Course Topics and Objectives
1. History and Terminology of Phlebotomy
The student will learn about the people behind the modern techniques and the tools we use today. We will discuss and demonstrate the piston and barrel techniques (syringe draw) and the development of the modern Vacutainer systems. The student will become familiar with the terminology used in the modern clinical laboratory, and will learn about the composition of blood. Upon completion of this section, the student will be able to perform the following:
- Identify and describe the cellular and non-cellular components of blood, including erythrocytes, leukocytes and platelets.
- Explain the differences between plasma and serum.
- Define the phlebotomy practice and list the essential competencies for individuals performing phlebotomy procedures.
- Identify health care providers who generally perform phlebotomy procedures.
- Identify the importance of phlebotomy procedures to the overall care of the patient.
- Describe various health care settings, both inpatient and ambulatory, where phlebotomy services are routinely performed.
- Describe the role of the clinical laboratory in blood collection and testing services.
- Describe the following terms: ambulatory care, acute care, point of care, primary care, secondary care, and tertiary care
2. Heart and Circulatory System
The student will receive information regarding the circulatory system, including the heart, veins, and arteries. We will discuss basic coagulation and the student will learn the fundamental purpose of the circulatory system. Upon completion of this section, the student will be able to perform the following:
- Identify and discuss the structures and functions of the heart.
- Trace the flow of blood through the cardiovascular system.
- Identify and describe the structures and functions of different types of blood vessels.
- Locate and name the veins most commonly used for phlebotomy procedures.
- Describe the phases of hemostasis.
- Describe how to take a person’s blood pressure and pulse.
- Describe the two systems involved in the coagulation process.
3. Blood Collection System
The student will learn about evacuated and non-evacuated blood collection systems. They will become knowledgeable about the order of draw and the use of anticoagulants for the different laboratory procedures. Upon completion of this section, the student will be able to perform the following objectives:
- Define evacuated and non-evacuated blood collection systems.
- Define the components and purpose of each tube type.
- Identify what tubes are used for different types of testing.
- Identify correct order of draw and (its importance) when multiple tubes are to be collected.
- Define venipuncture and capillary draws.
4. Infection Control and Safety
The student will learn about personnel protective equipment such as using gloves to avoid contact with body fluids, and face shields to protect from splashing and aerosols. Isolation precautions as they apply to phlebotomy will be reviewed and students will learn to use needle safety devices when performing a phlebotomy and the proper disposal of such devices. They will also learn to use safety lancets for capillary punctures. Upon completion of this section, the student will be able to perform the following:
- Describe types and use of personnel protective equipment.
- Describe safety precautions in collecting and transporting blood specimens.
- Discuss safety awareness for health care workers.
- Define the term “nosocomial infection”.
- Explain proper technique for hand washing, gowning, gloving, masking, double bagging, and entering and exiting the various isolation areas.
- Identify the potential routes of infection and methods for preventing transmission of microorganisms through these routes.
- Identify steps to avoid transmission of blood borne pathogens.
- Describe the various isolation procedures and reasons for their use.
5. Venipuncture Technique
This practical activity will allow the student to perform the basic venipuncture technique. The student will begin to practice on a device used to emulate the physical arm. After the student has shown competence with the device, they will then; under supervision, draw samples from another student. Upon completion of this section, the student will be able to perform the following:
- Describe three patient identification processes for inpatients, emergency room patients, and ambulatory patients.
- List supplies that would be used in a typical venipuncture procedure.
- Identify the most common sites for venipunctures and describe situations when these sites might not be acceptable sites for venipuncture. Identify alternative sites for the venipuncture process.
- Describe the process and time limits for applying a tourniquet to a patient’s arm.
- Describe the decontamination process and the agents used to decontaminate skin for routine blood tests and blood cultures.
- Describe the actual venipuncture procedure and the steps that are different using the evacuated method, the syringe method, and the butterfly or winged infusion system.
- List examples and explain reasons for the importance of collecting “timed specimens" at the requested times.
- Describe what the terms “fasting” and “STAT” mean.
- Perform venipuncture.
6. Capillary Puncture
The student will learn how to perform a capillary puncture and how to collect a capillary sample without compromising the integrity of the specimen. This procedure will first be performed on a device and then after competency is demonstrated, the student will perform the capillary puncture on another student. Upon completion of this section, the student will be able to perform the following:
- Describe the reasons for performing a capillary puncture.
- Identify the proper sites for performing a capillary puncture procedure.
- Explain why controlling the depth of the puncture is necessary.
- Describe and perform the process of making a blood smear.
- Explain why blood from a capillary puncture is different from blood taken by venipuncture.
- Perform capillary puncture.
7. Blood Specimen Handling and Transportation
The student will learn to separate plasma/serum from red blood cells. The student will use a centrifuge for this purpose and transfer the specimen to a clean container. Storage requirements for the sample will be discussed. Students will be trained in the current requirements for packaging and shipping specimens for both UPS and FedEx. Upon completion of this section, the student will be able to perform the following:
- Describe how to properly label specimens.
- Describe procedure for separating plasma and serum specimens.
- List five special requirements for proper transportation of selected tests and give examples of tests for each requirement.
- Describe packaging requirements for shipping biological specimens via FedEx or UPS.
- Describe proper labeling of packages containing biological specimens for transport.
8. Point of Care Testing
The student will be shown a glucose test using a glucose meter and test strips. They will learn about the possible errors that could occur with this procedure. Upon completion of this section, the student will be able to perform the following:
- List two other terms that are synonymous with point of care testing.
- Identify four analytes whose levels can be determined through point of care testing.
- Describe the most widely used application of point of care testing.
- Describe what occurs if a patient’s blood glucose levels become too elevated.
- Describe quality control procedures for blood glucose monitoring testing.
- List three manufacturers of blood glucose monitors.
- Describe procedure for performing point of care blood sugar testing.
- Identify two critical steps in point of care blood sugar testing procedure.
9. Student Externship
The student will participate in an externship working along-side a certified phlebotomist. The student will be exposed to the functions and activities of a laboratory facility, and will collect blood samples from patients, prepare and secure blood samples, secure other samples as needed. Assist phlebotomist with day-to-day activities allowing the student to have a better understanding of how a laboraotry facility functions.