Phlebotomy Unit 1 test

Hippocrates

• Theorized disease was the result of excess substance in the body 

• Removal of excess would restore balance

Bloodletting: Egypt 1400 BC

Release the body of evil spirits, cleanse body of impurities, or bring the body back into balance.

Exsanguinate

drain of blood

Exsanguination

death caused by loss of blood

Venipuncture

collection of blood by penetrating a vein with a needle, syringe, or other collection device

Capillary puncture

-collection of blood after puncturing the skin with a lancet

What can Phlebotomy do?

Diagnose, Monitor therapy, blood donation, therapeutic

NAACLS

• National Accrediting Agency for Clinical Laboratory Sciences

Certification

Agency grants recognition for meeting defined academic/training requirements and satisfactory score on exam

Licensure

Act of granting a license-official document or permit to practice in a particular field. Some states require a license to practice

American Medical Technologists

Registered Phlebotomy Technician

National Health career Association

Certified Phlebotomy Technician

American Society for Clinical Pathology

Phlebotomy Technician

National Center for Competency Testing

National Certified Phlebotomy Technician

Continuing Education Units (CEUs)

Designed to update knowledge.Required by most certifying and licensing agencies

IACET

(International Association for Continuing Education and Training)

Inpatient

Status once “admitted” by MD order

>23 hours

Outpatient

Also includes UO (under observation) status

<24 hours (even if overnight)

Primary

Care by a general practitioner  who assumes ongoing responsibility for maintaining a patient’s health

Secondary

Care by a practitioner (specialist) who can perform more complex procedures in outpatient facilities

Tertiary

Highly complex care and therapy services from practitioners in a hospital or overnight facility.

Department of Laboratory Medicine and Pathology

administrator/director

2 Major Divisions

  -Clinical Analysis

      -specimen processing

       -hematology

       -chemistry

       -blood bank

  -Anatomical/Surgical Path

     -Tissue Analysis

       -cytologic exam

       -biopsy 

     -autopsies

Anatomical

Surgical Pathology

Histology

Cytology

Surgical Pathology

Common tests-biopsy, frozen section, Pap smea

Point of Care

Outpatient Service

-Reference Labs

Nursing POCT

Satellite Labs-close to department they serve.  Quick TAT’s

STAT Labs

Blood Bank

Immuno/Hematology

Transfusion Medicine

Common Tests-Type and Crossmatch, Type and Rh, hold autologous and donor blood for transfusions

Chemistry

Toxicology

Therapeutic Drug

    Monitoring

          Molecular Diagnostic

Common Tests-BMP, CMP, Hepatic function, Lipid panel,

Hematology

Coagulation

Immunology

Urinalysis

Common Tests-CBC, PT, PTT, D-dimer

Flow Cytometry

HLA

Stem Cell Analysis

Common tests-tissue typing for transplants, immunotherapy

Microbiology

Bacteriology

Mycology

Virology

Parasitology

Common tests-ANA, HCV, HepB, CRP, HCG, C&S, O&P

Clinical Laboratory Improvement Amendments of 1988 (CLIA ‘88)

Federal law that allows the CMS in the Department of HHS to

Regulate all sites performing laboratory testing in the US.  

All labs must use same standards for testing and requirements for personnel

Lab Director/Pathologist

MD or PhD

Lab Administrator/Manager

Technologist-advanced degree/yrs of experience

Technical Supervisor

Oversees particular area of lab 

MT/MLS

Performs all levels of testing in any area

MLT

Performs routine testing, operates equipment

• Direct Pay

• Patient pays directly for health care cost

• Good unless have major illness 

• Private Insurance

• Either buy individual or group insurance

• Usually less expensive

• Government Plans

• Military-VA

• Medicare

• Medicaid

• Health Savings Accounts (HSA)

Consumer deposits set amount of money into an account (tax free) that must be used for healthcare costs

• Prepaid Plans

• Pay for services before they are performed

• Physicians paid a set amount before service is completed

• Enrollees must use physicians who contracted with insurance companies

in hopes that only a limited members will use the plan. That's how they make profit.

• Negotiated Fees

These are pre-agreed upon amounts for specific services between healthcare providers and insurance companies.

• Primary Care Providers (PCP)

• Also known as gatekeepers

• They evaluate patient complaint and determine the appropriate level of care

• Review of Services

• Get pre-authorization of services  prior to procedures being done. 

High Deductible Health Plan (HDHP)

• Insured party pays a set amount of money (OOP) before benefits begin

 Health Maintenance Organization (HMO)

• Prepaid medical group. Predetermined benefit package both insurers and providers

Accountable Care Organization (ACO)

• network who voluntarily offer to coordinate care for Medicare patients.  Share cost of savings

Preferred Provider Organization (PPO)

• Group of hospitals and physicians who contract fee for service

Point of Service Plan (POS)

• Receive service from participating or non participating provider. Level of coverage is reduced if using non participating provider

ICD-10-PSC

Replaced CPT codes for inpatient settings-2014

Ambulatory services still use CPT