9781437725551

Table of Contents


PART I	THE PRACTICE OF PHLEBOTOMY	1
Chapter 1	Introduction to Phlebotomy John C. Flynn, Jr.	2
	History	2
	Current Phlebotomy Practice	3
	Professional Recognition	5
	Summary	7
Chapter 2	Anatomy and Physiology Debra Lynn Eckman	8
	Introduction	9
	Body Planes and Cells	9
	Tissues	10
	Organ Systems	10
	The Integumentary System	12
	The Skeletal System	13
	The Muscular System	13
	The Nervous System	13
	The Endocrine System	15
	The Cardiovascular System	16
	The Heart	16
	Blood Flow Summary	17
	Heartbeat and Blood Pressure	18
	Blood Vessels	21
	The Blood	21
	Coagulation	26
	Blood Typing	26
	The Lymphatic System	28
	The Respiratory System	30
	The Digestive System	30
	The Renal System	31
	The Reproductive System	32
	Summary	33
Chapter 3	Infectious Diseases and Their Prevention Donna Larson	36
	Introduction	37
	Infectious Diseases Encountered in a Health Care Setting	38
	Bloodborne Pathogens	38
	Hepatitis B	38
	Hepatitis C	38
	Human Immunodeficiency Virus	39
	Other Bloodborne Pathogens	40
	Communicable Diseases	41
	Route of Infection	41
	Contact Transmission	41
	Indirect Contact Transmission	42
	Droplet Transmission	42
	Airborne Transmission	42
	Common Viral Diseases	43
	Influenza	43
	Rubella	44
	Measles	44
	Mumps	45
	Common Bacterial Infections	45
	Methicillin-Resistant Stapbylococcus Aureus	45
	Meningococcal Meningitis	45
	Tuberculosis	46
	Pneumonia	46
	Multidrug-Resistant Organisms	46
	Infection Control Practices to Prevent Infection	47
	Sharps Injury Prevention	47
	Occupational Safety and Health Administration Law	47
	Education	47
	Hand Hygiene	48
	Personal Protective Equipment	49
	Standard Precautions	52
	Transmission-Based Precautions	52
	Environmental Infection Control	54
	Special Precautions	54
	Special Considerations in the Hospital Setting	54
	Special Considerations for Outpatient (Ambulatory) Care	55
	Special Considerations for Long-Term Care	55
	Summary	56
Chapter 4	Medical Terminology Leticia M. Rodriguez	58
	Introduction	58
	Medical Terminology - The Basics	59
	Prefixes	59
	Word Roots	59
	Suffixes	59
	Plurals	61
	Abbreviations	61
	Summary	62
Chapter 5	Equipment John C. Flynn, Jr.	63
	Introduction	64
	Tubes and Anticoagulants	64
	Yellow-Stoppered Tubes	64
	Blue-Stoppered Tubes	64
	Red-Stoppered Tubes	64
	�Tiger Tops� and Gold Tubes	64
	Green-Stoppered Tubes	65
	Lavender-Stoppered Tubes	65
	Gray-Stoppered Tubes	65
	Pink Tubes	65
	Tubes with Other-Colored Stoppers	65
	Tube Size	66
	Splashguards	66
	Needles	67
	Needle Size	67
	Multiple-Draw Needles	67
	Winged Infusion Needles	67
	Blood Lancets	67
	Needle Disposal Equipment	68
	Tube Holders	69
	Vein Location Equipment	69
	Tourniquets	69
	Vein Locating Device	69
	Gloves	70
	Goggles	72
	Phlebotomy Trays	72
	Phlebotomy Chairs	73
	Training Equipment	73
	Other Common Supplies	73
	Summary	74
Chapter 6	Proper Procedures for Venipuncture John C. Flynn, Jr.	75
	Introduction	76
	Patient Greeting and Identification	76
	Routine Venipuncture	77
	Positioning and Tourniquet Application	77
	Choosing the Site	77
	Assembling the Equipment	77
	Cleansing the Site	77
	Performing the Venipuncture	81
	Releasing the Tourniquet	81
	Removing the Needle	81
	Needle Disposal	81
	Specimen Labeling and Transportation	81
	Hand Washing and Departure	82
	Microcapillary Blood Collection	82
	Venipuncture Using a Butterfly Set	82
	Order of Draw	84
	Physiological and Biological Considerations	85
	Summary	88
Chapter 7	Special Collection Procedures John C. Flynn, Jr.	94
	Introduction	95
	Bleeding Time Test	95
	Syringe Collections	95
	Glucose Tolerance Test	97
	Arterial Punctures	98
	Cold Agglutinin Tests	99
	Blood Cultures	100
	Blood Donation Collections	101
	Therapeutic Blood Collections	102
	Tests for Fibrin Degradation Products	103
	Peripheral Blood Smears	103
	Peripheral Venous Access	104
	Blood Drawing and Fluid Administration	104
	Summary	105
Chapter 8	Neonatal and Geriatric Procedures and Considerations John C. Flynn, Jr.	107
	Introduction	108
	Neonatal Blood Collection	108
	Geriatric Collection Considerations	112
	The Geriatric or Older Adult Population	112
	Phlebotomy Considerations for Selected Medical Conditions	112
	Vision	112
	Hearing	113
	Skin	113
	Mental and Emotional	113
	Other Conditions	113
	Summary	114
Chapter 9	Considerations and Complications of Phlebotomy John C. Flynn, Jr.	116
	Introduction	117
	The Uncooperative or Absent Patient	117
	Medical and Physiological Considerations	118
	Common Considerations	118
