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Phlebotomy Handbook : Blood Collection Essentials,9780131133341

Phlebotomy Handbook : Blood Collection Essentials

by ;
Edition:
7th
ISBN13:

9780131133341

ISBN10:
0131133349
Format:
Paperback
Pub. Date:
1/1/2005
Publisher(s):
Prentice Hall
List Price: $59.20
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Summary

This is the most timely and comprehensive source of blood and specimen collection information available on the worldwide market. Provides today's health care professionals with the latest safety guidelines; condensed information about new federal regulations; updates on equipment and supplies; new NCCLS standards and hazard prevention techniques; and extensive coverage on transcultural communication skills for all ages. Medical Technologists, Medical Technicians, Medical Assistants, Specimen collection supervisors, Laboratory Managers/Directors, Nurses. Also, a valuable resource for hospital laboratories, out patient clinics, physicians' office practices, and emergency rooms.

Table of Contents

Preface xxi
Acknowledgments xxiv
Reviewers xxv
PART I OVERVIEW
Phlebotomy Practice and Quality Essentials
1(42)
Chapter Objectives
1(1)
Phlebotomy Practice, Definition, and Duties
2(1)
Health Care Organizations
3(1)
Professional Competencies and Certifications
3(9)
Professional Character Traits
9(3)
Role of the Clinical Laboratory in Specimen Collection Services
12(1)
Communications Strategies for Phlebotomists
13(18)
Verbal Communication
14(5)
Communication for Confirming Patient Identification
19(2)
Nonverbal Communication
21(6)
Active Listening
27(1)
Appearance, Grooming, and Physical Fitness
27(3)
Nutrition, Rest, and Exercise
30(1)
Role of Family, Visitors, and Significant Others
30(1)
Quality Improvement and Assessment
31(9)
Perceptions of Quality
31(2)
Customer Satisfaction
33(1)
Tools and Trends for Performance Assessment
33(1)
Quality in Specimen Collection Services
34(1)
Important Factors Affecting Quality
35(3)
Equipment and Preventive Maintenance
38(2)
Self Study
40(1)
Key Terms
40(1)
Study Questions
40(1)
References
41(2)
Ethical, Legal, and Regulatory Issues
43(18)
Chapter Objectives
43(1)
Ethics Overview
44(1)
Governmental Laws
44(1)
Basic Legal Principles
45(4)
Legal Terminology
45(1)
Negligence
45(1)
Malpractice
46(1)
Patient Confidentiality
47(1)
Confidentiality and HIV Exposure
47(1)
Standard of Care
47(1)
Informed Consent
48(1)
Informed Consent for Research Purposes
48(1)
Implied Consent
49(1)
Statute of Limitations
49(1)
Legal Claims and Defense
49(2)
Expert Witness
50(1)
Evidence
50(1)
Advice to Avoid Lawsuits
51(1)
Respondeat Superior
51(1)
Medical Records
51(2)
HIPAA
53(1)
Legal Cases Related to Clinical Laboratory Activities
54(1)
Schmerber v. State of California
54(1)
Lazernick v. General Hospital of Monroe County (PA 1977)
54(1)
Walton v. Providence Hospital
54(1)
Helmann v. Sacred Heart Hospital
55(1)
Cases Resulting from Improper Technique and Negligence
55(1)
HIV-Related Issues
56(1)
Malpractice Insurance
56(1)
Clinical Laboratory Improvement Amendments (CLIA)
56(2)
Self Study
58(1)
Key Terms
58(1)
Study Questions
58(1)
References
59(2)
Basic Anatomy and Physiology of Organ Systems
61(30)
Chapter Objectives
61(1)
Anatomic Regions
62(3)
Structural Organization
65(4)
Major Organ Systems
69(18)
Integumentary System
69(1)
