PHLEBOTOMY

PORTFOLIO

NAME: PHEBE T. MAHABIER

INSTITUTE: IRVING INSTITUTE

TEACHER: MISS CLARKE

 TABLE OF CONTENT

TITLE: PAGE #:

Introduction............................................................................…..............3

Unit 01 [Introduction to

phlebotomy]......................................................................................…4-8

Unit 02 [Medical

Terminology].........................................................................................9-18

Unit 03 [Anatomy and

Physiology].............................................................................................19-21

Unit 04 [The steps in Procedures and their

Importance].........................................................…...…………………22-33

Unit 05 [Phlebotomy

Techniques].........................................................................................….34-38

Unit 06 [Clinical Laboratory

Procedures].................................................................................……..39-42

Unit 07 [Communication and Interpersonal

Relationship]...........................................................…….……….……43-45

Unit 08 [Professional Ethics].........................................................................................

….....46-50

1
Unit 09 [Regulatory Guidelines for Phlebotomy

Practice]................................................................……………..51-53

Unit 10 [Waste Disposal and Decontamination Techniques].....................................

…………..........................54-56

Unit 11 [Features and use of Phlebotomy

Equipment].......................................................................…….57-58

Unit 12 [Quality Assurance].................................................…..59-61

References…………………………………………………….62-64

2
 INTRODUCTION
Phlebotomy is defined as the surgical opening or puncture of a vein in order

to withdraw blood. This portfolio is consist of 12 units, each unit will give you a full

and concise understanding about phlebotomy. The purpose of this portfolio is to

expand the understanding of those you wants to know more about phlebotomy. I

completed this portfolio by doing researches on the internet, in books and my own

knowledge, upon completion of this portfolio I’ve faced challenges such as limited

time and technical issues but it is successfully completed.

3
INTRODUCTION
TO
PHLEBOTOMY
[UNIT 01]

4
I am a visual learner, I mostly learn this faster the more I see what is happening. As I

go further in this course I would like to develop kenetic and auditory learning. Going

forward in this course I would love to develop a full understanding of phlebotomy and

I would also want to develop my writing, hand-eye coordination, communication and

multitasking skills. I will achive these skills by using visual learning style. I plan on

achieving auditary learning by being an active listener. To develop my auditary

leaning when the teacher is dictating I would have to listen more to write what is

being said and that will also help me to develop my writing skills whereas the teacher

will be reading fast therefore I would have to write faster. Kenetic learning will be

developed by using my hands more to do things, kenetic learning will be developed

as soon as I start doing the practical part of the course; because I will start using my

hands more. I will achieve the skills by the help of my teacher, classmates, and by

doing the practical part of the course. My teacher will help me to develop my

multitasking skills by instructing me to do more than one things at once. My

classmates will help me to develop my communication skills by doing class activities

or quiz together whereas I would have to learn to communicate with others. By doing

this practical part course I think it is the most important part to help me develop most

of the skills I would like achieve it will help me to achieve skills such as multitasking,

writing,hand eye coordination, and communication skills. By doing the practical part

of the course this will firstly help with communication, whereas I would have to

communicate more by asking peaople to assit me by giving me a blood draw, I would

have to indroduce myself. explain the procedure to convince them. it will help with

the writng skills by having to write quickly on tubes. Hand eye coordination will be

developed by seeing the vein and being able to perform venepuncture. Multitasking

will be achieved by comfort and reassuring the patient whilst doing the procedure.

5
The skills developed can benefit the patient by them feeling better and safer when

doing the procedure and help them to get through faster. For example if my

communication and multitasking skills are developed while doing the doing the

procedure I can speak to them more and assure them that it will not be a very painful

procedure and there is nothing to worry about. Multitasking skills may also help by

saving time, while in the vein I could invert the tubes which will be a shorter wait for

the patient. And also if my writing are achieved I can write up the tubes faster so they

can leave quickly, because the tubes have to be wriiten up in there presence.

