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February, 2010


©Copyright 2010 Center for Phlebotomy Education, Inc.
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Haiti Earthquake Relief Update

Randolph World Ministries, Inc. (RWM) is a small, non-profit Christian organization that has provided medical laboratory and other faith-based services to the country of Haiti since 2001. Tim Randolph, Ph.D., founder and president of RWM Randolph, has helped build and run 23 medical clinics throughout the Caribbean nation, including seven in Port-au-Prince. Teaching phlebotomy to Haitians and providing a steady stream of supplies is one of his biggest challenges.    

The Center for Phlebotomy Education, publisher of the Phlebotomy Today family of e-newsletters, has been a long-time supporter of RWM. After the earthquake, we partnered with Greiner Bio-One to deliver blood collection supplies and equipment for distribution to Tim's Haitian labs—including 108,000 red top tubes. We thought our readers would appreciate knowing how the recent earthquake has affected this important ministry. Below is the latest update from Tim Randolph regarding Haiti and the earthquake relief efforts that are currently underway.

I received a phone call last night (01-18-10) from Pastor Michel, president of Eben-Ezer Mission in Gonaives. He has been asked by the Haitian government to house 10,000 refugees from Port-au-Prince who have been rendered homeless. Many of them are orphans displaced from their orphanage that collapsed. Even though the earthquake has decimated the Port-au-Prince area and Gonaives is 3.5 hours north, the mass exodus of people leaving Port; the inability to get funds into Haiti due to bank closures; the inability to get food, water, fuel, and supplies into Haiti due to seaport and airport closures; food, water, and fuel are nearly out country-wide. Pastor Michel took his last tank of gas and drove to the Dominican Republic (DR) in hopes of getting one of his ministry partners to wire money to him so he can buy food, water, and fuel to take back to those he is serving in Gonaives. This morning Randolph World Ministries, Inc. wired Pastor Michel $2,500.00 for the purchase of these materials. This will purchase sufficient materials for a week unless the 10,000 arrive early. Until the Haitian government opens the sea ports and airports, we will not be able to get our collected materials to those who need them most. We will share this plan with several of our other Haitian ministry partners as a way to support them during the acute phase of this crisis. Until then Randolph World Ministries, Inc. has the following plan for the next 6 months:

  1. Collect funds for the following purposes:
    1. To wire to our primary minister partners for the purchase of materials in the DR
    2. To purchase food, water and medical supplies to supplement donations
    3. To fund the shipping charges once the ports are open for the delivery of goods
  2. Collect basic medical supplies (see list on website www.randolphworldministries.org)
  3. Collect basic medicines (see list on website www.randolphworldministries.org)
  4. Collect toiletries (see list on website www.randolphworldministries.org)
  5. Collect nonperishable food
  6. Collect bottled water

As of Friday, January 21, 2010, Tim has been able to secure two missionary airlines and one overseas shipper to deliver the supplies to various locations in Haiti. Tim will mail several shipments on Saturday, January 22 with expected delivery in Haiti the following Saturday. The plan is to ship medical supplies to six clinics that are still tending to the medical needs of the injured, three in the Port area and three in the north. Tim will also supply food, water, and toiletries to Pastor Michel in Gonaives who has agreed to house 10,000 evacuees from the Port area.

For those who may also wish to contribute, please send all donations to:
Randolph World Ministries, Inc.
Tim R. Randolph
318 Vandalia Street
Collinsville, IL 62234
(314) 920-0354
randoltr@slu.edu

 

Phlebotomy Jobs

Geisinger Medical Center—Phlebotomy Supervisor Position
Geisinger Health System in Danville, Pennsylvania is seeking a phlebotomy supervisor who will manage a phlebotomy staff of approximately 50 FTEs performing over 25,000 specimen collections per month. The staff includes Phlebotomists, Phlebotomy Technicians, Phlebotomy Trainers and Shift Technical Specialists. The 24/7 Phlebotomy Team covers inpatient units, including intensive care areas and the Emergency Department.  In addition to inpatient responsibilities, the team also staffs 3 outpatient locations on campus and will staff an outpatient location at our off-campus surgery center opening later this year. Geisinger Medical Laboratories has a School of Phlebotomy that provides a pipeline to outstanding students to fill phlebotomy positions, not only on the Danville campus but across the health system.

The 404-bed Geisinger Medical Center is a tertiary and quaternary medical center recently named one of the Top 100 Hospitals in the country. The medical center has also been designated as a Magnet hospital by the American Nurses Credentialing Center. Founded in 1915, Geisinger is a physician-led organization that is dedicated to serving 2.6 million people.

Minimum requirements / qualifications for the position include:

  • Bachelor’s degree in life science or related field
  • Minimum of six (6) years relevant experience in laboratory practices
  • Prior supervisory experience
  • Required Skills: Strong positive interpersonal skills; problem-solving ability; time management skills; organizational skills to function successfully in a fast-paced work environment; computer literacy in Word, Excel and databases; administrative skills to compile statistics and maintain logs; ability to multitask.