Skeletal System
70(1)
Muscular System
71(2)
Nervous System
73(2)
Respiratory System
75(4)
Digestive System
79(2)
Urinary System
81(2)
Endocrine System
83(1)
Reproductive System
84(1)
Lymphatic System
85(1)
Cardiovascular System
86(1)
Self Study
87(2)
Key Terms
87(1)
Study Questions
88(1)
References
89(2)
The Circulatory System
91(32)
Chapter Objectives
91(1)
The Heart
92(4)
The Blood
96(8)
Erythrocytes
97(3)
Leukocytes
100(1)
Thrombocytes or Platelets
101(1)
Plasma
101(3)
Serum
104(1)
The Vessels and Circulation
104(6)
Arteries
108(1)
Veins
108(2)
Capillaries
110(1)
Hemostasis and Coagulation
110(2)
Laboratory Tests of the Cardiovascular System
112(5)
Self Study
117(1)
Key Terms
117(1)
Study Questions
117(1)
References
118(1)
Case Studies
Career Pathways: Smooth or Stormy
119(1)
Changing Responsibility in Phlebotomy Practice
119(1)
Collection from the Dorsal Side of the Hand
120(1)
Communication and Cultural Sensitivity: Keys to Success
120(1)
Communication and Consent
120(1)
An Ethical Dilemma
121(2)
PART II SAFETY PROCEDURES AND EQUIPMENT
Infection Control
123(34)
Chapter Objectives
123(1)
Pathogens and Infection
124(1)
Personal Safety from Infection during Specimen Handling
125(2)
Exposure Control
125(1)
Health Care Providers' Health
125(2)
Chain of Infection
127(5)
Source
127(1)
Mode of Transmission
127(4)
Susceptible Host
131(1)
Breaking the Chain
131(1)
Standard Precautions
132(12)
Use of Standard Precautions
135(4)
Hand Hygiene and Gloving
139(2)
Isolation for Hospital Outbreaks
141(1)
Protective, or Reverse, Isolation
141(1)
Infection Control in Special Hospital Units
141(1)
Infection Control in the Clinical Laboratory
142(2)
Specific Isolation Techniques and Procedural Steps
144(1)
Isolation Item Disposal
144(1)
Prevention of Laboratory-Acquired Infections
145(1)
Sterile Technique for Health Care Workers
145(9)
Disinfectants and Antiseptics
151(1)
Preventing Infections from Glass Capillary Tube Use
152(2)
Self Study
154(1)
Key Terms
154(1)
Study Questions
154(1)
References
155(2)
Safety and First Aid
157(24)
Chapter Objectives
157(1)
Fire Safety
158(1)
Classification of Fires
158(1)
Fire Extinguishers
158(1)
Emergency Response to Possible Fire
159(1)
Laboratory Safety
159(4)
Cleaning Specimen Collection Areas and Biological Spills
161(2)
Electrical Safety
163(1)
Radiation Safety
164(1)
Mechanical Safety
165(1)
Chemical Safety
165(5)
Chemical Identification
166(2)
Safety Showers and the Eyewash Station
168(1)
Chemical Spill Cleanup
168(1)
Disposal of Chemicals
169(1)
Equipment and Safety in Patients' Rooms
170(1)
Patient Safety Outside the Room
171(1)
Patient Safety Related to Latex Products
172(1)
Disaster Emergency Plan
173(1)
Emergency Procedures
174(4)
Bleeding Aid
174(1)
Circulation Aid
175(1)
Shock Prevention
175(3)
Self Study
178(1)
Key Terms
178(1)
Study Questions
178(1)
References
179(1)
Additional Sources for Safety Information
180(1)
Documentation, Specimen Handling, and Transportation
181(26)
Chapter Objectives
181(1)
Fundamentals of Documentation
182(1)
The Laboratory Communication Network
183(5)
Policies and Procedures
185(1)
Continuing Education
185(1)
Communication Outside the Laboratory
185(2)
Use of the Telephone
187(1)
Confidentiality and Privacy
188(1)
Fax Transmission of Laboratory Information
188(1)
Computerized Communications
188(1)
Laboratory Test Requisition Forms
189(1)
Barcodes
189(1)