6
 Cave District;

Cave P.O;

Westmoreland

Jamaica;

June 24, 2022

Dear Kimberly;

As we were speaking on the phone last night and you told me you would like to apply

for the position of a phlebotomist; I want to take the time out to congratulate you and

explain a few things to you since I am a professional and working. I work at

Microlabs. A Clinical Laboratory Savana-la-mar in Westmoreland , the laboratory has

five (5) Departments. Clinical Chemistry, Clinical Microbiology, Hematology, Blood

banking and Serology. The Lab is consist of 50 staff members.The Phlebotomists,

Laboratory Technicians, Supervisors, Managers, and Janitors. Each of the staff

members have their role and responsibilities to carry out. I have been working as a

Phlebotomist for two (2) years now and it has been a good experience, sometimes

there are complications that I face as the patients not cooperating but by portraying

compassion and professional ethics I handled the situation very well. On a daily basis

about 150 patients are being catered for. As a Phlebotomists I play a vital role, my

responsibility is to collect blood for donation or for testing, so the blood can be

analyzed in the laboratory which is then used for blood test to diagnose illness,

7
evaluate the effectiveness of medications and determine whether a patient is receiving

proper nutrition. Working as a Phlebotomist require Professional certification in

phlebotomy from a recognized program, Ability to successfully draw blood from

patients with minimal or no complications, empathy and interpersonal skills for

working with patients, and detail-oriented and committed to ensuring patient

confidentiality. You must be able to multitask and communicate very well, you must

also always portray professional ethics and be very compassionate when dealing with

the patients. Supervision and support are an important part of Phlebotomy because

Phlebotomy Supervisors ensure that safety rules and regulations are met, and that the

laboratory is orderly, ensures duties are carried out correctly and well stocked for

performing daily testing and examinations.

8
 MEDICAL

TERMINOLOGY

[UNIT 02]

9
 CLINICAL LABORATORY

Clinical Laboratory: Clinical laboratory is for examination of materials derived from

the human body (such as fluids, tissues, or cells) for the purpose of providing

information on diagnosis, prognosis, prevention, or treatment of disease. A clinical

laboratorian uses chemistry to evaluate patient health. He/She may evaluate

blood, study DNA, examine tissue, or study cells. He/She may be a research

scientist or a developer of diagnostic products.

Two test that are performed in the clinical laboratory are cytology and

immunohistochemistry.

Blood and Urine are two specimens that are usually sent to the Clinical Laboratory

Department.

10
 HEMATOLOGY LABORATORY

In the hematology laboratory, manual and automated test techniques are used in the

study of blood

and other body cells and fluid. Blood tests obtained in the laboratory are used by the

clinician for

screening the health status of an animal or in making a diagnosis of a disease

condition.

Full Blood Count Testing and Hemoglobin Testing are two Laboratory test done in

the hematology laboratory.

Blood

11
 CYTOLOGY LABORATORY

The Cytology laboratory specimens from various body sites for the detection of
cancer,

precancerous changes and other benign conditions.

Two tests that are performed in the cytology laboratory department are Breast
cytology and Thyroid cytology.

Specimens that are sent to the Cytology Laboratory are Spit and Mucus (also called
phlegm or sputum)

12
 MICROBIOLOGY LABORATORY

A microbiology laboratory is a laboratory devoted to the culturing, examination, and

identification

of microorganisms including bacteria, fungi, yeasts, etc.

Two Laboratory Tests that are performed in the Microbiology Laboratory are
Bacteriology Tests and

Mycobacteriology Test.

Specimens that are sent to the Microbiology laboratory department are Blood and
Sputum.

13
 IMMUNOLOGY LABORATORY

Immunology and serology laboratories focus on the following: Identifying antibodies.

These are proteins made by a type of white blood cell in response to a foreign

substance (antigen) in the body.

Investigating problems with the immune system.

Two test that are performed in the Immunology Laboratory Department are

Acetylcholine receptor antibody and Adenovirus antibody titer.

Specimens that are sent the Immunology Laboratory department are peritoneal fluid,

Blood{Serum} and Urine.

14
DEPARTMENTS IN THE HOSPITAL SETTING, DESCRIPTION OF WHAT IS

DONE IN EACH DEPARTMENT AND THE NAME OF THE MEDICAL

PERSONNEL WHO WORKS IN THE SPECIALITY AREAS :

DEPARTMENT AND DESCRIPTION:

 Oncology: Oncology is the field of medicine that deal with the diagnosis,

treatment, prevention, and early detection of cancer.

MEDICAL PERSONNEL:

 Oncologist

DEPARTMENT AND DESCRIPTION:

 Urology: Urology is the branch of medicine that focuses on the diseases of

the male and female urinary tract and the male reproductive organs.

MEDICAL PERSONNEL:

 Urologist

DEPARTMENT AND DESCRIPTION:

 Proctology: A proctologist is a surgical specialist with a focus on diagnosing and

treating disorders of the colon, rectum and anus.

