JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 14, 21, 26

The first critical step in completing a laboratory procedure is PROFESSIONAL GROOMING

that of obtaining an adequate specimen and providing the
correct handling and proper identification of the samples • No visible tattoos

ALWAYS REMEMBER THAT A LABORATORY PROCEDURE IS NO • No body piercing other than a maximum of two in
MORE ACCURATE THAN THE SPECIMEN USED FOR ITS ears
PERFORMANCE
• No fingernails longer than ¼ inch
PHLEBOTOMY
• No blue jeans or casual attire
• Is an integral part of medical laboratory practice
• No open-toed shoes
• Is the act of obtaining a blood sample using a needle
• No wearing of T-shirts and sweatshirts
attached to a syringe or stoppered evacuated tube
FACTORS FOR GOOD PHLEBOTOMY
• Most blood is collected by trained phlebotomists, but
medical laboratory technologists and technicians • Phlebotomists
must nevertheless be somewhat proficient at • Patient
collecting blood samples. • Equipment

PHLEBOTOMISTS BRIEF HISTORY OF PHLEBOTOMY

• A persons who collects blood BLOODLETTING

• Must possess skills in communication and have a good • Was a cure for disease
grasp of basic psychology and good common sense • Bleeding removed “bad” blood
when working with patients and family members
POPE INNOCENT VIII
• Manual dexterity is a must and one must be
psychologically prepared for inserting needles into • 1492
sometimes unwilling patients • Blood was taken from three young men and given to
the stricken Pope Innocent VII in the hope of curing
CHARACTERISTICS OF A GOOD PHLEBOTOMISTS him; unfortunately, all four died.

• The phlebotomist must be professional, competent METHODS OF PHLEBOTOMY

and thorough
VENESECTION
• PROFESSIONALISM is the first thing a patient will
notice about the person who comes to collect his or • most common
her blood
• Used to reduce fever or to produce a faint
• PROFESSIONAL BEHAVIOUR is paramount in the
person who is collecting blood from a patient who is CUPPING
already at a high level of stress due to illness or
• A heated glass cup was placed on a person’s back.
perhaps from having the procedure itself performed
• Cup cooled and created suctionà cut areas using the
• Calm and confident approach along with an
blade to produce massive number
explanation of the procedure being
performed

JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 12, 14, 21, 24,29
JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 14, 21, 26
GEORGE WASHINGTON’S DEATH AREAS OF THE HOSPITAL

• December 14, 1799 ELECTROCARDIO-GRAPHY

• He had a sever sore throat and they cure him using
• Recording of impulses of the heart.
heavy bleeding
• Impulses make tracing record of size and shape of the
• After bleeding of more than 9 pints in less than 24 heart
hrs., he died.
ELECTROENCEPHALOGRAMS
• After his death, the philosophy of bleeding as cure
began to change • Record the electrical activity of the brain.
• Help locate and assess the extent of brain injury or
LEECHES determine if there is any brain activity

• Limited uses today like surgery PHARMACY

• Leeches are used for amputations to remove
• Dispenses drugs that are much potent that a
excess blood and prevent clotting when an
prescription taken at home.
appendage is reattached. Therapeutic
phlebotomy usually removes 500 milliliters of • Acceptable specimen= possible best treatment
blood from the patient.
PHYSICAL THERAPHY
BLEEDING
• Works with patient who, due to disease or injury,
• Bleeding in form of therapeutic phlebotomy done are no longer able to function to their full
today for disease polycythemia vera and hereditary physical capacity.
hemochromatosis
OCCUPATIONAL THERAPY
PHLEBOTOMY IN HEALTHCARE
o Patients work to overcome their
Centralized (80%) physical handicaps so they can be
productive again
• Phlebotomist is part of laboratory team and
dispatched to hospital units to collect blood samples RADIOLOGY

• WAITING-TO-SERVE-TIME Includes the following:

• Time of waiting for work • Cardiac catheterization

• Computed tomography (CT scans)
Decentralized (80%) • Magnetic Resonance Imaging (MRI)
• Ultrasound
• All members of the health care team share
responsibility to collect blood samples. NURSING

• Patient-focused care • Largest department the phlebotomist works with

• Prone to hemolyzed samples AREAS OF NURSING

Hybrid phlebotomy • Neonatal

• Blend of centralized and decentralized phlebotomy • Obstetrics

• Use to reduce the errors of decentralized phlebotomy • Oncology

JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 12, 14, 21, 24,29
JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 14, 21, 26
• Orthopedics PHASES OF SAMPLE TESTING