Qualified applicants can contact David Wranovics, Operations Director - Clinical Pathology, Geisinger Medical Center, Danville, PA by e-mail (djwranovics@geisinger.edu) or by phone at 570-214-6128.

 

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This Month in Phlebotomy Today

Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 11th year of publication, are reading about this month:

  • Feature Article: Promoting Phlebotomy Professionalism: One Laboratory’s Strategy for Success
  • Phlebotomy in the News: a round-up of articles on phlebotomy and phlebotomists who made Internet headlines in January including these stories:
    • Phlebotomist Recoups $31,000 in Workman’s Comp Benefits
    • Retired Phlebotomist Documents Neighbor’s Abuse
    • Phlebotomist Found Guilty of Disorderly Conduct
    • Austin Police Department to Present Plan for Phlebotomist Program
    • Needlesticks among Top Ten Technological Hazards in Healthcare
  • According to the Standards: Revised Order of Draw
  • Tip of the Month: Ten Things You Should Never Say to Your Patient
  • CEU questions (institutional version only).

Buy this issue for only $9.95.

For subscription rates and to subscribe to Phlebotomy Today, click here. The current month’s issue will be emailed to you immediately upon subscribing.

 

Featured FAQ
Hemolysis chart

Q: Do you know of any source of information that defines the levels of hemolysis? We are searching for information that would help us standardize what "trace, 1+, 2+, 3+, 4+" actually means relative to hemolysis. We would like to develop or purchase some visual standards so that our techs can compare serum or plasma to these standards when evaluating serum for testing. Thank you.

A: There are two places in the literature where the hemolysis chart you’re looking can be found: the March, 2003 issue of Transfusion (Volume 43, page 297) and the November, 2006 issue of MLO (Medical Laboratory Observer) (Volume 38, No. 11, page 26).

The Transfusion chart shows eight levels of hemolysis and indicates the quantity of red cells ruptured in mLs corresponding to each level. The MLO chart also shows eight levels of hemolysis, but gives the amount of hemoglobin in each in mg/dL instead. Some manufacturers of chemistry analyzers also provide similar charts.

Each month, PT-STAT! will publish one of the hundreds of phlebotomy FAQs in the growing database of questions and answers available in Phlebotomy Central, the members-only section of the Center for Phlebotomy Education's web site. For information on joining Phlebotomy Central, click here.

 

Featured Product
Order of Draw Pens

Just Write for Lab Week, Order of Draw Retractable Pens

Managers and trainers looking for an inexpensive but uniquely educational gift for their students and staff can keep the recommended order of tube collection right at their fingertips. Just in time for National Medical Laboratory Professionals Week (April 18-24), the Order of Draw pen is comfortable and attractive with the order of draw illustrated in full color on the barrel for easy reference.

Many studies have proven that when blood collection tubes are filled in the wrong order, test results can vary, sometimes wildly, from the patient’s actual condition. Those who follow the prescribed order of draw collect specimens that are less likely to yield misleading test results that impact how the patient is diagnosed, medicated, and managed.

Reinforce the importance of the order of draw with phlebotomists, nursing personnel, medical assistants, the ED staff, and all those who draw blood specimens in your facility by putting this constant reminder in every pocket. The pens are available for immediate delivery in packs of 10 for $19.99.

For more information or to order, click here.

 

 

Survey Says
Competency Assessment

Our latest survey polled visitors to our website regarding if and how their facilities evaluate the competence of personnel who perform blood specimen collection. The results are below:

  1. Does your facility formally evaluate the competence of all staff who perform phlebotomy procedures?

  2. Yes: 79.4%
    No: 20.6%

    Sample comments:

    • “The nursing department feels no need to evaluate the competence of their staff. They assume that because they are RN's they are completely qualified and competent to perform phlebotomy.”
    • “I HAVE BEEN EMPLOYED HERE 3 YEARS AND I HAVE YET TO TAKE ANY BI ANNUAL OR ANNUAL COMPETENCY TEST. THIS IS NOT A LAB THAT FOLLOWS GUIDELINES!!!!!! I HAVE WITNESSED MANY SHORTCUTS TAKEN BY THE PHLEBOTOMIST. I WON’T LET THEM DRAW MY RELATIVES.”
    • “Non laboratory staff NO; Lab phlebotomist YES”
    • “We only perform competencies on Lab staff. We are implementing competencies for the nursing areas that perform phlebotomy. Not yet in place.”
    • “We evaluate on all processes, venipuncture, blood culture, specimen processing, registration, testing performed, etc.”
    •  “My supervisor has no idea what or how I do my job. She has never worked in a lab in her life. Her evaluations are given on the basis of her not hearing anything bad about me.”
  3. If so, how frequently are competency evaluations conducted?
  4. Within six months of hiring and/or assignment of task, and annually thereafter: 60.6%
    Annually: 27.3%
    Other: 12.1%

  5. Please indicate what methods are used by your facility to assess staff competence.
  6. Direct observation: 84.8%
    Written test: 60.6%
    Oral test: 12.5%
    Case studies: 9.1%
    Other: 12.5%

(Note:  Total exceeds 100% due to responses citing multiple evaluation methods.)