MEDICAL PERSONNEL:

 Proctologist

15
DEPARTMENT AND DESCRIPTION:

 Cardiology: Cardiologists diagnose, assess and treat patients with defects and

diseases of the heart and the blood vessels, which are known as the

cardiovascular system.

MEDICAL PERSONNEL:

 Cardiologist

DEPARTMENT AND DESCRIPTION:

 Endocrinology: An endocrinologist is a doctor who specializes in the diagnosis

and treatment of hormones as well as the glands that produce them. This includes

the pituitary, thyroid and adrenal glands as well as the pancreas.

MEDICAL PERSONNEL:

 Endocrinologist

DEPARTMENT AND DESCRIPTION:

 Neurology: Neurologists diagnose, treat and manage conditions affecting the

brain and spinal cord, and disorders of the nerves and muscles that activate

movement and transmit sensations from around the body to the brain.

MEDICAL PERSONNEL:

 Neurologist

16
DEPARTMENT AND DESCRIPTION:

 Anesthesiology: Similar to your primary care doctor, your physician

anesthesiologist manages all aspects of your medical care (blood pressure,

diabetes, asthma and heart conditions).

MEDICAL PERSONNEL:

 Anesthesiologist

DEPARTMENT AND DESCRIPTION:

 Orthopedics: Orthopaedic surgeons are devoted to the prevention, diagnosis, and

treatment of disorders of the bones, joints, ligaments, tendons and muscles.

MEDICAL PERSONNEL:

 Orthpedists

DEPARTMENT AND DESCRIPTION:

 Ophthalmologists: Ophthalmologist are responsible for the diagnosis, prevention,

and treatment of almost all eye conditions and visual issues.

MEDICAL PERSONNEL:

 Ophthalmologists

17
DEPARTMENT AND DESCRIPTION:

 Hematology: Hematologis tand hematopathologists are highly trained healthcare

providers who specialize in diseases of the blood and blood components. These

include blood and bone marrow cells.

MEDICAL PERSONNEL:

 Hematologist

18
 ANATOMY
AND
PHYSIOLOGY
[UNIT 03]

19
BODY MAIN DISORDER TEST COLOU LAB
SYSTEM FUNCTION R TOP DEPT
TUBE

1. Circulatory To transport High blood CPK Red Clinical

System blood. pressure Chemistr
y

2. Respiratory Regulates Asthma Spirometr

System the breathing y and
process and FeNO
exchanges
gases at
lungs and
tissues.
3. Digestive To break Gastroesophagl Upper
System nutrients reflux disease gastrointe
into parts. stinal
(GI)
endoscop
y

4. Reproductive To produce HIV/AIDS ELISA Diagnostics

Developmen
System eggs and t Laboratory
sperms cells. (DDL

5. Endocrine To release Acromegaly OGTT

System hormones
into the
bloodstream

6. Nervous To transmit Epilepsy Electroen neurology

System signals cephalogr

between the am
brain and the (EEG)
rest of the
body,
including
internal
organs.

7. Skeletal Allows Osteoporosis Dexa a

radiologist's
System movement, scan office.
Give sthe

20
 body its
shape and
provides
protection
for organs.

8. Integumentar To regulate Atopic Patch a doctor's

office.
y System body dermatitis testing
temperature, (eczema)
maintain cell
fluid, and to
detect
stimuli.
Gold-top serology
9. Excretory To get rid of urinary tract Antimicr serum
System waste from infections obial separator
tube (SST)
our bodies. susceptibi
lity
testing
(AST)

10. Immune To fight familial molecula Red chemistry,

System harmful Mediterranean r genetic

substances fever testing
and Germs
that enter the
body.
Nuclear
11. Lymphatic It maintains Lymphedema Lymphos Medicine
System fluid levels in cintigrap Department

our body hy
tissues by
removing all
fluids that
leak out of
our blood
vessels.

21
 THE STEPS IN

PHLEBOTOMY

PROCEDURE AND

THEIR IMPORTANCE

[UNIT 04]

22
Step 1. Assemble equipment

Collect all the equipment needed for the procedure and place it within safe and easy

reach on a tray or trolley, ensuring that all the items are clearly visible. The equipment

required includes:

 A supply of laboratory sample tubes, which should be stored dry and upright in a

rack; blood can be collected in.

 well-fitting, gloves.

 safety-engineered devices or needles and syringes.

 a tourniquet.

 alcohol hand rub.

 70% alcohol swabs\pads for skin disinfectant.

 gauze or cotton-wool ball to be applied over puncture site.

 laboratory specimen labels.

 writing equipment.

 laboratory forms.

