The Healthcare Setting

Phlebotomy: A Historical Perspective  cupping and leeching.

 Since very early times, people have
been fascinated by blood and have
believed in some connection between Phlebotomy Today
the blood racing through their veins  The practice of phlebotomy continues
and their well-being.  to this day; however, principles and
methods have improved dramatically. 
 From this belief, certain medical
 Today, phlebotomy is performed to:
principles and procedures dealing with
blood evolved, some surviving to the  Obtain blood for diagnostic
purposes and to monitor
present day . prescribed treatment
Hippocrates  Remove blood for transfusions
 An early medical theory developed by at a donor center
Hippocrates (460–377 B.C.) stated that  Remove blood for therapeutic
disease was the result of excess purposes, such as treatment for
substance—such as blood, phlegm, polycythemia, a disorder
black bile, and yellow bile—within the involving the overproduction of
body red blood cells
 The process of removal and extraction  Phlebotomy is primarily
became the treatment and could be accomplished by one of two
done either by expelling disease procedures:
 Venipuncture, which involves
materials through the use of drugs or collecting blood by penetrating
by direct removal during surgery. a vein with a needle and syringe
or other collection apparatus
Venesection/Phlebotomy  Capillary puncture, which
 One important surgical technique was involves collecting blood after
venesection (cutting a vein), used in the puncturing the skin with a
process of bloodletting. Venesection— lancet
which comes from the Latin words Duties and Responsibilities of a Phlebotomist
vena, “vein,” and sectio, “cutting”—was

the most common method of general

bloodletting.
 Venesection is another word for
phlebotomy, which comes from the
Greek words phlebos, “vein,” and tome,
“incision.”

Phlebotomy
 During the 17th and early 18th
centuries, phlebotomy was considered
a major therapeutic (treatment)
Patient Client Interaction
process, and anyone willing to claim  Recognizing Diversity
medical training could perform  Despite similarities,
phlebotomy. fundamental differences among
 During this same period, phlebotomy people arise from nationality,
was also accomplished by ethnicity, and culture as well as
from family background, life
 experiences, and individual Some of the personal behaviors and
challenges. characteristics that make
 Critical factors in providing up this professional image, are as follows:
healthcare services that meet
the needs of diverse  Self Confidence
populations include
 A phlebotomists who exhibit
understanding the:
self-confidence has the ability
 Beliefs and values that to trust his or her own personal
shape a person’s judgment.
approach to health and  “Perception is reality”
illness  The more self-confidence you
 Health-related needs of have, the more professional
patients and their you appear.
families according to
the environments in
which they live
 Compassion
 Knowledge of customs
and traditions related to  Compassion means being
health and healing sensitive to a person’s needs
 Attitudes toward and willing to offer reassurance
seeking help from in a caring and humane way.
healthcare providers  A phlebotomist may show
compassion by appreciating the
 Professionalism fear that illness or the unknown
 Professionalism is defined as generates, by using empathy to
the conduct and qualities that
sense others’ experiences, and
characterize a professional
by demonstrating a calm and
person.
helpful demeanor toward those
 As part of a service-oriented
in need.
industry, persons performing
 Self-Motivation
phlebotomy must practice
professionalism.  A person with motivation finds
 The public’s perception of the the workplace stimulating no
phlebotomy profession is based matter what the tasks may
on the image created by the entail.
phlebotomist’s conduct and  A phlebotomist who is
appearance motivated makes every effort
 Besides displaying a to provide excellence in all
professional appearance, a aspects of patient care in which
person performing phlebotomy he or she is involved.
is required to display attitudes,  Dependability
personal characteristics, and  A phlebotomist who works hard
behaviors consistent with and shows constant, reliable
accepted standards of effort and perseverance is a
professional conduct. valuable asset to a healthcare
organization
 Ethical Behavior
 A phlebotomist should know
that there are policies designed
to regulate what should or
should not be done by those
 who work in the healthcare vocabulary that is easily
setting.  understood by his or her
 The Hippocratic oath includes clients.
the phrase primum non nocere,
which means “first do no
harm.”
 The primary objective in
any healthcare
professional’s code of
ethics must always be
to safeguard the
patient’s welfare

 Active listening
 Active listening means taking
positive steps through
feedback to ensure that the
listener is interpreting what the
speaker is saying exactly as the
speaker intended.
 Non-verbal communication
 nonverbal communication is
multidimensional and involves
the following elements:
 Kinetics
 Proxemics
 Appearance
Communication skills  Touch
 Phlebotomy is both a technical and a
people-oriented profession. 
 A phlebotomist who lacks a good

bedside manner increases the chances

of becoming part of a legal action
should any difficulty arise while a
Effective Communication in Healthcare
specimen is being obtained.
 It is not easy for the patient or the health
professional to face disease and
Communication components suffering every day.
 For many patients, being ill is a fearful and
 Verbal communication even terrifying experience; having
 Effective healthcare blood drawn only contributes to their
communication should be an anxiety
interaction in which both  Recognizing the elements in healthcare
participants play a role. communication—such as empathy,
 To encourage good verbal control, trust, and confirmation—will
communication, the help the phlebotomist to interact with
phlebotomist should use a the patient successfully.
Elements in Healthcare Communication healthcare facility that has these four main
 Empathy characteristics:

 Control  Permanent inpatient beds

 Respect and Confirmation  24-hour nursing service

 Therapeutic and diagnostic
 Trust
services
 Telephone Communication  Organized medical staff
Healthcare Delivery
 Two general categories of facilities,
inpatient (nonambulatory) and
outpatient (ambulatory), support all
three (primary, secondary, and tertiary)
levels of healthcare currently offered in
the United States.

