Phlebotomy textbook readings

HIPPA

Health Insurance Portability and Accountability Act

• passed in 1996

• requires providers to get written permission before disclosing healthcare information to anyone outside the provider team

PHI

Protected health information

• any individually identifiable health information that is transmitted or stored electronically

• protected under HIPPA

TJC

The Joint Commission

• founded in 1951 and is the oldest watchdog group in healthcare facility oversight

• accredits healthcare programs and organizations to uphold the highest standards of care

CLSI

Clinical and Laboratory Standards Institute

• develop standard practices that are used universally

Informed consent

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

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

Implied consent

The patient's actions permit the procedure without verbal or written consent. For example, this includes a patient going to the emergency room or holding out an arm when told they need blood drawn

HIV testing consent

Special permission is needed to administer a test that detects HIV

Parental consent for minors

A parent or guardian must permit procedures administered to underage patients depending on the state law, ranging from 18 to 21 years of age

OSHA

Occupational Safety and Health Administration

• oversees Occupational Safety and Health Act

The complaint inspection

This inspection occurs after an employee files a formal complaint with OSHA. This is the most common inspection type

The fatality or accidents inspection

This inspection occurs after OSHA receives notice from the employer of a workplace fatality or accident resulting in three or more employees’ hospitalizations. OSHA also notes media reports and frequent investigations that do not result in deaths or hospitalizations

The programmed inspection

This kind of inspection is conducted on randomly chosen workplaces determined to be engaged in particularly hazardous work types according to their Standard Industry Classification (SIC)

The imminent danger inspection

This inspection type occurs when OSHA receives a report that a condition of imminent danger exists at a workplace. This is the least common type of inspection

NSPA

Needlestick Safety and Prevention Act

• passed on November 6, 2000

• revises OSHA’s Bloodborne Pathogens Standard to include safer medical devices

Sharps injury log must contain…

• the type and brand of device involved in the incident

• the department or work area where the exposure incident occurred

• an explanation of how the incident occurred

Types of environmental hazards

• biologic

• sharps

• chemical

• electrical

• fire or explosive

• physical

• allergic rxn (nitrile gloves as an alternative to latex)

HBV

Hepatitis B is the most commonly occurring nosocomial infection for lab employees. In the US, approximately 300,000 people are infected with HBV annually

Bodily fluid spills must be disinfected with a…

1:10 ratio NaClO (sodium hypochlorite) solution

Hemostasis

process by which blood vessels repair after injury

First stage of hemostasis

Vascular phase

• injury to blood vessel causes it to constrict, slowing blood flow

Second stage of hemostasis

Platelet phase

• injury to the endothelial lining causes platelets to adhere

• additional platelets stick to the site forming a temporary platelet plug in a process called aggregation

Third stage of hemostasis

Coagulation phase

• involves a cascade of interactions between coagulation factors that convert the temporary platelet plug to a fibrin clot

  • PT/INR test evaluates extrinsic pathway

  • PTT test evaluates intrinsic pathway

Fourth stage of hemostasis

Fibrinolysis

• the breakdown and removal of the clot by the enzyme plasmin

• FDP (fibrin degradation product) measurement evaluates the rate of fibrinolysis

Hemochron

A device used for POCT regarding PT/INR coagulation testing

Plasma

liquid portion of UNCLOTTED blood and still contains the clotting factors

• drawn in tubes WITH anticoagulants

Serum

liquid portion of blood that has been allowed to clot (no clotting factors as they have been used to clot the blood)

• drawn in tubes WITHOUT anticoagulants

Types of infectious microorganisms

• viruses

• bacteria

• fungi

• parasites

Percent of whole blood that consists of plasma

55%

Percent of while blood that contains formed elements

45%

Thrombocytes