23
 leak-proof transportation bags and containers.

 a puncture-resistant sharps container.

24
Step 2. Put on laboratory coat then perform hand hygiene and put on glove.

Perform hand hygiene; that is:

Wash hands with soap and water, and dry with single-use towel

if hands are not visibly contaminated, clean with alcohol rub use 3 ml of

alcohol rub on the palm of the hand, and rub it into fingertips, back of hands

and all over the hands until dry.

After performing hand hygiene, put on well-fitting, gloves.

Fig1. Washing of hands. Fig 2. Sanitizing of hands if not

visible
dirty.

Fig 3. Putting on gloves

25
Step 3. Identify and prepare the patient

 Introduce yourself to the patient, and ask the patient to state their full name.

 Check that the laboratory form matches the patient's identity (i.e. match the

patient's details with the laboratory form, to ensure accurate identification).

 Ask whether the patent has allergies, phobias or has ever fainted during previous

injections or blood draws.

 If the patient is anxious or afraid, reassure the person by telling them it will not be

very painful and it only takes a minute to perform the venipuncture procedure and

ask what would make them more comfortable.

 Place a clean paper or towel under the patient's arm.

 Discuss the test to be perform and obtain verbal consent. The patient has a right

to refuse a test at any time before the blood sampling, so it is important to ensure

that the patient has understood the procedure.

26
Step 4. Select the site

General

 Extend the patient's arm and inspect the antecubital fossa or forearm.

 Locate a vein of a good size that is visible, straight and clear. The median cubital

vein lies between muscles and is usually the easiest to puncture.

 The vein should be visible without applying the tourniquet. {If the vein is not

visible apply tourniquet, tell the patient to make a fist and palpate to locate the

vein. Once vein is being located loose the tourniquet}. Locating the vein will help

in determining the correct size of needle.

27
Step 5. Disinfect the entry site

 Clean site using 70% isopropyl alcohol, Apply firm but gentle pressure. Start

from the centre of the venipuncture site and work downward and outwards to

cover an area of 2 cm or more.

 Allow the area to dry. Failure to allow enough contact time increases the risk of

contamination.

 NB: DO NOT touch the cleaned site; in particular, DO NOT place a finger over

the vein to guide the shaft of the exposed needle. It the site is touched, repeat the

disinfection.

28
Step 6. Take blood

Venipuncture

Perform venipuncture as follows:

 Apply tourniquet
 Ask the patient to form a fist so the veins are more prominent.

 pull skin back and enter the vein swiftly at a 30 degree angle or less, and continue

to introduce the needle along the vein at the easiest angle of entry.

 Draw blood collection tubes in the correct order, to avoid cross contamination

from additives between tubes.

 Release the tourniquet as soon as blood enters the last tube upon collecting the

required amount of blood.

 Withdraw the needle gently and apply gentle pressure to the site with a clean

gauze or dry cotton-wool ball. Ask the patient to hold the gauze or cotton wool in

place, with the arm extended and raised. Ask the patient NOT to bend the arm,

because doing so causes a haematoma.

29
Step 7. Labeling\writing up of tubes :

 While the patient is pressing\holding down on the cotton\gauze write up the tubes

with the necessary information required.

30
Step 8. Apply bandage:

 After writing up the tubes, take cotton\gauze off the area the venipuncture was

performed{if excess cotton is lft on the site take another cotton to clean area then

apply bandage to the area where the needle stick.

Step 9: Bring tubes to the correct place\Lab:

 Ensure Tubes are taken to the correct Laboratory

31
Step 10: Remove Lab coat then Gloves

Removing Gloves

32
TWO STEPS IN THE PHLEBOTOMY PROCEDURE AND THE

IMPORORTANCE OF EACH:

Step 3. Identify the patient:

 Patient Identification , the process of verifying a patient's identity, is the most

important step in specimen collection. Obtaining a specimen from the wrong

patient can have serious, even fatal, consequences, especially specimens for type

and cross-match prior to blood transfusion.

Step 5. Disinfect the entry site:

 The use of skin antiseptics before collection of blood specimens is commonplace,

for preventing contamination of blood samples, especially those collected for

blood culture and other microbiological examinations, as well as for safeguarding

patient safety from accidental contamination with bacteria and other

pathogens.Failure to clean site before doing the venipuncture procedure this can

allow bacteria to infect the puncture site. A serious infection of the blood

(septicemia) or of the tissue (cellulitis) may result.

