Phlebotomy Standards, Safety, and Procedures Flashcards

A set of 45 question and answer flashcards for reviewing phlebotomy regulations, ethical standards, safety precautions, quality control, complications, and equipment selection based on the lecture transcript.

What standard must phlebotomists follow to maintain ethical behavior and prevent harm to patients?

Ethical behavior requires following a standard of right or wrong conduct.

Which federal entity is tasked with researching and recommending strategies to prevent workplace injuries and illnesses?

The National Institute for Occupational Safety and Health (NIOSH).

NIOSH is a component of which federal agency and department?

It is a component of the Centers for Disease Control and Prevention (CDC) within the Department of Health and Human Services (DHHS).

How is gender identity defined in the context of healthcare?

An individual's internal sense of their own gender, whether male or female, a blend of both, neither, or any other gender.

What is gender expression?

How a person outwardly expresses their gender identity through physical appearance, clothing, hairstyles, behavior, voice, and other forms of presentation.

What is misgendering?

Using the wrong pronouns or gendered language.

When is an alcohol-based hand sanitizer explicitly prohibited for hand hygiene?

When the hands are visibly soiled.

When must soap and water be used for hand washing instead of alcohol-based hand sanitizer?

When hands are visibly soiled, before eating, after using the restroom, and when caring for patients with C. difficile and norovirus.

For how long should hands be rubbed together vigorously during proper handwashing?

For at least $15\,\text{seconds}$, covering all areas of the hands and fingers.

Why should hot water be avoided when washing hands?

To prevent burning or drying the skin.

Which three organizations create and enforce operational standards in phlebotomy?

The Joint Commission (TJC), the Clinical and Laboratory Standards Institute (CLSI), and the Centers for Disease Control and Prevention (CDC).

What is the primary mission of The Joint Commission (TJC)?

To ensure safety in health care by establishing standards, promoting safety, and encouraging continued education.

What is the role of the Clinical and Laboratory Standards Institute (CLSI)?

To assist with developing standards around the world to improve medical laboratory testing and patient care, promoting standardization and best practices.

By how many patient identifiers must a patient be identified immediately before any procedure occurs?

By at least $2$ patient identifiers.

What are examples of patient identifiers used prior to a procedure?

The patient's first and last name, and date of birth.

What defines what tasks a health care professional can legally and ethically perform based on their education and training?

Scope of practice.

What non-routine duties fall within a phlebotomist's scope of practice?

Performing quality controls and performing and documenting instrument or equipment maintenance.

What front-office and computer tasks may be assigned to a phlebotomist?

Scheduling, coding, and documentation.

What is the primary purpose of quality control (QC) for laboratory equipment?

To ensure diagnostic tests and procedures are accurate, reliable, and consistent, preventing errors and maintaining equipment performance.

What can result from omitting or improperly performing quality control checks?

Invalid or inaccurate test results, requiring extra testing and delaying diagnosis and treatment.

Which advisory committee was formed to assist in administering regulations and advising on standard revisions?

The Clinical Laboratory Improvement Advisory Committee (CLIAC).

How does checking for responsiveness differ between a child and a baby prior to CPR?

For a child, tap their shoulder and shout; for a baby, tap their foot and shout.

What is the ratio of compressions to rescue breaths during CPR for a child or infant?

$30$ compressions to $2$ rescue breaths.

How should chest compressions be delivered to a small child versus a baby during CPR?

For a small child, use one hand in the center of the chest; for a baby, place both thumbs on the center of the chest.

What standard must all documentation in a patient's medical record meet?

It must be factual and objective.

Which federal agency requires immediate reporting of needlestick injuries or cuts contaminated with blood?

The Occupational Safety and Health Administration (OSHA).

Why is immediate reporting of a needlestick injury required by OSHA?

To allow for timely evaluation, medical care, and postexposure prophylaxis when indicated.

What PPE is required for every interaction with a patient under contact precautions?

A gown and gloves.

What PPE item must always be worn when caring for a patient under droplet precautions?

A mask.

What special room and PPE requirements apply to patients under airborne precautions?

Placement in a negative pressure room and wearing an N95 mask or respirator put on before entering.

If a hematoma begins to develop during venipuncture, what steps must be taken immediately?

Stop the procedure and apply pressure to the insertion site for $5\,\text{minutes}$.

What must a phlebotomist do if a patient requests that the procedure stop during blood collection?

Stop the collection immediately, even if it is going well.

What troubleshooting step should be performed if needle placement is perceived to be too shallow?

Advance the needle slightly farther.

What troubleshooting step should be performed if needle placement is perceived to be too deep?

Withdraw the needle slightly.

What troubleshooting step should be taken if a vein collapses during blood collection?

Release the vacuum pressure by removing the tube, wait for the vein to fill, and reapply vacuum pressure.

Which collection tubes typically yield serum upon centrifugation?

Red, gold, or serum separator tubes.

How long must serum tubes be allowed to clot before centrifugation?

For $30\text{ to }60\,\text{minutes}$.

When can plasma samples be centrifuged relative to collection?

Immediately after collection.

When using a blood pressure cuff as a tourniquet, to what pressure should it be inflated?

$40\,\text{mm Hg}$.

Where should a tourniquet be applied relative to the venipuncture site, and for how long?

Applied $3\text{ to }4\,\text{inches}$ above the site and removed in less than $1\,\text{minute}$.

What complication results from leaving a tourniquet on longer than 1 minute?

Hemoconcentration.

What gauge needle is typically used for most routine venipunctures?

$21\,\text{gauge}$.

What needle gauge range is typically used for blood donation?

$16\text{ to }18\,\text{gauge}$.

What alcohol pad concentrations are standard for routine site preparation, and what antiseptics are used for blood cultures?

Standard is $70\%$ isopropyl or ethyl alcohol; blood cultures use $1\%\text{ to }10\%$ povidone-iodine swab sticks or chlorhexidine gluconate.

Which three veins in the antecubital region are used for venipuncture, and which is the preferred first choice?

The median cubital, cephalic, and basilic veins; the median cubital vein is the first choice.