Unit ``1 Phlebotomy Book Questions

another name for a dermal puncture

finger stick

Phlebo means

vein

-tomy means

incision

Where were the earliest depictions of venipuncture found?

on egyptian hieroglyphics dating at least 3500 years ago

blood letting rid the body of

excess fluids or humors believed to be infected

does the state mandate certification for phlebotomy?

No it does not.

What two patient identifiers are used to identify patients?

spelling of last and first name

and DOB

Lack of communication during a blood draw can be a sign of?

a pending dramatic reaction episode (fainting, etc.)

The american Hospital Association has created an easy to read pamphlet that informs patients of their rights called

The Patient Care Partnership

True or False - a patient can terminate the venipuncture at any point even if the procedure has already begun.

True.
Failure to terminate the procedure can result in assault & battery charges.

HIPAA stands for?

Health Insurance Portability and Accountability Act

What does HIPAA do?

requires that healthcare providers get written permission before disclosing healthcare information to anyone outside their care team

what does PHI stand for?

protected health information

What is PHI

it is any identifiable health information of an individual that is stored transmitted or stored electronically

IF HIPAA or PHI is violated what disciplinary actions can be taken?

Fines and possible jail time

What percentage of communication is nonverbal?

80% of communication is non verbal

Hearing and understanding each other is a form of

effective communication

Is a patient likely to keep talking when displaying a shut down body position

No, the patient may just stop talking in the case

which is better open loop communication or closed loop communication?

Closed loop - it is the active back and forth encoding and decoding of information between two people

open loop - send information and leave the conversation which creates zero conversation

What is the oldest watch dog group in healthcare facility oversight?

TJC - the joint commission (founded in 1951)

independent and nonprofit

what does the TJC do?

looks out for pateint and establish standards and practices of operations in all healthcare settings

improves healthcare offerings to the public

brings quality assurance to healthcare market

TJC’s program focuses on

quality care

patient safety

continuous pre-analytical and post-analytical processes

oversites to Point of Care Testing (POCT)

What does CLSI stand for?

Clinical and Laboratory Standards Institute

What does CLSI do?

global and nonprofit org that develops standards using representatives taken from the fields they directly oversee

What do QC checklists do?

quality control checklists ensure machines are inspected for performance and operation compliance at time intervals specific to the equipment and clinical application

ie prevent expiration or skewed testing outcomes or patient mismanagement

CLSI’s mission statement is

develop clinical and laboratory practicies and promote their use worldwide

what does an incident report form do?

it records and tracks internal issues, id’s people involved, the problem and the actions taken to correct the issue.

• typically handled by office manager

What is risk managment?

the prevention or management of loss of property or injury in the healthcare industry

What are some examples of illegal and unethical behaviors?

Negligence

Assault & Battery

Slander & Libel

Duty of Care

Breach of Duty

Malpractice

Legal issues occur when?

an establish law is broken, even if the provider is unaware of the law

if industry standards are broken will it result in criminal charges?

No, it will not result in criminal charges but can result in CIVIL actions and be reviewed by the health professional’s certifying agency (can be revoked).

Ethical behavior entails conforming to a….

standard of right and wrong to avoid harming the patient

true or false

patients can always know what tests are being performed?

True

What should you do when a patient declines medical treatment

report it to your supervisor

Should you give patient’s results or explain what the tests check for?

No, don’t give patient results or explain what the tests check for.

you are not medically qualified to do so.

informed consent is when?

a competent person gives voluntary permission for a medical procedure after receiving adequate information about the risk of the procedure’s methods and consequences

Expressed consent is when

permision is given by the patient verbally or in writing for a procedure

Implied consent is when

the patient’s actions permit the procedure without verbal or written consent

ie a patient in the ER holds out their arm when they are told they need a blood draw

HIV Testing requires special consent - true or false

true - special permission is needed to administer the HIV test

Who must permit procedures to underage patients?

Parent or legal guardian for patients under age 18 or 21 (in some states)

If a patient is a minor or under law enforcement custody, can the patient refuse care?

No, refusal of care falls to the parent or law enforcement with custodian of that individual.

What can form can be signed to cover the provider and clinic from future litigation revolving around failure to provide care?

An AMA or Discharge Against Medical Advice form

Sexual harassment is defined as

a form of sexual discrimination and violates Title VII of the Civil Rights Act of 1964

it includes persistent or offensive conduct

If a patient is inpatient, where must their ID band be located for accurate patient identification

on the patient themselves, it can’t be on the bed rails or in their pocket

If a patient is outpatient, what ID can help id them and why?

a state issued ID with their DOB along with insurance card

If a patient is not identified what rules can’t be followed?

HIPAA rules

If a patient has a barcode on their ID band what are the steps you should take?

Scan the barcode on their bracelet

then Scan the lab requisition

and make sure all labels match and are assigned to the right patient

If there is a discrepancy with the ID band, can you go ahead and draw blood?

No, you can’t perform the procedure until the descrepancy is resolved.

If you make a mistake, should you hide it?

NO! Do not hide a mistake, instead report the incident to your supervisor so they can take step to correct it and help the patient

The organization OSHA stands for

Occupational Safety and Health Administration

What does the

Occupational Safety and Health Administration do?>

fed agency responsible for overseeing the Occupational Safety and Health Act.