33
PHLEBOTOMY
TECHNIQUES
[UNIT 05]

34
FOUR DIFFERENT PHLEBOTOMY TECHNIQUES:

Four different ways of taking blood were observed: evacuated system, butterfly with

syringe, butterfly with vacutainer and the syringe system.

Four different ways of taking blood were observed: cannulation and a syringe (38%),

cannula with evacuated tube and adaptor (42%), syringe and needle into vein (14%)

and evacuated tube system used conventionally (6%).

EQUIPMENTS THAT ARE USED IN EACH SYSTEM ARE:

 Evacuated System:

The evacuated tube system requires three components:

 Evacuated sample tube

 Double-pointed needle

 A special plastic holder

 The butterfly with syringe system requires:

 the wing infusion set

 the syringe

 Needle

35
 Butterfly with vacutainer:

 Safety Needles, 22g or less.

 Butterfly needles. 21g or less.
 Syringes.
 Vacutainer tube holder.
 Transfer Device
 Blood Collection Tubes.

 The syringe system:

 Syringe – syringes are used to collect blood from patients with small or fragile
veins.
 Multi-sample blood collection needle – this device has two needles that are
screwed into the holder.
 Tourniquet – this device is used to occlude venous blood flow and help
phlebotomists discover the vein.

ADVANTAGES OF EACH SYSTEM:

 The evacuated tube system:

 Decreases the possibility of needlesticks.

 Helps to eliminated some labelling errors.

 Decreases the likelihood of inappropriate specimens.

 The butterfly with syringe system:

 Butterfly needles enable IV access using a small needle for IV infusions or blood

draws.

 Using a butterfly needle reduces the likelihood a person will experience profuse

bleeding after an IV stick or blood draw.

36
 Allows for greater flexibility during angled insertion, accuracy and is typically

less painful for the patient.

 The butterfly with vacutainer system:

 The Vacutainer system is quicker and simpler to use,

 Greater versatility, producing blood specimens of higher quality

 At a cost comparable with that by the syringe system.

 Syringe system:

 . They are less likely to collapse under a vacuum which is controlled by the
technician.

 This method requires less manipulation than the Vacutainer System for small
volume draws (1-2 tubes).

 This system is very labor intensive for large volume draws

DISADVANTAGES OF EACH SYSTEM:

 The evacuated tube system:

 One of the main disadvantages of Vacutainers is that there is no flashback to let

the phlebotomist know that it is in the vein.

 If the needle is not in the vein and the phlebotomist attaches the tube, no blood

will be drawn and the tube will have to be discarded

 It is more difficult to obtain than venous or capillary blood sample

 The butterfly vacutainer system:

37
 Because of their small needle size, blood collection tends to be slower

 A butterfly needle can damage a vein if the unit is suddenly yanked.

 Butterfly needle have the highest rate of accidental needle sticks.

 Butterfly with syringe system:

 Takes more time: A smaller needle draws blood at a slower rate than a larger one.

 May cause hemolysis: Needles with a gauge size 25 or higher are not always

recommended because as needle size gets smaller, the risk of hemolysis

increases.

 No blood in syringe so Blood will start to clot.

 Syringe system:

 There is the potential for needle stick when depositing blood into the collection

tube.

 The volume of syringe used limits the fluid dispensing volume.

 Excessive resistance may lead to the build-up of pressure and eventual failure of

the syringe pump.

 The flow rate during the transient period cannot be known without flow sensors.

38
 CLINICAL

LABORATORY

PROCEDURES

[UNIT 06]

39
DESCRIPTION OF EACH SPECIAL COLLECTION PROCEDURES:

 Bleeding time tests: Bleeding time is a medical test that measures how fast small

blood vessels in the skin stop bleeding. The bleeding time test is used to evaluate

how well a person's blood is clotting. The test evaluates how long it takes the

vessels cut to constrict and how long it takes for platelets in the blood to seal off

the hole.

 Arterial Blood Gases: An arterial blood gases (ABG) test is a blood test.

It measures the acid-base balance (pH) and the levels of oxygen and carbon

dioxide in the blood. It uses blood drawn from an artery. This is where the levels

of oxygen and carbon dioxide can be measured before they enter body tissues.

 Cold Agglutinin Test: A cold agglutinins blood test is done to check for

conditions that cause the body to make certain types of antibodies called cold

agglutinins. Cold agglutinins are normally made by the immune system in

response to infection. They cause red blood cells to clump together (agglutinate)

at low temperatures.

