Clinical Laboratory Science:
Phlebotomy
Occupational Description
The phlebotomist is primarily responsible for collecting blood specimens from patients for the purpose of laboratory analysis. He/She is also knowledgable about the health care delivery system; collection of materials and equipment; venipuncture and capillary puncture techniques; specimen transport and processing techniques; quality assurance and safety techniques; concepts of oral and written communications skills; and medical, legal and ethical implications of blood collection. Phlebotomists work in a variety of health care settings such as hospitals, clinics, rehabilitation facilities, long-term care facilities, extended care facilities, and industry.
Accreditation and Certification
Phlebotomy programs are approved by the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), 8410 West Bryn Mawr Ave., Suite 670, Chicago, IL 60631-3415, phone number is (773) 714-8886. Students who successfully complete the Phlebotomy Program are eligible to take the national certification examinations given by either the National Certification Agency for Medical Laboratory Personnel (NCA) or the American Society of Clinical Pathologists, Board of Registry (ASCP).
Patient Identification
Selection of Collection Site
Equipment
Procedure
Patient Identification
Proper identification decreases the risk of harm to the patient. Proper identification can be determined by asking the patient to tell you his/her full name or through the utilization of the hospital ID band. Many institutions state in their procedure manuals that blood collection can not be done unless a ID band is present. It is important to be aware of the organization's policies and procedures.
Prior to specimen collection compare requisition with patient identification band.
In outpatient or other settings when no identification band is available, ask the patient to
state their full name. Do not state their name and ask if that is correct. Check the
requisition and patient identification again after specimen collection is complete.
Selection of collection site
Collection site selection involves consideration of several factors.
Select a vein that is readily palpated.
Do not select a site above an indwelling IV.
Do not select a site on the side of a mastectomy.
Do not select a site on the arm of the AV fistula of a dialysis patient.
Do not select a site with a hematoma or bruise.
Equipment
The following are suggested supplies for blood specimen collection.
Non sterile exam gloves
Puncture resistant sharps container.
Alcohol wipes.
Tourniquet.
Appropriate specimen collection lab tubes.
2x2 gauze.
Tape.
Vacutainer holder.
Vacutainer needle.
Procedure
Univeral Precautions should be employed during any specimen collection.
The following is a suggested method of performing blood specimen collection.
1.Make positive patient identification.
2.Gather necessary equipment
3.Wash your hands.
4.Don non sterile exam gloves.
5.Explain test and planned procedure to patient.
6.Position patient's arm in comfortable position.
7.Select appropriate collection site.
8.Place the tourniquet above the selected collection site. Do not leave tourniquet on for
longer than for one minute.
9.Clean site with alcohol using circular motion from center outward.
10.Grasp arm 1-2 inches below the site to decrease vein rolling.
11.Enter the vein with the vacutainer needle bevel up at a 15 degree angle.
12.Fill necessary specimen containers.
13.Release tourniquet.
14.Place sharps in puncture resistant sharps container.
15.Apply gauze and tape holding pressure for at least five minutes if the patient is receiving
anticoagulants.
16.Label the specimen containers, checking requisition for patient identification and
requested tests.
17.Remove gloves and wash hands.
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