Transmittal of the Test Request to the Laboratory
190(3)
Specimen Labels and Blood Collection Lists
193(1)
Specimen Handling
193(6)
Basic Handling Guidelines
196(1)
Chilled Specimens
197(1)
Protection of Specimens from Light
198(1)
Microbiological Specimens
199(1)
Warmed Specimens
199(1)
Specimen Delivery Methods
199(1)
Hand Delivery
199(1)
Pneumatic Tube Systems
199(1)
Transportation by Automated Vehicles
200(1)
Shipping Infectious Substances
200(2)
Reporting Laboratory Results
202(2)
Written Reports
202(1)
Verbal Reports
202(1)
Computerized Reports
202(2)
Self Study
204(1)
Key Terms
204(1)
Study Questions
204(1)
References
205(2)
Blood Collection Equipment
207(38)
Chapter Objectives
207(1)
Introduction to Blood Collection Equipment
208(1)
Venipuncture Equipment
208(1)
Blood Collection Tubes and Additives
208(7)
Gray-Topped Tubes
212(1)
Green-Topped Tubes
212(1)
Purple-Topped and Light Blue-Topped Tubes
213(1)
Red-Topped, Royal Blue-Topped, Brown-Topped, and Tan-Topped Tubes
213(1)
Black-Topped Tubes
213(1)
Yellow-Topped Tubes
214(1)
Serum Separation Tubes (Mottled-Topped, Speckled-Topped, and Gold-Topped Tubes)
215(1)
Pink-Topped Tubes
215(1)
Molecular Diagnostics Tubes
215(1)
Safety Syringes
215(1)
Safety Needles/Holders
216(4)
Needles
220(3)
The Butterfly Needle (Blood Collection Set)
221(2)
Needle and Other Sharps Disposal
223(1)
Tourniquets
223(3)
Bleeding-Time Equipment
226(1)
Gloves for Blood Collection
226(2)
Antiseptics, Sterile Gauze Pads, and Bandages
228(1)
Microcollection Equipment
228(8)
Lancets and Tubes
230(4)
Transporting Microspecimens
234(2)
Blood-Drawing Chair
236(1)
Infant Phlebotomy Station
237(1)
Specimen Collection Trays
237(2)
Web Addresses for Suppliers of Safety Blood Collection Equipment
239(1)
Self Study
240(1)
Key Terms
240(1)
Study Questions
240(1)
References
241(1)
Case Studies
Running Late on the Day Shift
242(1)
A Supervisor's Folly
242(1)
Stocking Supplies in Phlebotomy Practice
242(1)
Traumatic Transport
243(1)
Accidental Injury
243(1)
Transporting Specimens from Homebound Patients to the Laboratory
244(1)
PART III PHLEBOTOMY PROCEDURES
Venipuncture Procedures
245(44)
Chapter Objectives
245(1)
Blood Collection
246(1)
Health Care Worker Preparation
246(1)
Exercising Universal Precautions
247(1)
Needlestick Prevention Strategies
247(2)
Assessing, Identifying, and Approaching the Patient
249(11)
Test Requisitions
249(2)
Patient Identification Process
251(6)
Physical Disposition of the Patient
257(1)
Approaching the Patient
257(3)
Equipment Selection and Preparation
260(11)
Supplies for Venipuncture
260(1)
Positioning of the Patient and Venipuncture Site Selection
260(7)
Warming the Puncture Site
267(2)
Tourniquet Application
269(1)
Decontamination of the Puncture Site
269(2)
Venipuncture Methods
271(9)
Evacuated Tube System and Winged Infusion System, or Butterfly Method
271(4)
Syringe Method
275(1)
Bandage for the Puncture Site
276(1)
Proper Disposal
276(1)
Order of Tube Collection
277(1)
Specimen Identification and Labeling
278(1)
Assessing the Patient before Leaving
278(2)
Prioritizing Patients
280(5)
Timed Specimens
282(1)
Specimens for Hormones and Renin
283(1)
Fasting Specimens
284(1)
STAT Specimens
284(1)
Self Study
285(1)
Key Terms
285(1)
Study Questions
285(1)
References
286(3)
Procedures for Collecting Capillary Blood Specimens
289(14)
Chapter Objectives
289(1)