 Fibrin Degradation Test: This test is done to see if your clot-dissolving

(fibrinolytic) system is working properly. The fibrin degradation products test

is a specific test that determines the amount of FDPs in your blood. The test is

also known as the fibrin split products (FSPs) test, or the fibrin breakdown

products test.

40
COMPARISON BETWEEN ROUTINE VENEPUNCTURE SITE PREPARATION

AND BLOOD CULTURE COLLECTIONS:

The most critical step in collecting a blood culture is the proper cleansing of the site.

Bacteria are normally present on the skin surface. It is imperative for quality test

results that bacteria is not introduced into the specimen being collected. Before the

collection of a specimen for blood culture analysis, the selected venipuncture site

must be prepared by aseptic technique. Routine venipunctures require an antiseptic to

be used on the site. Blood culture collections require a sterile site, one that is free of

living microorganism. Due to the special site preparation once the site has been

prepared do not repalpate, Repalpating the site will contaminate it. The traditional

method involves first cleansing the site for 60 seconds with alcohol to remove the oils

and dirt on the skin surface. The site is then painted with a 2 percent tincture of 70

percent alcohol which is allowed to dry to killsurface skin bacteria. .the only recourse

is to cleanse thoroughly with 70 percent alcohol is painted on the area, with a circular

motion, starting at the site of the puncture and moving in concentric circles outward.

Do not flood the site.The cleansing procedure varies from one laboratory to another.

Instead of using a syringe to draw the blood and inoculate the bottles, a butterfly

collection set can be used. An adapter can be attached to the end of the butterfly

which attaches to the blood culture bottle and directly inoculates the bottle with blood.

Each bottle is filled to the proper level of blood. There are also blood culture bottles

with long necks that insert into an evacuated needle holder. These are the preferred

methods because they minimize the chance of contamination due to the blood being

drawn directly into the prepared tube. It is critical that the tops of the tubes be

cleansed prior to collection.Blood cultures are always collected first. The blood is

41
collected and placed in a bottle containing a solution that enhances the growth of

significant microorganisms if they are present. An anticoagulant is also present.

42
COMMUNICATION

AND

INTERPERSONAL

RELATIONSHIPS

[UNIT 07]

43
AN EFECTIVE COMMUNICATION BETWEEN A PHLEBOTOMIST AND A

PATIENT WAS OBSERVED IN A YOUTUBE VIDEO. THE PEOPLE

INVOLVED WILL BE IDENTIFIED ON HOW THEY USED THE FOLLOWING

SKILLS: ON THE POSITIONING, PROXIMITY, USE OF CONTACT, FACIAL

EXPRESSION, GESTURES, TOUCH, USE OF LANGUAGE AND TONE OF

VOICE.

A youtube video was observed, the positioning and proximitiy, patient was sitting on

a chair with a upright posture being maintained during the entire venepuncture

procedure. The phlebotomist portray excellent use of eye contact with the patient,

while the identification process the phlebtomist was using eye contact efficiently. The

phlebotomist kept a pleasant facial expression throughout the entire procedure, the

patient’s facial expression was also pleasant which looked pleased with what the

phlebotomist was doing. The phlebotomist did a positive gesture(thumbs up), she did

this when compended her for doing a good job, she notifys the patient before touching

her hand to perform venepuncture which is good because it would be offensive if she

touched the patient without her consent or the patient may get a fright especially if

she’s afraid of the procedure. The phlebotomist also used language effectively. The

Phlebotomist spoke to the patient with respect and the words she used was not

offensive, the plebotomist tone of voice was moderatly good. There is room for

improvement for the phlebotomist tine of voice is was a bit low where the patient ask

her to repeat once. From the video I have learnt that skills needed to communicate

effectively are you have to be an active listener, so if the patient ask you a question

you can answer there questions effectively, also you must be clear when speaking to

the patient meaning telling them the exact thing. Upon communicating with the

patient you must also be relaxed as much as possible, reason being if you are acting

44
panicked the patient will think you do not know what you are doing and they would

start to get worried and be panicked also or if you are not relaxed when answering a

question they asked are if you explaning the procedure they may not understand what

is being said. Informing the patient of the procedure is an essenssial skill of

comunicating, when you inform the patient what you are doing it eliminates the fear

of the patient and give them a better understanding of the procedure.

45
PROFSSIONAL

ETHICS

[UNIT 08]

46
THREE (3) PROFESSIONAL ETHICS A PHLEBOTOMIST SHOULD PROTRAY:

In order to be accountable, Phlebotomists act under a code of ethical conduct that

includes adherence to the scope and standards of medical practice and such moral

principles such as respect and dignity, self-determination of patient and gratitude.

