Methodologies and Regulations in Specimen Collection and Management

1. Methodologies and Regulations in Specimen Collection and Management Module 6: Laboratory Departments, Quality Control, and Professionalism

2. Objectives After this presentation and activity participants will be able to: • List separate departments within the lab and tests performed in each department • Define Quality Assurance and its application in the phlebotomy section of the laboratory • List the requirements for collecting a quality specimen

3. Objectives Continued... After this presentation and activity participants Will be able to: • Define professionalism and list the descriptive terms of a professional employee • Discuss the Dos and Don’ts of effective communication • Discuss customer satisfaction related to phlebotomy

4. Today’s Agenda • List separate departments within the lab and tests performed in each department • Define Quality Assurance and its application in the phlebotomy section of the laboratory • List the requirements for collecting a quality specimen

5. Departments in the Clinical Laboratory • Hematology • Chemistry • Blood Bank (Immunohematology) • Microbiology/Serology

6. Hemotology • Studies the cellular portion of blood, detecting abnormal conditions or disease • Type of specimen: Purple top, EDTA • Whole Blood

7. Hemotology Continued • Tests: • Complete Blood Count (CBC)/Full Blood Count (FBC),WBC, RBC, HGB, HCT, INDICES, PLT, DIFFERENTIAL • CD4 Testing • HIV/AIDS • Purple Top EDTA • Room Temperature (20 – 25 degrees C)

8. Chemistry • Measures the quantity of chemical substances in blood and other body fluids • Types of Specimen: • Serum: red, red/marble, gold top tubes • Plasma : green top tube

9. Chemistry Testing • Renal System: Body Fluid Balance • Blood Urea Nitrogen (BUN) • Creatinine • Electrolytes: Sodium (Na), Potassium (K), Chloride (Cl), and Bicarbonate (Total CO2) • GLUCOSE • Fasting Blood Sugar (FBS) • Serum or plasma are acceptable specimens

10. Chemistry Testing • Liver Function Tests • Lactate Dehydrogenase (LD) • Alanine Aminotransferase (ALT) • Aspartate Aminotransferase (AST) • Alkaline Phosphatase (ALP) • Gamma Glutamyl Transferase (GGT)

11. Liver Function Testing • Total Bilirubin: • elevated with liver disease, hemolytic disease and obstruction • protect from light • no hemolysis • Neonatal Total Bilirubin • testing for jaundice • protect from light • Serum is acceptable

12. Immunohaematology • The Department of Blood Bank • Transfusion medicine • Provides blood producst to clients • Type of Specimen: • Plain Red Top • A Purple Tube • Gel Tubes are not recommended MUST BE LABELED CORRECTLY

13. Immunohematology • Confirmation of HIV Rapid Testing • ELISA (Enzyme immunoassay) • Serum is required (red top tube)

14. Microbiology • Culture and identify bacterial pathogens and their toxins • Type of Specimens: • For Blood Cultures a sterile technique is a must • Aerobic and Anaerobic Blood Culture Bottles are used

15. Any questions?

16. Today’s Agenda • List separate departments within the lab and tests performed in each department • Define Quality Assurance and its application in the phlebotomy section of the laboratory • List the requirements for collecting a quality specimen

17. Quality Assurance • Policies and procedures that ensure reliable test results • Laboratory testing is important part of patient diagnosis • Physicians rely on validity of lab tests

18. What is Quality? • Defined as a degree of excellence • It includes: • Delivering the right product • Satisfying the client’s needs • Meeting client expectations • Courtesy and respect • Treating every client with integrity

19. What is QA in Phlebotomy? QA in Phlebotomy: • Lab tests are important to client care • Lab tests help diagnose and treat clients • Careful monitoring of the collection and handling processes is necessary to assure quality laboratory results

20. QA in Phlebotomy Client Physician/Client Specimen Collection Laboratory Results Specimen Handling Laboratory Testing

21. Phlebotomy QA • A test result is no better than the quality of the specimen in the lab • Performing the right type of phlebotomy (venipuncture vs. skin), doing it on time, doing it correctly the first time • Proper specimen collection is the first step in the process of acquiring reliable results

