NCCT Exam Review

what does phleb/o mean?

vein

what does -otomy mean?

surgical incision

what is exsanguination?

when blood is removed to a dangerous or deadly amount

what is venipuncture?

collection of blood from a needle inserted into a vein

what is capillary puncture?

blood collection via lancet skin puncture

what does CE stand for? what does it entail?

Continuing Education, in order to maintain licensure and certification, professionals must complete Continuing Education Units in order to ensure that their knowledge is refreshed and up-to-date

what does POCT stand for? what is it?

Point Of Care Testing, testing materials being brought to the patient (tests being performed at bedside, at people's homes, at a roving station, etc)

name three reasons a phlebotomist would remove blood

obtain blood for testing and diagnostic purposes, remove blood for therapeutic purposes, remove blood for transfusions at a blood bank

what is HIPAA?

Health Insurance Portability and Accountability Act, establishes standards for exchange of Protected Health Information (PHI), states patients must be informed of rights, and requires written authorization for disclosure of PHI

what does PHI stand for?

Protected Health Information

what is kinesics?

study of nonverbal communication

what is proxemics?

individual's concept and use of space

what is a kinesic slip?

when verbal and nonverbal messages do not match

what should you do if someone is being very rude on the phone?

DON'T hang up! try to assist, be patient and understanding

how should handwritten communication be performed?

legible and in ink

what does ambulatory mean?

outpatient, people come to get their blood drawn and leave to go home

what does nonambulatory mean?

inpatient, people who are in the hospital and don't have to go to the lab to get their blood drawn

what is primary care?

patient's main source for routine care (PCP, family medicine doctor)

what is secondary care?

specialist or facility with specific expertise (physical therapist)

what is tertiary care?

highly specialized care to perform advanced procedures (neurosurgeon)

what happens in the chemistry department?

detection and measurement of chemical substances in body fluids

what happens in the hematology department?

identify and monitor diseases in blood and blood-forming tissues

what happens in the coagulation department?

identify and monitor defects in blood clotting mechanism

what happens in the serology/immunology department?

identify antibodies and antigens

what happens in the urinalysis department?

urine specimens are tested

what happens in the microbiology department?

analyze blood and other body tissues for microbes

what happens in the immunohematology department?

blood bank, prepare blood for transfusion

what are satellite laboratories?

smaller labs close to the populations they serve, faster turnaround times, for tests needed immediately

what are reference laboratories?

larger independent labs which receive specimens from many facilities in the area, provide routine and specialized analysis of specimens, cost less but have longer turnaround times

what are HCWs?

healthcare workers

what are sensitive services?

services having to do with substance or alcohol abuse, sexual assault, pregnancy, STIs, or family planning for minors above the age of 12

what is CMS?

Centers for Medicare and Medicaid Services

what does CPT stand for?

Current Procedural Terminology (provide system of codes and terms for physician billing) AND Certified Phlebotomy Technician

what's the difference between medicare and medicaid?

medicare is insurance for seniors or disabled people, medicaid is insurance for any low-income individual

what is a cardiologist?

heart specialist

what is a dermatologist?

skin specialist

what is a gastroenterologist?

specialist in the treatment of stomach and small intestinal disorders

what is an endocrinologist?

specialist in the treatment of endocrine system (gland) disorders

what is Hct?

hematocrit

what is Hgb?

hemoglobin

what is histology?

study of tissues

what is cytology?

study of cells

what is TAT?

Turn Around Time (time it takes for specimen to be analyzed and for results to be communicated)

what is the TJC and what do they do?

The Joint Commission, the oldest and largest standard-setting body for hospitals and other healthcare facilities, seeks to improve patient care through evaluation

what is CLIA? explain what it is

Clinical Laboratory Improvement Amendments, establish federal quality regulations for all laboratories

what is the CLSI?

Clinical Laboratory Standards Institute, an organization that suggests standards of lab practice and promotes their use worldwide (not legally enforced)

what is NAACLS?

National Accrediting Agency for Clinical Laboratory Sciences, an authority on educational quality for programs that train laboratory professionals

what is pt an abbreviation for?

patient

what is QA?

Quality Assurance, systems and practices that prevent mistakes before they occur

what is QC?