Indications for Skin Puncture
290(1)
Composition of Capillary Blood
290(1)
Basic Technique for Collecting Diagnostic Capillary Blood Specimens
291(1)
Preparation for Skin Puncture
291(1)
Supplies for Skin Puncture
291(3)
Skin Puncture Sites
292(1)
Warming the Skin Puncture Site
292(1)
Cleansing the Skin Puncture Site
293(1)
Skin Puncture Procedure
294(1)
Order of Collection
295(1)
Blood Films for Microscopic Slides
295(1)
Microhematocrit
295(3)
Blood pH and Blood Gas Determinations
298(1)
Lancet Disposal, Labeling the Specimen, and Completing the Interaction
298(3)
Self Study
301(1)
Key Terms
301(1)
Study Questions
301(1)
References
302(1)
Preanalytical Complications in Blood Collection
303(24)
Chapter Objectives
303(1)
Overview
304(1)
Complications Associated with Patient Assessment and Physical Disposition
304(7)
Diet
304(1)
Obesity
305(1)
Damaged, Sclerosed, or Occluded Veins
305(1)
Allergies
306(1)
Exercise
306(1)
Stress
307(1)
Diurnal Rhythms and Posture
307(1)
Age
307(1)
Mastectomy
307(1)
Edema
308(1)
Menstrual Cycle
308(1)
Medications
308(1)
Interference of Drugs and Other Substances in Blood
309(1)
Thrombosis
310(1)
Infections
310(1)
Vomiting
311(1)
Other Factors Affecting the Patient
311(1)
Complications Associated with Test Requests and Identification
311(1)
Identification Discrepancies
311(1)
Time of Collection
311(1)
Requisitions
311(1)
Complications Associated with the Specimen Collection Procedure
312(5)
Tourniquet Pressure and Fist Pumping
312(1)
Failure to Draw Blood
312(1)
Fainting (Syncope)
312(1)
Hematomas
313(1)
Petechiae
313(1)
Excessive Bleeding
314(1)
Neurologic Complications
314(1)
Intravenous Therapy
315(1)
Hemoconcentration
316(1)
Hemolysis
316(1)
Collapsed Veins
317(1)
Turbid or Lipemic Serum
317(1)
Improper Collection Tube
317(1)
Complications Associated with Specimen Transport
317(1)
Chilled Transport
317(1)
Exposure to Light
317(1)
Complications Associated with Specimen Receipt in the Laboratory
318(2)
Processing Delays
318(2)
Specimen Rejection
320(1)
Self Study
321(1)
Key Terms
321(1)
Study Questions
321(1)
References
322(2)
Case Studies
Ambulatory Health Care Collections
324(1)
Venipuncture Site Selection
325(1)
Finding the Right Site
325(1)
Tricky Complications with an IV
326(1)
PART IV SPECIAL PROCEDURES AND POINT OF CARE TESTING
Pediatric Procedures
327(34)
Chapter Objectives
327(1)
Age-Specific Care Considerations
328(1)
Preparing Child and Parent
328(7)
Psychological Response to Needles and Pain
334
Distraction Techniques
332(1)
Room Location
332(1)
Equipment Preparation for a Friendlier Environment
332(3)
Positions for Restraining a Child
335(1)
Combative Patients
335(1)
Interventions to Alleviate Pain
336(1)
Oral Sucrose
336(1)
Prevention of Disease Transmission---Standard Precautions
336(1)
Precautions to Protect the Child
336(1)
Latex Allergy Alert
337(1)
Pediatric Phlebotomy Procedures
337(19)
Microcapillary Skin Puncture
337(4)
Heelstick
341(4)
Neonatal Screening
345(1)
Venipuncture
346(6)
Collecting Blood from IV Lines
352(4)
Self Study
356(1)
Key Terms
356(1)
Study Questions
356(1)
References
357(4)
Arterial, Intravenous (IV), and Special Collection Procedures
361(34)
Chapter Objectives
361(1)
Arterial Blood Gases
362(4)
Radial Artery Puncture Site
362(1)
Brachial and Femoral Artery Puncture Sites
363(1)
Preparation of Supplies and Patient
363(3)
Capillary Blood Gases
366(2)
