Pre-analytical Phase: Phlebotomy Technicians

Phlebotomy is usually by a phlebotomist, although medical practitioners, EMTs, paramedics, medical technologists, and nursing staff are also trained to take blood. Phlebotomists are also referred to as allied health professionals, and they draw blood for laboratory testing from patients. Nurses, medical technologists, and laboratory mangers supervise phlebotomists.

Phlebotomists are also responsible for:
1. Explaining the procedure to patients, knowledge of Patient’s Bill of Rights and patient considerations
2. Maintaining and Updating patient records
3. Preparing stains and laboratory reagents
4. Cleaning and sterilizing equipment
5. Taking a patient’s temperature, blood pressure, pulse and respiration rate
6. Sending urine and fecal samples for lab testing

In addition to all these, a professional phlebotomist has a basic knowledge of skills of drawing blood. The interface between the clinical laboratory and the patient is a phlebotomist. Phlebotomist uses the professional discretion for use of appropriate collection procedure like venipuncture, capillary blood, skin punctures, and collection of blood from neonates. Another special field for phlebotomists is drawing blood from indwelling lines.

Related areas of specimen transportation, handling, and processing must also by fully understood and practiced by phlebotomist. It is important to understand the proper means for collecting, preserving, and processing blood samples. Usually a 5 ml to 25 ml sample of blood is adequate depending on what blood tests have been requested. In many circumstances this is done by a phlebotomist, although medical practitioners, some EMTs, paramedics, other nursing staff are also trained to take blood.

Studies on diseased and normal states of body are usually done on blood since blood samples are comparatively simple to acquire. Important information for diagnosis is obtained by the physicians through laboratory results at a lower cost and in shorter time with minimal patient discomfort. Nowadays, at many facilities new hospital admissions require some routine blood tests in hematology and biochemistry. Culture of blood for microbes is carried out in microbiology department. Patient blood serum is used to detect antibodies in immunology and serology departments. Serum is used in almost all immunological testing. Plain tubes are used for collection of blood, which is allowed to clot completely and then centrifuged to get serum.

Any clinic or hospital cannot function without utilizing medical laboratory. Information obtained from laboratory testing is used for upto 85% of patient’s clinical decisions. Major changes in patient treatments can result due to minute errors in pre-analytical procedures or small changes in test results. The quality of data provided by lab technicians and phlebotomists is the key to patient diagnosis, for managing therapy, and to determine prognosis of disease in that patient.

Owing to high personnel turnover rates, lack of understanding about good laboratory practices, and inadequate training, there are several opportunities for making errors during phlebotomy, which mainly concern patient misidentification and collection of unsuitable specimens for testing due to unsuited venous accesses, venous stasis, inappropriate collection devices and containers. Improved standardization of phlebotomy techniques, continuous education, certification, and training of health care professionals involved in blood drawing responsibilities would help to obtain high quality specimens, with improved health care system and better service for the patients.

It is not mandatory to be certified in order to be a phlebotomist however, getting a phlebotomist job without certification is nearly impossible. The actual requirements of phlebotomy practitioners vary state by state. Some states (California and Louisiana) require “all persons who are not doctors, nurses or clinical lab scientists” to be licensed in those states in order to draw blood. Phlebotomists can draw blood under proper supervision regardless of former experience or education in the remaining states. However, regardless of location of practice, phlebotomists need to be thoroughly trained in order to take blood. They can opt for a phlebotomy diploma, which are offered through vocational/technical schools and generally last for a couple of months, or choose an associate’s degree program at a community college. In addition to education and certification, some states require phlebotomists to be licensed and registered before beginning practice. These regulations can be found at respective state’s department of health and phlebotomy schools.

Written by Phlebotomy Training specialist Dr Shahbaz A. Cheema, Course Director for Maxis Healthcare who run NHS Accredited Phlebotomy Training courses for medical and non medical practitioners. Learn the 3 Steps To Become a Phlebotomist