The good news is that over three-fourths (79.4%) of those polled indicated that their facility has a mechanism in place to formally evaluate the competence of all employees who draw blood as part of their assigned duties. Kudos to those organizations that have implemented and standardized phlebotomy competence assessment processes across the board and across department lines! 

The survey results also reflect that every facility hasn’t reached this goal (20.6%). Some employers are headed in the right direction though, with blood collection competencies on the horizon for nursing personnel who perform phlebotomy procedures. More concerning were the comments expressing a lack of organizational understanding or emphasis on performing staff assessments outside the realm of the laboratory, or in some instances, at all.

In terms of frequency, the vast majority of those with a comprehensive phlebotomy competency assessment program in place reported that evaluations are conducted at least annually (87.9%). Direct observation was by far the most common assessment method used (84.8%). In some facilities, it is the only evaluation tool employed (19%). But most often, direct observation is used in combination with one or more assessment methods (71%). Of those, 58% reported using two methods, while 13% indicated three or more methods in use.

Patients may not be aware of the job title or educational background of the person collecting their blood sample. But they do expect the procedure to be performed correctly. Regularly and thoroughly evaluating every collector who wields a needle is the best way for facilities to meet that expectation and minimize the risk of phlebotomy-related injuries and litigation.

[Editor's note: a competency assessment tool for blood collection personnel is available in the Center for Phlebotomy Education's Manager's Toolbox. It includes a checklist for observational assessments and questions that can be administered as a written or oral quiz.]

This month’s survey question: Does your facility limit the number of winged collection (butterfly) sets specimen collection personnel can use per month? If so, what is the limit (per individual or per department)?

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What Would You Do?

Each month, What Would You Do? presents a different case study, then asks readers to contribute their ideas as to how each situation would best be handled. The following month, selected responses will be chosen by the editor and published (sender will be identified by first name and state only). The most accurate, well written response will receive a free download from the Center for Phlebotomy Education’s To the Point® library of articles. The exercise will conclude with a review of the selected submissions and a discussion of the standards pertinent to the case study.

 

Last Month’s Case Study:
Chatty Cathy

Your facility serves as a clinical site for phlebotomy students. One of your new students shows promise, but chats excessively with outpatients. Patients compliment on her friendliness, but her socializing is creating a backlog in the draw station waiting room. What would you do?

 

The vast majority of PT-STAT! readers (83%) who responded to last month’s case study agreed that the first step in addressing this issue would be to commend the student on her friendliness and excellent people skills. Several respondents stated they would then explain that in addition to making the patient feel at ease, how not being kept waiting also contributes to a patient’s favorable experience with the laboratory.  Barbara in Florida put it this way: “I would suggest that they limit their conversation to the time it takes to complete the phlebotomy. When the labeling process is completed, so is the conversation.”  

Providing a patient’s perspective, one reader made the point that patients are often tired and may not welcome a great deal of chatter while having their blood drawn. Respondents also shared other negative outcomes associated with too much talking, including:

  • the “distraction factor” that can lead to errors in patient identification, labeling, etc. (33%);
  • the risk of saying something inappropriate to the patient/client (17%);
  • the increased workload that may be unfairly shifted to others (17%);   
  • keeping the patient and those after them from their other appointments (17%).

Margo from Tennessee approached the situation this way:  “We have had situations very similar to this with students and new employees. I would explain clearly to the student that the patients deserve and expect friendly and courteous service, but they also deserve and expect prompt service. Delays in collection lead to delays in results which lead to delays in treatment. A good phlebotomist must be able to perform efficiently and safely, while maintaining a courteous and friendly demeanor“. 

For her articulate response and seizing the moment as a teaching opportunity, Margo will receive a free download from the Center for Phlebotomy Education’s To the Point® library of articless.

 

This Month’s Case Study:
Off to the Races

Helen, your next patient, is a real estate agent who is always in a hurry. She takes a seat in your outpatient phlebotomy chair, anxiously taps her toe while you draw her blood, and wants to jump up and get on with her day as soon as you've pulled out the needle. You tell her she needs to wait until you bandage her, but she insists she can tend to the wound herself. Before you've even labeled the tubes, she demands you release the latch on the arm rest in front of her so she can go.
What would you do?

Tell us what you'd do in this case. Submit your response by the 20 th of the month and send it to this address and this address only: WWYD@phlebotomy.com. Submissions sent to any other address will not be considered. Keep your suggested solutions less than 100 words. Although you don’t have to be an English scholar to be considered for inclusion, submission with proper grammar and punctuation will be given priority. If you’re not sure of the appropriate solution, check your facility’s procedure manual or ask your manager. Who knows, you might be presented with the very same dilemma tomorrow.

 

 

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Newsletter Information:

PT STAT! is a free, monthly educational service provided by the Center for Phlebotomy Education, Inc., the most respected authority in phlebotomy. For a complete company profile and product list for all healthcare professionals who perform, teach or manage specimen collection procedures, visit us on the Internet at: http://www.phlebotomy.com.
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