Bleeding-Time Test
368(1)
Possible Interfering Factors
369(1)
Blood Cultures
369(7)
Site Preparation
372(3)
Possible Interfering Factors
375(1)
Glucose Tolerance Test
376(4)
Postprandial Glucose Test
380(1)
Lactose Tolerance Test
381(1)
Therapeutic Drug Monitoring (TDM)
381(2)
Collection for Trace Metals (Elements)
383(1)
Genetic Molecular Tests
383(1)
IV Line Collections
384(1)
Collecting Blood Through a CVC
384(1)
Cannulas and Fistulas
385(1)
Donor Room Collections
385(5)
Donor Interview and Selection
388(2)
Collection of Donor's Blood
390(1)
Therapeutic Phlebotomy
390(1)
Autologous Transfusion
391(1)
Self Study
392(1)
Key Terms
392(1)
Study Questions
392(1)
References
393(2)
Elderly, Home, and Long-term Care Collections
395(18)
Chapter Objectives
395(1)
Considerations for the Elderly
396(1)
Glucose Monitoring
397(5)
Quality in Point-of-Care Testing (POCT)
401(1)
Blood Gas and Electrolyte Analysis
402(3)
Point-of-Care Testing for Acute Heart Damage
405(1)
Blood Coagulation Monitoring
406(1)
Hematocrit, Hemoglobin, and Other Hematology Parameters
407(1)
Cholesterol Screening
408(1)
Future Trends
409(2)
Self Study
411(1)
Key Terms
411(1)
Study Questions
411(1)
References
412(1)
Urinalysis, Body Fluids, and Other Specimens
413(18)
Chapter Objectives
413(1)
Urine Collection
414(5)
Single-Specimen Collection
416(1)
Timed Collections
416(3)
Cerebrospinal Fluid
419(2)
Fecal Specimens
421(1)
Seminal Fluid
421(1)
Amniotic Fluid
421(1)
Other Body Fluids
422(1)
Culture Specimens
422(1)
Other Nonblood Procedures
423(4)
Throat and Nasopharyngeal Culture Collections
423(2)
Skin Tests
425(1)
Gastric Analysis
426(1)
Breath Analysis for Peptic Ulcers
427(1)
Sweat Chloride by Iontophoresis
427(2)
Self Study
429(1)
Key Terms
429(1)
Study Questions
429(1)
References
430(1)
Forensic Toxicology, Workplace Testing, Sports Medicine, and Related Areas
431(18)
Chapter Objectives
431(1)
Overview and Prevalence of Drug Use
432(1)
Forensic Toxicology Specimens
433(1)
Chain of Custody
434(1)
Federal Workplace Drug Testing
435(2)
Tampering with Specimens
437(1)
Drug Testing in the Private Sector
437(2)
Drug Use in Sports
439(1)
Preferred Specimens for Drug Tests
439(1)
Breath Testing for Alcohol
440(1)
Collecting Specimens for Alcohol Levels
440(2)
Neonatal Drug Testing
442(1)
Self Study
442(1)
Key Terms
442(1)
Study Questions
442(1)
References
443(2)
Case Studies
Home Care Collections
445(1)
Bedside Glucose Testing
446(1)
Newborn Nursery Collections
447(1)
Collecting Blood from an Infant
447(1)
Blood Donor Complications
447(2)
Appendices
449(79)
Appendix 1: Finding a Job
449(4)
Appendix 2: The Basics of Vital Signs
453(9)
Appendix 3: CDC Guideline for Hand Hygiene in Health Care Settings
462(5)
Appendix 4: Laboratory Assays and the Required Types of Anticoagulants
467(14)
Appendix 5: Maximum Amounts of Blood to be Drawn from Patients Younger than 14 Years
481(1)
Appendix 6: OSHA Labeling Requirements
482(2)
Appendix 7: Whole Blood or Apheresis Donation Procedure
484(19)
Appendix 8: Units of Measurement and Symbols
503(3)
Appendix 9: Formulas, Calculations, and Metric Conversion
506(4)
Appendix 10: Military Time (24-hour clock)
510(2)
Appendix 11: Basic Spanish for Specimen Collection Procedures
512(4)
Appendix 12: Answers to Self Study Questions and Cases
516(12)
Glossary 528(19)
Index 547


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