This is a image showing that the phlebotomist is portraying respect and dignity to a

visually-impaired patient by shaking her hand and treating her with compassion and

care. The patient was given the chance to have their views listened to by the

phlebotomist and taken into consideration.

47
This image is showing self determination; this is where the patient decide whether or

not to accept suggested treatment or care.

This image is depicting that the phlebotomist is showing gratitude; a positive emotion

that involves being thankful and appreciative to the patient. For example thanking

him/her for their time and patience and for being cooperative etc.

48
THREE (3) ATTRIBUTES A PHLEBOTOMIST SHOULD PORTRAY:

 Hand–eye coordination

the way that one's hands and sight work together to be able to do things that require

speed and accuracy. For example as a phlebotomist when your eyes sees the vein you

should be able to perform venipuncture.

In this image the phlebotomist is portraying hand-eye coordination. She saw the vein

and she is performing venipuncture quickly and accurately on the patient.

 Ability to Multitask

Phlebotomists work in busy environments and have to handle several specimens, meet

tight deadlines, therefore having the skill to do more than one things at once

[multitask] is essential.

49
The image showing that the phlebotomist is multitasking. She is doing the

venipuncture procedure while she is comforting the patient by talking.

 Team Player

Medical staff is essentially a big team, it's important for a phlebotomist to be able to

work well with other people in order to deliver the highest standard of care possible to

patients.

The image above is showing three (3) phlebotomist communicating with each other

about how the can improve the patients needs. Each phlebotomist contributes by

adding there input on how they think they can be a better worker.

50
 REGULATORY

GUIDELINES FOR

PHLEBOTOMY

PRACTICE

[UNIT 09]

51
ONE (1) REASON WHY IT IS IMPORTANT FOR THE PHLEBOTOMIST TO

FOLLOW REGULATORY GUIDELINES:

 It is critical that you follow regulations to prevent injury or exposure to

bloodborne illnesses. Failure to follow the OSHA guidelines could result in

serious injury, for example if OSHA states that you should not recap the needles

and you disobeyed, recapping can cause injury by sticking your self and it can

expose you to bloodborne illnesses such as human immunodeficiency virus

(HIV).

DEFINITION OF THE FOLLOWING WORDS BELOW:

 Fiduciary Obligations: The fiduciary accepts legal responsibility for duties of

care, loyalty, good faith, confidentiality, and more when serving

the best interests of a beneficiary.

 Standard of Care: Standard of Care is the level of attentiveness and care that a

certain person owes to another person under the circumstances. If there is a

reasonable treatment option available and the phlebotomist does not pursue it,

and the patient suffers as a result, then he may be subject to a lawsuit for

neglecting him under the medical standard of care.

 Tort: A wrongful act, other than breach of contract, committed against one's

person, property, reputation, or other legally protected right.

 Plaintiff: A Plaintiff is person who brings a case against another in a court of law

or the party who brings a legal action or in whose name it is brought as opposed

to the defendant, the party who is being sued.

52
 Defendant: A person or group against whom a criminal or civil action is

brought; someone who is being sued or accused of committing a crime.

 Intentional Torts: The act of intentionally causing someone to fear that he or she

is about to become the victim of battery or incomplete battery. Common

intentional torts are battery, assault and false imprisonment.

 Unintentional Torts: An unintentional tort is a type of unintended accident that

leads to injury, property damage, or financial loss. The person who caused the

accident is considered negligent because they failed to exercise the same degree

of care that a reasonable person would have in the same situation.

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 WASTE DISPOSAL

AND

DECONTAMINATION

TECHNIQUES

[UNIT 10]

54
Waste Disposal: Waste Disposal is any solid waste that is generated in the diagnosis,

treatment or immunization of humans. This type of waste was once collected in

special bags and plastic boxes in clinical settings and then disposed of like normal

trash.

TYPE OF WASTES EXAMPLES HOW THEY ARE

DISPOSED

Sharps Needles In a sharps disposal

container.

Biohazard/Infectious Body Fluids Flushed down the toilet

Waste where practicable.

Organic Waste Urine Urine is to be disposed

of down the sluice or

toilet.

Solid Waste Gloves In Biohazard bag

Pharmaceutical Waste Used and unused expired Taken to special recycling

prescription sites and incinerated to

pharmaceuticals reduce the potential

harmful effect on the

environment.

Chemical Waste Unused and surplus Disposed of through the

reagent grade chemicals. EHS Hazardous Waste

Program.

