LESSON 1

PHLEBOTOMY
- The practice of drawing blood
- Greek words: phlebo “vein”, and -tomy “to make an incision”

PAST
- Ancient profession - 3500 years to the time of the ancient Egyptians
- In Europe (Middle Ages) barbersurgeons performed bloodletting to balance the four humors (phlegm,
black bile, yellow bile, and blood) or bodily fluids
- Early tools: lancets (fleams), suction cups and ornate ceramic bowls (collects the blood)
- Use of blood-sucking leeches
- Bloodletting now called “therapeutic phlebotomy”

PRESENT
- Obtain blood for screening and diagnostic purposes and to monitor prescribed treatment
- Remove blood for transfusions at a donor center
- Remove blood for “therapeutic” purposes, such as treatment for polycythemia
- Two procedures:
+ venipuncture - collecting blood by penetrating a vein with a needle attached to a syringe
+ capillary puncture - collecting blood after puncturing the skin with a lancet/incision device

PHLEBOTOMIST
- Blood collector
- Person trained to obtain blood samples (venipuncture or microtechniques)
- Familiar with anatomy and physiology related to laboratory testing, and phlebotomy
- collection and transport requirements for tests performed in all sections of the laboratory
- Documentation and patient records
- Interpersonal skills needed to provide quality patient care
- The only personal contact to a patient has with the laboratory

TRADITIONAL DUTIES

Major traditional duties and responsibilities of the phlebotomist include:

1. Correct identification and preparation of the patient before sample collection
2. Collection of the appropriate amount of blood by venipuncture or dermal puncture for the specified tests
3. Selection of the appropriate sample containers for the specified tests
4. Correct labeling of all samples with the required information
5. Appropriate transportation of samples back to the laboratory in a timely manner
6. Effective interaction with patients and hospital personnel
7. Processing of samples for delivery to the appropriate laboratory departments
8. Performance of computer operations and record-keeping pertaining to phlebotomy
9. Observation of all safety regulations, quality control checks, and preventive maintenance
procedures
10. Attendance at continuing education programs
ADDITIONAL DUTIES

✓ Training other health-care personnel to perform phlebotomy

✓ Monitoring the quality of samples collected on the units
✓ Evaluation of protocols associated with sample collection
✓ Performing and monitoring point-of-care testing (POCT)
✓ Performing electrocardiograms
✓ Performing measurement of patient’s vital signs
✓ Collection of arterial blood samples
✓ Collection of samples from central venous access devices (CVADs)

PROFESSIONAL AND PERSONAL CHARACTERISTICS FOR PHLEBOTOMISTS

Dependable, Cooperative, Committed
❑ Phlebotomist report to work whenever scheduled and on time.
❑ Willing to demonstrate commitment to job and cooperation to assist fellow employees.
❑ Committed phlebotomist attends staff meetings, reads pertinent memoranda, and observes notices placed on
bulletin boards or in newsletters

Compassionate, Courteous, Respectful

❑ Must be sensitive to their needs, understand a patient’s concern about a possible diagnosis or just the fear of
a needle, and take the time to reassure each patient.
❑ A smile and a cheerful tone of voice
❑ Courteous phlebotomists introduce themselves to the patients before they approach them
❑ Phlebotomists must also understand and respect the cultural diversity of their patients

Honesty, Integrity, Competence

❑ Should never hesitate to admit a mistake, because a misidentified patient or mislabeled sample can be
critical to patient safety.
❑ Patient confidentiality must be protected, and patient information is never discussed with anyone who does
not have a professional need to know it.
❑ Never perform a procedure that you have not been trained to perform. When faced with this situation
do not hesitate to ask for assistance from someone more experienced.

Organized, Responsible, Flexible

❑ Always maintain an organized and wellstocked collection tray or station.
❑ Not only do phlebotomists need to organize their collection equipment, they must also organize and
prioritize their work.
❑ Phlebotomists on the morning shift receive many collection requisitions when they arrive at work. These
collections must be made before the patients can receive breakfast. For efficiency the requisitions must be
organized regarding patient location.

APPEARANCE
General Appearance Guidelines
1. Clothing and lab coats must be clean and unwrinkled.
2. Shoes must be clean, polished, closed toed, and skid-proof.
3. If jewelry is worn, it must be conservative.
4. Perfume and cologne are usually not recommended or must
be kept to a minimum.
5. Hair including facial hair must be clean, neat, and trimmed.
6. Personal hygiene is extremely important.
7. Fingernails must be clean and short.

CULTURAL DIVERSITY
Diversity in our population includes more than just
the diversity encountered with verbal communication.
In addition to language, culture includes the
integration of:
✓Customs
✓Beliefs
✓Religion
✓Values.

COMMUNICATION SKILLS

Verbal Skills
➢ Enable phlebotomists to introduce themselves,
explain the procedure, reassure the patient,
and help assure the patient that the procedure is
being competently performed.
➢ Tone of your voice and emphasis on certain
words also is important.
➢ Barriers to verbal communication that must be
considered
✓ physical handicaps such as hearing impairment
✓ patient emotions
✓ the level of patient education
✓ age
✓ language proficiency

Listening Skills
Active listening involves:
➢ Looking directly and attentively at the patient
➢ Encouraging the patient to express feelings, anxieties, and concerns
➢ Allowing the patient time to describe why he or she is concerned
➢ Providing feedback to the patient through appropriate responses
➢ Encouraging patient communication by asking questions

Nonverbal Skills (Body Language)

➢Include facial expressions, posture, and eye contact
➢Allows patients to maintain their zone of comfort
(space)

TELEPHONE SKILLS

Phlebotomists should have a thorough understanding of the telephone

system regarding transferring calls, placing calls on hold, and paging
personnel.
To observe the rules of proper telephone etiquette:
1. Answer the phone promptly and politely, stating the name of the
department and your name.
2. Always check for an emergency before putting someone on hold, and
return to calls that are on hold as soon as possible.
3. Keep writing materials beside the phone to record information.
4. Make every attempt to help callers, and if you cannot help them,
transfer them to another person or department that can.
5. Provide accurate and consistent information.
6. Speak clearly and make sure you understand what the caller is asking
and that he or she understands the information you are providing.
7. Goal 2 of the National Patient Safety Goals.

PHLEBOTOMY EDUCATION AND CERTIFICATION

Certification is a voluntary process by which an agency grants recognition to an individual who
has met certain prerequisites in a specific technical area.
▪ Certification indicates the completion of defined academic and training requirements and the
attainment of a satisfactory score on an examination that tests proficiency in that area.
▪ Phlebotomist certification is signified by initials that the individual has the right to display after
his or her name
LICENSURE
Licensure is the act of granting a license. A license in healthcare is an official document or permit granted by a
state agency that gives legal permission for a person to work in a particular health profession. Without a
license, it would be against the law for a person to practice that profession in that state

CONTINUING EDUCATION

Continuing education is designed to update the knowledge or skills of participants and is generally geared to
a learning activity or course of study for a specific group of health professionals, such as phlebotomists Many
organizations, such as the American Society for Clinical Pathology (ASCP), the American Society for Clinical
Laboratory Sciences (ASCLS), and the American Medical Technologists (AMT), sponsor workshops, seminars,
and self-study programs that award continuing education units (CEUs) to those who participate.