	Syncope	118
	Hematoma	118
	Short Draw or No Blood Collected	119
	Other Complications	120
	Petechiae	120
	Edema	120
	Excessive Bleeding	120
	Intravenous Lines	120
	Obesity	120
	Allergies	121
	Nausea	121
	Unintentional Arterial Puncture	121
	Damaged or Scarred Veins	121
	Burned Areas	121
	Convulsions	121
	Mastectomy	122
	Nerve Injury	122
	Reflux or Backflow of Anticoagulant	122
	Technical Problems	122
	Unacceptable Specimens	122
	Hemolysis	122
	Hemoconcentration	123
	Clots	123
	Short Draw	124
	Mislabeled Specimens	124
	Summary	124
Chapter 10	Multiskilling and Point-of-Care for Phlebotomists David Delvecchio	126
	Introduction	127
	Cardiopulmonary Resuscitation	127
	Vital Signs	128
	Temperature	128
	Pulse	128
	Respiration	129
	Blood Pressure	130
	CLIA �88 Waived Testing	131
	Point-of-Care Testing	132
	Quality Control	132
	Glucose	132
	Blood Gases and Electrolytes	133
	Coagulation	133
	Hemoglobin and Hcmatocrit	133
	Cholesterol	134
	Electrocardiography	134
	Blood Donor Center Skills	136
	Summary	136
PART II	PROFESSIONAL ISSUES	138
Chapter 11	Interpersonal Communication and Professionalism John C. Flynn, Jr.	139
	Introduction	140
	Effective Communication	140
	A Life Skill	140
	Keys to Successful Communication	141
	Obstacles to Successful Communication	141
	Communication Breakdown	142
	General Guidelines for Effective Communication	142
	Professionalism	143
	Continuing Education	144
	Summary	145
Chapter 12	Phlebotomy Department Management David Delvecchio	147
	Introduction	148
	Organization	148
	Training and Professional Attributes	148
	Planning	149
	Outpatient Collections Location and Facilities	149
	Inpatient Collections	150
	Collection Schedules	150
	Processing Requests	150
	Staffing	151
	Operational Plan	151
	Equipment Management	152
	Consumable Equipment	152
	Nonconsumable Equipment	152
	Maintaining Quality	153
	Quality Improvement	153
	Continuing Education	153
	Communication	153
	Employee Performance and Review	153
	Budgeting	153
	Summary	154
Chapter 13	Total Quality in Phlebotomy Service John C. Flynn, Jr.	155
	Introduction	156
	Quality: Definition and Principles	156
	Quality Applied to Health Care	156
	Quality Control	157
	Quality Assurance	158
	Quality Improvement	159
	Facts of Quality in Phlebotomy Service	160
	The Procedure Manual for Specimen Collection	161
	Unacceptable Specimens	162
	Unsuccessful Collection Attempts	165
	Newborn and Pediatric Patients	165
	Quality Control of Supplies and Instruments	167
	Evaluating Evacuated Test Tubes	167
	Evaluating the Stopper Assembly	167
	Centrifuge Test	167
	Additive Test	167
	Perceptions of Quality in Phlebotomy Service	167
	Summary	168
Chapter 14	Medical-Legal Issues and Health Law Procedures Shirley E. Greening	170
	Introduction	171
	Sources of Laws	172
	Areas of Law Applicable to Phlebotomy Practice	173
	Intentional Torts	173
	Unintentional Torts	174
	Negligence: What Must Be Proved?	174
	Liability of Employers for Phlebotomy Personnel	175
	How Is the Phlebotomy Standard of Care Determined?	176
	Other Legal Doctrines and Areas of Law Applicable to Phlebotomy Practice	177
	Interplay Among the Rights of Privacy, Confidentiality, and Informed Consent	177
	Right of Privacy	177
	Confidentiality	178
	Consent and Informed Consent	178
	Health Insurance Portability and Accountability Act of 1996	178
	Patient�s Bill of Rights and the Patient Care Partnership	179
	Medical Devices and Equipment Failures	179
	Case Law	180
	Defenses to Legal Claims	182
	Statutes of Limitation	182
	Contributory Negligence	182
	Adequate and Accurate Records as the Best Defense	182
	Chain of Custody in the Clinical Laboratory	183
	Legal and Professional Protections for the Phlebotomisl	183
	Regulation of Laboratories and Laboratory Practitioners	184
	Clinical Laboratory Improvement Amendments of 1988	184
	Subpart J: Facility Administration for Nonwaived Testing	185
	Subpart K: Quality Systems for Nonwaived Testing	185
	Subpart M: Personnel for Nonwaived Testing	188
	Other Regulatory Agencies Governing Laboratories and Phlebotomists	188
	Summary	189
Appendix A	Answers to Chapter Review Questions	191
	Chapter 1	191
	Chapter 2	191
	Chapter 3	192
	Chapter 4	194
	Chapter 5	194
	Chapter 6	194
	Chapter 7	195
	Chapter 8	195
	Chapter 9	196
	Chapter 10	196
	Chapter 11	197
	Chapter 12	197
	Chapter 13	197
	Chapter 14	198
Appendix B	Practice Examination for Certification	200
Appendix C	Helpful Spanish Terms and Phrases	213
	Glossary	215
	Illustration Credits	220