Tabels Ch 1-3

• Prepare pts for specimen collection

• Collect venous/capillary specimens

• Prepare/transport specimens

Typical duties of a phlebotomist

• Collecting/documenting monthly workload/record data

• Perform/document equipment maintenance

• POCT

• Prepare drafts of procedures for lab tests

• Lab computer info operations

• Front-office - scheduling, coding, itinerary updates, Advanced Beneficiary Notice

• Train new students

Additional duties of a phlebotomist

1. CPT - ACA (American Certification Agency)

2. CPT - NHA (National Health Career Association)

3. CPT - NPA (National Phlebotomy Association)

4. PTC - ASPT (American Society of Phlebotomy Technicians)

5. PBT - ASCP (American Society for Clinical Pathology)

6. RPT - AMT (American Medical Technologists)

7. NCPT - NCCT (National Center for Competency Testing)

List phlebotomist title and initials awarded by certificate agencies

• Principal source of healthcare services

• Routine care in physician’s office

• PCPs

• Secondary physicians (specialists) - routine surgery, emergency tx, therapeutic radiology, same-day service centers

Ambulatory/Outpatient

• Key resource and center of the US healthcare system

• Specialized instrumentation/technology - unusual diagnoses/tx

• Tertiary care - pts stay overnight

• Acute care hospitals, nursing homes, extended-care facilities, hospices, rehab centers

Nonambulatory/Inpatient

• APC = ambulatory pt classification - payment for Medicare/Medicaid pts

• DRG = diagnosis-related groups - groups pts w/ similar diagnoses. Controls costs and reimbursement

• FFS = free for service - reimburses providers for their services, rather than a fixed amount/based on pt outcomes

• PPS = prospective payment system - limit and standardizes Medicare/Medicaid payments

Healthcare payment methods

• ICD = international classification of diseases - codes based on med conditions, s/sx, body systems

• CPT = current procedural terminology - describe med procedures when billing insurance companies

• HCPCS = Healthcare Common Procedure Coding System - identifies procedures, products, supplies, services not in CPT codes

Healthcare billing codes

• Federally funded insurance program for people >65 yo and certain people w/ disabilities or dialysis

• Run by CMS

• Med bills paid from trust funds

• Entitlement program - right earned through employment

• Financed through SS payroll deductions/copayments

Medicare

• Federal/state med assistance program for low-income people

• Run by state/local government

• Funds from federal grants and state/local governments

Medicaid

• Patient: nursing care, emergency services, ICUs, surgery

• Support: central supply, dietary, environmental, health info tech

• Diagnostic: cardiodiagnostics (EKG), ENT or EEG, radiology

• Professional: OT, PT, RT, pharmacy

Typical hospital services and departments

1. Clinical Analysis areas: specimen processing, hematology, chemistry, microbiology, blood bank/immunohematology, immunology/serology, urinalysis

2. Anatomical and surgical pathology: tissue analysis, cytologic examination, surgical biopsy, frozen sections, autopsies

Two major divisions in the clinical lab

• FMEA = failure modes and effects analysis

• Lean

• Six Sigma

• Lean Six Sigma

• RCA = root cause analysis

Quality/Process Improvement Tools

• Standardization for quality service or product/prevention of problems

• Goal: improve work processes so errors don’t occur, prevent errors by being proactive

• Managerial tool for lab supervisors

• Determined by team before work begins

Quality assurance

• Specific activities/techniques to fulfill requirements for quality service

• Goal: identify weaknesses/errors in lab processes at the practice level, identify and correct errors by being reactive

• Corrective tool for lab personnel

• Adherence to requirements by personnel

Quality Control

• Purpose of procedure

• Policy

• Specimen type/collection method

• Equipment/supplies needed

• Step-by-step procedure

• Limits/variables of the method

• Corrective actions

• Method validation

• Normal values and references

• Review and revision dates

• Approval signatures and dates

Typical info in a procedure manual

Concerned with laws (felonies, misdemeanors)

Criminal Actions

Actions between 2 private parties (individuals/organizations) - damages and monetary penalties

Civil actions

• Level 1: lowest risk, microbes that don’t generally cause disease to healthy individuals (Escherichia coli)

• Level 2: moderate, microbes that cause disease but are not transmissible by inhalation (HIV, HBV, salmonella)

• Level 3: high, microbes that can become airborne, infect without direct contact, and cause serious life-threatening diseases (tuberculosis)

• Level 4: highest, fatal and no tx/vaccine (Ebola, Marburg)

CDC biosafety levels

• Absorb with paper towel

• Discard in biohazard waste container

• Clean area w/ disinfectant

Cleanup procedure for small spill

• Use special clay/chlorine-based powder to absorb the gel/liquid

• Scoop/sweep up absorbed material

• Discard in biohazard waste container

• Wipe w/ disinfectant

Cleanup procedure for large spill

• Moisten with disinfectant

• Absorb with towels

• Discard in biohazard waste container

• Clean with disinfectant

Cleanup procedure for dried spill

• Wear heavy-duty utility gloves

• Scoop/sweep material

• Discard in biohazard sharps container

• Clean with disinfectant

Cleanup procedure for spills involving broken glass

• Harmonized signal word: danger or warning

• Pictogram

• Hazard statement: nature of the hazard, hazard degree

• Precautionary statement: minimize or prevent adverse effects of exposure/improper handling/storage

• Supplier ID: name, address, phone #

Globally Harmonized System (GHS) Elements Incorporated into HazCom Standards

1. P: pull pin

2. A: aim nozzle

3. S: squeeze trigger

4. S: sweep nozzel

PASS