The Changing of the Healthcare System

 Managed Care
 Managed care is a generic term
for a payment system that
attempts to manage cost,
quality, and access to
healthcare by:
 Detecting illnesses or
risk factors early in the
disease process
 Putting into practice
various financial
incentives for providers
 Offering patient
education
 Encouraging healthy
lifestyles
Organization of Hospital Services
 Hospitals are often large organizations
with a complex internal structure
required to provide acute care to
patients who need it. Actually the term
hospital can be applied to any
Clinical Laboratory Services
 Traditional Laboratories
 There are two major divisions in
the clinical laboratory, the
clinical analysis area and the
anatomical and surgical
pathology area.
 Clinical Analysis Areas
 Hematology with
coagulation studies
 Histopathology
 Clinical Chemistry
 Clinical Microscopy
 Bacteriology
 Immunology and
Serology with Blood
Banking
Clinical Laboratory Personnel Modes of Transmission
Pathologist/Laboratory Director
 Laboratory Administrator/Laboratory
Manager
 Technical Supervisor
 Medical Laboratory
Technologist/Scientist]
 Clinical Laboratory Assistant
 Phlebotomist
 Other Laboratory Personnel
Infection Control

 Infection How to break the chain?

 Infection is a condition that results
when a microorganism (microbe
for short) is able to invade the
body, multiply, and cause injury or
disease.
 Categorized as:
 Communicable Infections
 Nosocomial and
Healthcare-Associated
Infections

Infection Control Methods

Chain of Infection
 Hand Hygiene
 Hand hygiene is one of the
most important means of
preventing the spread of
infection provided that it is
achieved properly and when
required.
 Use of Alcohol-Based
Antiseptic Hand
Cleaners
 Hand Washing
 Gloves
 Gowns
  Lab coats
 Mask, Face Shield and
Goggles
 Respirators
Hand Washing Steps (WHO)

Isolation Procedures
 Protective/Reverse Isolation
 Protective or reverse isolation
is used for patients who are
highly susceptible to infections.
 In this type of isolation,
protective measures are taken
to keep healthcare workers and
others from transmitting
infection to the patient rather
than vice versa.
 Traditional Isolation Systems
 Universal Precautions
 TREAT EACH
SAMPLE/SPECIMENS AS
PATHOGENIC
Proper Removal of Gloves  Body Substance Isolation

Biosafety
 Biosafety is a term used to describe the
safe handling of biological substances
that pose a risk to health.
 Biological hazards can be encountered
in a healthcare setting on a daily basis.
 Biohazard
 Anything harmful or potentially
harmful to health is called a
biohazard (short for biological
hazard) and should be identified
by a biohazard symbol
 Biohazard Exposure Routes
 Airborne
 Ingestion
 Nonintact skin
  Percutaneous
 Permucosal
Blood Borne Pathogens
 Hepatitis B
 Hepatitis C
 Human Immunodeficiency Virus (HIV)

Electrical Safety

 Fire and electrical shock are potential

hazards associated with the use of
electrical equipment.
 Knowledge of the proper use,
maintenance, and servicing of electrical
equipment such as centrifuges can
minimize hazards associated with their
use

Radiation Safety
 The principles involved in radiation
exposure are distance, shielding, and
time. 
 This means that the amount of
radiation you are exposed to depends
Fire Safety
upon how far you are from the source
 All employees of any institution should
of radioactivity, what protection you
be aware of procedures to follow in have from it, and how long you are
exposed to it.
case of fire.
 Exposure time is important because
 They should know where fire
radiation effects are cumulative.
extinguishers are located and how to
Chemical Safety
use them.
 A phlebotomist may come in contact
with hazardous chemicals when using
cleaning reagents, adding preservatives
 to 24-hour urine containers, or  Stress Management
delivering specimens to the laboratory.
 Inappropriate use of chemicals can
have dangerous consequences. 
 For example, mixing bleach with other
cleaning compounds can release
dangerous gases.

First Aid

Personal Wellness
 “The doctor of the future will give no
medicine but will interest his patients in
the care of the human frame, in diet,
and in the cause and prevention of
disease.” – Thomas Edison
 Maintain:
 Personal Hygiene
 Proper nutrition
 Rest and Exercise
 Back Protection