• mandates safety regulations across every workplace

  • ergonomics, to bloodwork

investigates hazardous workplaces or on the job injuries for prevention purposes

Can you eat, drink smoke or chew gum in the lab?

No

Should you place pens or pencils in your mouth in the lab?

Never place pens or pencils in your mouth in the lab

can you store food or drinks in the specimen refrigerator?

No

Wearing long chains, large earrings or loose bracelets is acceptable in the lab. True or false?

False

Wearing perfume, cosmetics, or cologne in the lab is ok.

True or False

False

You should always wear a fully buttoned lab coat in the lab.

True or False

True

wearing your lab attire or lab coat outside the lab is fine.

true or false

false

Wearing open toed shoes is okay in the lab. True or False

False - shoes should be comfortable, non-slip, made of impenetrable materials

Wearing your hear loose and down is okay in the lab

True or False

False. Hair should be tied back

Biting your fingernails and wearing long nails is not acceptable in the lab. True or False

True. Nails should be kept short and not bitten.

Wearing PPE when working is the lab is unreasonable.

True or False

False. One should wear proper PPE in the lab

IF a patient is unresponsive, what should you do?

Report it immediately

Can you run in the clinic or hospital?

No, avoid running

It is okay to touch electrical equipment in patient care rooms while drawing blood

True or False

False. Do not touch electrical equipment

What precautions should you always follow when drawing blood or handling specimens?

standard precautions

If you put down the patient’s bedrails to draw blood, what should you do before you leave the room?

Put the bedrails back up

If you see that an IV or line has infiltrated or there are other IV problems what should you do?

Report it

If there are unusual orders in the patient’s room what should you do?

Report it

When entering a patient’s room what should you be on the look out for on the floor?

Spilled food or liquid

What are the four types of OSHA compliance inspections?

1. The Complaint Inspection

2. The fatality or Accidents Inspection

3. The Programmed Inspection

4. The Imminent Danger Inspection

The imminent danger inspection occurs when?

when OSHA receives a report that condition of immediate danger exists in the workplace — very rare - least common

the programmed inspection occures when ?

Conducted on randomly chosen workplaces determined to engaged in hazardous work types according to SIC codes (Standard Industry Classification)

Fatality or Accidents Inspection occurs when

When OSHA receives notice from the employer of a workplace fatality or accident resulting in three or more employees hospitalizations

• media reports and frequent investigations that do not result in deaths or hospitalizations are also noted

Complaint Inspections occur when

an employee files a formal complaint with OSHA

- this is the most common type of inspection

What do we use to protect ourselves from pathogens in bodily fluids or airborne contaminates?

Barriers

Hepatitis B and HIV can be transmitted via

Human blood

Bodily Fluids

Sexual Contact

Sharing of Needles

Maternal-Fetal Transmission

Accidental Puncture from Needle or sharps or glass

Contact between mucous membranes and infected body fluids

Blood to blood contact with infected blood or bodily fluids

through the eyes, nose and mouth mucous membranes

If a bodily fluid doesn’t have blood in it, can it still carry a pathogen?

Yes, it can still carry a pathogen even if there is no visible blood

You should always assume the fluid you are handling is possibly contaminated. True or False

True

Unbroken skin is an impervious barrier to bloodborne pathogens

True or False

True

Sores, cuts, abrasions, acne, damaged skin like sunburn or blisters can be an entry point for infected blood to enter your system.

True or False

True

The most common way for transmission of a pathogen to occur in lab situations is due to?

accidental punctures or lacerations from needle sticks, broken glass or other sharps

Name the four types of infectious agents

Bacteria

Viruses

Fungus

Parasites

What is direct contact transmission

when a pathogen is trasnmitted directly from an infected person to and other person or creature

How do you prevent direct contact transmission

Wear gloves

Indirect Contact transmission is when

when a fomite serves as a temporary reservoir for the disease

(contaminated clothing with scabies or bed bugs or lice)

Droplet transmission is when

an infectious agent travels in saliva or mucous as it leaves the reservoir (sneezing or coughing)

what protects you against droplet transmission

a mask

Airborne transmission occurs when

the infectious agent is so small it can be suspended in air and travel across vast space

what can be used to protect against airborne transmission

N95 mask/respirator

Vehicle transmission occures when

the agent is contained in the bodily fluid that the susectiple host contacts (doorknobs, phones, faucets, pen in mouth)

Vector borne transmission occurs when

a pathogen transmits through an invertebrate such as an insect

(mosquito)

Parenteral Transmission occurs when

a disease or infection is transmitted other than by mouth, nose or eyes (ie a needlestick, open wound, hangnail)

what is an exit portal in infectious disease?

When an infectious microorganism leaves its reservoir or agent

what is a susceptible host?

a person who is not resistant or immune who can become infected due to a breakdown in prevention systems

Control measures used to prevent the spread of disease as infectious agents exit the reservoir

Standard precautions

what is the transmission mode

how microorganisms travel from the reservoir to the suseptible host

What is a nosocomial infection?

Any infection contracted in the healthcare setting

**typically respiratory H

What percentage of patients admitted to medical facility will receive a noscomial infection?

Five percent

Prevention of disease conditions is accomplished by using what two things?

anti-infective drugs OR infection control practices