Non-infectious Waste Swabs Non-infectious waste

bags.

55
FEATURES AND USE OF

PHLEBOTOMY

EQUIPMENT

[UNIT 11]

56
FLIER ADVERTISING THE DIFFERENT PHLEBOTOMY EQUIPMENT MY

COMPANY (FIRST CHOICE EQUIPMENTS) IS SELLING.

57
 QUALITY
ASSURANCE
[UNIT 12]

58
Mr. Barry Green’s sample was collected by a phlebotomist working in a health centre.

After Mr.Green’s departure the sample was transported to be analysed at a laboratory.

The requisition form came back stating the sample was unsuitable for testing.

FIVE (5) REASONS WHY THE SAMPLE WAS REJECTED:

i. Inappropriate blood to anticoagulant ratio: Incomplete dissolution of

anticoagulant in the syringe due to inadequate mixing immediately after

collection can result in the formation of blood clots.

ii. Wrong or missing identification: Ensuring accurate specimen labeling is critical

because errors resulting from a failure in this step can, at best, provide results of

no clinical value and can cause Misdiagnosis.

iii. Contamination from infusion route: Blood collection above an IV catheter leads

to IV contamination of blood samples, which can cause inaccurate lab test results.

iv. Haemolysed, clotted, and insufficient samples: Haematology rejects clotted

samples because all results are unreliable. Clots are not always detected and can

cause falsely low or high results. If the amount of blood taken is too small then

the lab will struggle to produce enough plasma from it.

v. Incorrect order of draw: incorrect order of draw can cause cross-contamination of

the sample by additives found in different collection tubes.

59
An individual you are collecting blood from starts to develop a develop a Syncope.

Syncope: Syncope is another word for fainting or passing out. Someone is considered
to have syncope if they become unconscious and go limp, then soon recover.

60
 INCIDENT REPORT FORM

EMPLOYEE DETAIL
NAME: Phebe T. Mahabier
DEPARTMENT: Phlebotomy
PHONE NUMBER: 1876-869-6368

DID THE INCIDENT RESULT IN AN INJURY? YES NO

DESCRIPTION OF THE INCIDENT

LOCATION: In the venepuncture area (Room11)
DATE: July 11, 2022 INCIDENT DETAILS:
TIME: 11:11 AM
Upon collecting Blood from a patient
Travis Walton when suddenly he started
to develop a Syncope. I firstly gently
remove the needle out of the patient’s
arm to eliminate injuries, then I remove
the tourniquet off his arm. I applied gauze
and pressure to the skin puncture site he
remained seated therefore I put his head
between his knees, about 15 seconds later
he recovers.

ACTIONS TAKEN: Discontinue procedure, apply gauze, and put the patients head
between his knees.

SIGNITURE: P. Mahabier

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and-serology

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alcohol-gel-clean-her-hands_477666-476.jpg?w=740

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%20enable%20IV%20access,IV%20stick%20or%20blood%20draw.

https://www.verywellhealth.com/butterfly-needles-for-blood-draws-and-simple-ivs-
430065#:~:text=a%20butterfly%20needle%20can%20damage%20a%20vein%20if
%20the%20unit%20is%20suddenly%20yanked.

https://www.chemyx.com/support/knowledge-base/application-reference-by-topic/
advantages-and-disadvantages-of-syringe-pumps/
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%20cold%20agglutinins%20blood%20test,(agglutinate)%20at%20low
%20temperatures.

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%20tests%20can%20measure%20your,the%20fibrin%20breakdown%20products
%20test.

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%20CULTURE.pdf

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%2Fblog%2Fphlebotomy-
career&psig=AOvVaw2h2khTbICxQECMJe7aRoYm&ust=1665784509287000&sou
rce=images&cd=vfe&ved=0CAsQjhxqFwoTCKiL4tOZ3voCFQAAAAAdAAAAAB
AJ

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%20pathogens.

https://work.chron.com/osha-requirements-phlebotomists-16757.html#:~:text=It
%20is%20critical%20that%20you,and%20patients%20your%20first%20priority.

https://legaldictionary.net/standard-of-care/

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https://www.chegg.com/flashcards/phlebotomy-chapter-2-terms-ee9ce262-74a3-4548-
925b-984f9a00f9f6/deck#:~:text=The%20level%20of%20acceptable%20practice,or
%20other%20legally%20protected%20right

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supervisor/#:~:text=A%20Phlebotomy%20Supervisor%20oversees%20a,performing
%20daily%20testing%20and%20examinations.

64