• Pediatrics • PREEXAMINATION

• Intensive care – Previously known as preanalytical phase

• Coronary care – Includes all processes from collecting the

sample to having it ready for testing
• Emergency
• EXAMINATION
• Nephrology
– Previously known as analytical phase
• Geriatrics
– Includes all processes done to sample to
PATIENT-FOCUSED CARE CONCEPT achieve result
• Takes laboratory out of physical location • POSTEXAMINATION

– Brings laboratory to patient – Previously known as postanalytical phase

– Point of Care Testing – Process in which the results of the testing are
communicated to the health care provider or
Instrumentàpatient’s roomà collected bloodà tested in the
physician
instrument
MANAGED CARE
Eg. glucometer
• Coordinates providing health services and health
AREAS OF THE LABORATORY
benefits
• Phlebotomy
• Control the use of health services and accompanying
• Chemistry costs

• Hematology HEALTH MAINTAINANCE ORGANIZATION

• Coagulation • Provide healthcare coverage for both hospital and

physician services
• Histology
• Required to use only certain contracted physicians for
• Urinalysis their care

• Microbiology PREFERRED PROVIDER ORGANIZATION

• Immunology • Also contracts with certain health facilities

• Immunohematology (blood bank) • Offers more freedom for patients to choose to whom
they go.
• Cytology
AFFORDABLE HEALTH CARE ACT
• Molecular Diagnostics
• Enacted to help those who could not afford insurance

• Requires all people to have health insurance

JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 12, 14, 21, 24,29
JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 14, 21, 26
• Laboratories should produce quality testing in less PHLEBOTOMY TECHNICIAN
time and less cost
• Emphasis on increasing the outpatient services and
decreasing the length of stay of inpatients
• Lab do the testing rapidly and more frequently
• The sooner the diagnosis and treatment the sooner
the recovery
TWO METHODS FOR FASTER RESULTS AND TREATMENT
1. POCT
• Results are available faster for the physician to
respond to with treatment
2. Reducing hospital cost
• Consolidation and reengineering
• Building patient service centers (PSCs)
• PSCs- patients do not have to go to the hospital to get
their blood drawn
LABORATORY STAFF
PATHOLOGIST
• Head of the laboratory
• Reads and interprets the results of laboratory tests
• Examines tissues under a microscope to diagnose and
monitor disease
MEDICAL LABORATORY SCIENTIST/ CLINICAL LABORATORY
SCIENTIST
• Responsible for a full range of lab tests
• confirms the accuracy of results
• Reports lab findings to pathologists and other
physicians
MEDICAL LABORATORY TECHNICIAN
• Under the supervision of medical technologists
JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 12, 14, 21, 24,29
• Collect blood samples to be used in many lab test to
detect and monitor treatment
• Categories of Phlebotomy Technician
1. Limited Phlebotomy Technician
Ø Only performs skin punctures
Ø Must perform 25 fingersticks
2. Phlebotomy Technician I
Ø Performs skin (50) and venipuncture (10) and pass an
approved national certifying organization
3. Phlebotomy Technician II
Ø Performs skin (50) , venipuncture (10) and arterial
puncture (20)
PATIENTS RIGHTS
• Patient has right to considerate and respectful care
• Patient has right to receive understandable
information
• Patient has right to make decisions about plan of care
and refuse treatment
• Patient has right to have an advance directive
• Patient has the right to privacy
• Patient has the right to confidentiality of his or her
medical records
• Patient has the right to review records
• Patient has right to expect that within its capacity and
policies, a hospital will make reasonable response to
the request of a patient for appropriate and medically
indicated care and services
• Patient has the right to information regarding hospital
business relationships that might impact his or her
care
• Patient has the right to consent or decline to
participate in proposed research studies
JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 14, 21, 26
• Patient has the right to expect continuity of care

• Patient has the right to be informed of hospital

policies and practices that relate to patient care,
treatment, and responsibilities

REGULATROY AGENCIES

CAP - College of American Pathologists

CLSI - Clinical Laboratory Standards Institute

CLIA - Clinical Laboratory Improvement Act of 1988

OSHA - Occupational Safety and Health Administration

NAACLS - National Accrediting Agency for Clinical Laboratory

Sciences

QUALITY ASSURANCE

• Quality is phlebotomist’s responsibility

• Result of test sent to physician depends on quality of

sample obtained

• Laboratories must have certain levels of patient

satisfaction to continue receiving payments from
insurance companies

• Must have quality assurance program, total quality

management program, and continuous quality
improvement program

• All programs work to ensure the quality of the

samples and result as a method of improving patient
satisfaction.

JOSE ANGELO ANGELES BUNAG, RMT, MSMT|2020|PMTP II - SECTIONS: 12, 14, 21, 24,29