22. Components of Phlebotomy QA Client preparation: • Interview client • Be aware of all protocols • Document

23. Components of Phlebotomy QA Specimen Collection: • Identification • Technique • Correct tube • Correct amount of blood • Labeling • Collection Priorities • Number of attempts

24. Components of Phlebotomy QA Specimen Handling: • additive tube mixing • correct tube • correct anti – coagulant ratio • transporting • special handling • time constraints

25. Components of Phlebotomy QA Phlebotomy Supplies: • Manufacturer defects • Sterility • Volume of draw • Expiry date • Use needles only once

26. Today’s Agenda • List separate departments within the lab and tests performed in each department • Define Quality Assurance and its application in the phlebotomy section of the laboratory • List the requirements for collecting a quality specimen

27. Requirements for a Quality Specimen • Standard precautions • Correct specimen are collected from correct clients, labeled properly • Correct anticoagulants with proper volume • Specimen is not hemolyzed

28. Requirements for a Quality Specimen • Fasting specimens collected in a timely fashion • Timed specimens are collected at proper time and documented • Transported back to the lab in a timely fashion

29. Today’s Agenda • Define professionalism and list the descriptive terms of a professional employee • Discuss the Dos and Don’ts of effective communication • Discuss customer satisfaction related to phlebotomy

30. Professionalism • Provide excellent customer service • Commitment to providing quality care • Motivation to make sure every encounter with every client is positive • Every client feels confidence that every aspect of their care is given high priority

31. Professionalism • Perform procedures properly • Perform procedures with skill • Interact with co-workers with respect • Take responsibility for your actions • Function as a team player • Create a positive working environment

32. Signs of Professionalism Personal Appearance • The image we project says a great deal about the quality of work we produce • Project a positive image • General appearance represents physical well being

33. Signs of Professionalism Personal Appearance • Lab coat clean and not torn • Appropriate clothing • Hair is well groomed • No excessive jewelry • Name tag is visible • Hands are clean and nails are trimmed

34. Signs of Professionalism Attitude • Healthcare personnel should be compassionate • Treat every client with respect • Treat each client as if the person was part of your family

35. Signs of Professionalism Code of Ethics • Safely draw blood • Collect blood according to standards • Properly identify clients and specimens • Transport blood and process without error • Treat each client fairly and with compassion

36. Signs of Professionalism Behaviors • Knocking on inpatient doors before entering • Asking permission to enter a room or pull back a curtain • Introducing yourself and stating your purpose • Smiling, making eye contact, speaking clearly • Listening with compassion • Explaining the procedure

37. Signs of Professionalism Behaviors • Responding to patient questions and requests • Respecting client refusal • Respecting client privacy and confidentiality • Make sure we clean up all used blood drawing supplies

38. Today’s Agenda • Define professionalism and list the descriptive terms of a professional employee • Discuss the Dos and Don’ts of effective communication • Discuss customer satisfaction related to phlebotomy

39. Communication Skills • Communication includes speaking, listening, gestures/body language and writing • Communication can be verbal or nonverbal • Goal for communication is to create a common understanding between two people

40. Do’s and Don’ts of Communication Skills DON’TS • I don’t know • No • That is not my job • That is not my fault • Calm down • I am busy right now DO’S • I’ll find out • What I can do is….. • This is who can help you • Let me see what I can do • I am very sorry • I will be with you in a moment

41. Today’s Agenda • Define professionalism and list the descriptive terms of a professional employee • Discuss the Dos and Don’ts of effective communication • Discuss customer satisfaction related to phlebotomy

42. Customer Service • Phlebotomists should provide quality service • When quality service is given, client satisfaction improves

43. Client Satisfaction • Keeping the client satisfied is the primary role of the phlebotomist • The client expects and demands quality service • The client expects an excellent skill level of the phlebotomist

44. Client Satisfaction • The client expects a clean facility • The client expects to be treated with respect and consideration • The client expects to be treated fairly • Understanding the fears and concerns of the client will allow the phlebotomist to give quality service

45. Summary You should now be able to: • List separate departments within the laboratory and tests performed in each department • Define Quality Assurance and its application in the phlebotomy section of the laboratory • List the requirements for collecting a quality specimen • Define professionalism and list the descriptive terms of a professional employee • Discuss the Dos and Don’ts of effective communication • Discuss customer satisfaction related to phlebotomy

46. Any questions?Thank you!