s skills. Most importantly, phlebotomists must protect patients and themselves from complications such as infection. Micro-organisms are everywhere-on inanimate surfaces and skin as well as in the blood. Some are harmless or even helpful, but others are pathogenic and can cause serious infections. Phlebotomists need a thorough understanding of infection control to prevent the transmission of pathogens. Doing so involves using personal protective equipment (PPE), disinfecting skin, appropriately handling and disposing of various supplies, and sanitizing and disinfecting surfaces. An understanding of these concepts-components of the phlebotomist\'s role; cardiovascular anatomy and physiology; medical terminology related to phlebotomy; and the fundamentals of communication and infection control-will help you advance toward proficiency in this essential professional role. It takes practice to build confidence as a phlebotomist, but a sound knowledge of the fundamentals of phlebotomy will accelerate the path to proficiency. Objectives ---------- Upon completion of this chapter, you should be able to: - Describe the role of the phlebotomist. - List the qualities that make a successful phlebotomist. - Explain the scope of practice, including ethical responsibilities of the phlebotomist. - Label the anatomical structures of the cardiovascular system. - Explain the physiology of the cardiovascular system. - Describe the importance of hemostasis and coagulation. - Understand medical terminology and abbreviations commonly used by phlebotomists. - Determine appropriate communication techniques to use during phlebotomy procedures. - Describe the infection cycle. - Determine the differences between medical and surgical asepsis. THE PROFESSIONAL PHLEBOTOMIST ============================= Role of the phlebotomist ------------------------ A phlebotomist is a professional who uses needles to puncture veins for the purpose of collecting blood for laboratory testing. This is a vital role in health care because providers base much of the treatment and care for patients on laboratory and diagnostic results. Laboratory results help providers detect problems, determine if treatment is having the intended effect, monitor patients over time, and point out the need for further testing or treatment. This would not be possible without the phlebotomist first accurately performing the specimen collection. Depending on the work setting, phlebotomists might have responsibilities other than collecting blood and ensuring its transportation to the laboratory for testing. Some phlebotomists collect other nonblood specimens, such as urine and sputum. Others perform point-of-care testing, such as checking blood glucose levels at a patient\>s bedside in an acute care facility. Phlebotomists often have to complete clerical duties in addition to obtaining specimens or conducting point-of-care testing. Desired traits of a phlebotomist -------------------------------- A phlebotomist must display the essential trait of professionalism, which encompasses the ability to perform skills competently and proficiently as well as the character traits required of any health care professional. Demonstrate respect for patients and coworkers by adhering to the policies and procedures of the organization (dress codes, personal hygiene, appearance, patient confidentiality). Display good posture, apply principles of ergonomics, and strive for personal health and wellness. Phlebotomists are in close contact with many patients over the course of a work day. Do not wear perfume, cologne, or any other scents that could trigger allergic reactions, nausea, or migraines in patients and coworkers. Use deodorant (preferably unscented) to prevent body odor. Phlebotomists serve a diverse population, so grooming should be conservative. This includes maintaining natural hair color, avoiding excessive piercings and visible tattoos, and wearing minimal or no makeup. Additionally, adhere to policies regarding safety, infection control, fire, and electrical precautions. Respect leads to another professional trait: service. Professionals must shift their focus from themselves to those they serve. Do this by making a commitment to exemplary performance. Demonstrate quality and accuracy, with minimal errors and contamination rates, while increasing speed and productivity when needed so patients\> wait times do not become unacceptable. Also remember to keep the focus on patients. For example, in conversing with a patient during a venipuncture, resist the urge to tell the patient about personal experiences. Instead, allow the patient to lead the conversation. Phlebotomists must be good listeners and great communicators, with engaging and efficient verbal and nonverbal skills. For example, phlebotomists must translate medical terminology effectively for patients who might not understand complex medical terms. Develop skills for interacting with patients, and sometimes coworkers and colleagues, who display anger or frustration. Throughout all job duties and responsibilities, display compassion and respect patients\' privacy and confidentiality during and after work. Phlebotomists also offer support by keeping their workspace clean and organized, treating others with courtesy, and working with colleagues to solve problems or improve situations. For example, in a hospital laboratory, best practice is to leave an ample amount of supplies immediately available in case the oncoming shift begins at a fast pace. A final category in this model of professionalism is growth: constantly expanding professional knowledge and learning more about the organization, its mission, and how it strives to improve quality of care. Actively seek continuing education opportunities, such as an in-service about disaster planning to learn how their role would change when working with multiple trauma victims or patients exposed to bioterrorism agents. Ethical standards ----------------- It is a well-known responsibility for everyone who works in health care to do no harm. Mistakes and errors happen, but anyone who intentionally harms someone does not belong in health care. Another ethical consideration is to use technical training, abilities, and good judgment to the greatest extent possible. As professional guidelines dictate, it is an ethical standard to respect patients\' rights at all times, including the right to refuse initiation or continuation of any procedure. Phlebotomists are responsible for ensuring the reliability, accuracy, and precision of the various aspects of specimen collection. These responsibilities and respect for all aspects of patients\' rights and dignity comprise a phlebotomist\'s ethical and professional conduct. Phlebotomists must dedicate themselves to high performance standards, seek assistance when they are unsure about a procedure, and take pride in using and constantly upgrading their knowledge and skills. Be accountable for doing things the right way, even when no one is watching. Seek opportunities to collaborate, learn, and grow, both personally and professionally.