Quality Control, evaluation of results and procedures to ensure that they are being performed correctly and safely

what is the "threshold value" with regard to quality assurance?

a level of acceptable practice beyond which quality patient care cannot be assured

what can be done if the threshold value for patient care is surpassed?

a CAPA (Corrective Action Preventative Action) plan

where should the phlebotomist go for answers to patient-related questions?

the patient's physician or nurse

where can the phlebotomist go for up-to-date info about policies and procedures for each specimen test or phlebotomy practice?

their workplace's specific policy and procedures manual

where can the phlebotomist go for up-to-date info about chemical, electrical, fire, and radiation safety, exposure control, disaster plans, and how to handle hazardous materials?

the workplace's safety manual

what should be documented on an incident report?

problem, consequence given, corrective action taken. facts included only, no opinions or feelings.

what is tort law?

deals with wrongful acts committed against people, property, or reputations committed without just cause.

what are some tort actions?

assault, battery, invasion of privacy, negligence, malpractice

what is sharing site criteria?

communicating appropriate, pertinent, and non-identifying info with other lab/medical staff

what is malpractice?

professional negligence

what is negligence?

failure to use ordinary or reasonable care

what is included in informed consent?

explain procedure in nontechnical terms, before it is performed

what are three types of consent that can be accepted by a phlebotomist?

verbal, written, implied

what is HIV consent?

obtaining consent after informing the patient about the test's purpose, how it will be used, its meaning, and its limitations

how do we obtain consent to perform venipuncture on a 12 year old?

consent must be obtained from parent or guardian

how do we obtain consent to provide sensitive services for a 12 year old?

we only need the patient's consent for sensitive services if they are over 12 y/o

what should we do if a patient does not consent to care?

refusal must be verified in writing, but the pt has every right to refuse care AMA (against medical advice)

what is an infection?

a condition in which microbes invade body, multiply, and cause injury or disease

what is a pathogen?

a microorganism that can cause disease

what is a nosocomial infection?

hospital acquired infection

what is an HAI?

Healthcare-associated infection (nosocomial infection)

what is a communicable disease?

a disease that is spread from person to person (ex. common cold, NOT something like cancer)

what is the \#1 HAI pathogen?

C. Diff (Clostridium Difficile)

what is the \#1 HAI infection?

UTI (Urinary Tract Infection)

what are the 6 links in the chain of infection?

(1) infectious agent, (2) reservoir, (3) exit pathway, (4) means of transmission, (5) entry pathway, (6) susceptible host

what is an infectious agent (\#1 on chain of infection)?

pathogenic microbe that causes the infection

what is a reservoir (\#2 on chain of infection)?

place where microbe can survive and multiply (human, animal, food, water, equipment)

what is an exit pathway (\#3 on chain of infection)?

a way the infectious agent leaves the reservoir host (secretions, exudates, tissue specimens, blood, feces, urine)

what are all the 5 means of transmission (\#4 on chain of infection)?

\-airborne

\-contact (direct and indirect)

\-droplet

\-vector

\-vehicle

\

what is an entry pathway (\#5 on chain of infection)?

way infectious agent enters susceptible host (body orifices, mucous membranes, breaks in skin)

what is a susceptible host (\#6 on chain of infection)?

someone with decreased ability to fight infection (old person, person on chemo)

what is the \#1 way to break the chain of infection?

handwashing

what is a fomite?

any object that is capable of harboring infectious agents

what is employee screening?

screening employees so they don't bring diseases into work (PPD or Quantiferon test for tuberculosis)

what is employee immunization?

making sure employees are vaccinated against diseases they could contract at work (HBV, MMR, TDap)

what is the order for donning PPE?

1. gown
2. mask or respirator
3. goggles or face shield
4. gloves

what is isolation?

isolating patients with communicable diseases so they don't spread them to others

what is protective isolation?

isolating patients with compromised immune systems to protect them from communicable diseases

what is a neutropenic patient?

pt with low neutrophil count due to chemo or disease, making them immunocompromised

what does UA stand for?

urinalysis

what are standard precautions?

precautions that are used during every patient interaction (hand hygiene, use of PPE, respiratory hygiene, safe injection practices, and disinfection of soiled surfaces and equipment)

what are transmission based precautions?

extra precautions for when patients are known or suspected to have certain infections (airborne, droplet, contact)

what is a biohazard?

anything that is potentially hazardous to humans (all specimens should be considered biohazardous)

what is the \#1 bloodborne pathogen exposure risk?

HBV (Hepatitis B Virus)

what are BBPs?

bloodborne pathogens

what are engineering controls?

a device, piece of equipment, or technology that removes or isolates a hazard in the workplace

what are work practice controls?

controls that reduce the likelihood of exposure by altering the manner in which a task is performed

what should we do for an accidental contaminated needlestick?

remove the needle, safety it, and put it in the sharps. wash site out with soap and water for at least 30 seconds, report incident

what should you do if one of your mucous membranes is exposed to blood?

flush site out with water for 10 minutes, report incident

what is the chemical name for bleach?

sodium hypochlorite