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March, 2011


Copyright 2011 Center for Phlebotomy Education, Inc.
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Phlebotomist Salaries Show Improvement

Phlebotomist salaries are gaining ground. So says a 2010 ADVANCE salary survey that lists the national average annual salary for a phlebotomist at $29,738.(1) This figure represents a 13 percent increase over the phlebotomist average salary reported by ADVANCE in 2008 of $26,297.(2) According to survey results published in the March issue of Medical Laboratory Observer, phlebotomy salaries average $31,970. No 2008 data was reported.

Salary.com calculates the U.S. national average median income for phlebotomists to be $29,407, which is in keeping with the latest ADVANCE survey results. According to Salary.com, the salary spectrum for phlebotomists ranges from the lowest 10 percent earning $23,802 to the top 10 percent earning $35,438 and higher.(3)

Factors affecting the wide variation in salaries include location and cost of living, years of experience, competition, labor shortages, and the type of facility where employed. So where will laboratorians find the highest salaries? Geographically, the Pacific region of the country (AK, HI, CA, OR, WA) offers the highest wages followed by the Middle Atlantic (NJ, PA, NY) and New England states.(1) But these areas typically have a higher cost of living compared to the national average. In terms of facility type, reference and commercial laboratories along with VA Medical Centers usually pay more than hospitals, with public health laboratories and physician office laboratories paying the least.(1)

References

  1. McDaniel G. How Does Your Salary Stack Up? ADV Med Lab Pro 2011;23(2):6-9.
  2. Patton M, Koehler A. Salaries on the Rise. ADV Med Lab Pro Dec 1, 2008:9-12.
  3. Salary.com Salary Wizard. http://swz.salary.com/SalaryWizard/Phlebotomist-Salary-Details.aspx.  Accessed 3/4/11.

 

Director Pens Cover Story on Phlebotomy Liability Insurance

The Center for Phlebotomy Education's Executive Director, Dennis J. Ernst MT(ASCP), authored the cover story in the latest issue of Advance for Medical Laboratory Professionals. The piece debates the need for phlebotomists to obtain liability insurance to protect their assets should a patient claim an injury occurred during a blood draw. Mr. Ernst also discusses the best insurance anyone with blood collection responsibilities can obtain. Link to article.

 

Ernst Speaking in Ireland


Dennis Ernst at the 2008 PAI Conference

Phlebotomy Today editor and Center for Phlebotomy Education Executive Director, Dennis J. Ernst, MT(ASCP) returns to Ireland this month to address attendees of the Phlebotomists Association of Ireland annual conference in Dublin. On March 12, Ernst will give two presentations: “Successful Strategies for Difficult Draws” covers the most challenging situations healthcare professionals are confronted with when drawing blood for laboratory testing. “Potassium Results Your Physicians Can Trust” examines the multitude of ways potassium results can be altered during collection or processing leading physicians to question patient test results.

For more information visit www.pairl.ie.

 

 

 

 

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Featured Product
Two Options for Lab Week Giveaways

National Medical Laboratory Professionals Week (April 24-30) is the perfect time to raise awareness of the important role phlebotomists and others who perform phlebotomy procedures play in patient care. One way is to promote the proper order of draw for blood collection tubes throughout your facility with the Center for Phlebotomy Education's Order of Draw packs and Order of Draw sticky notes.

Brilliantly illustrated on each sheet, the Order of Draw sticky note pad serves as a colorful reminder of the Order of Draw as recommended by the Clinical and Laboratory Standards Institute (CLSI) to any healthcare professional with blood specimen collection responsibilities.

For a sampler of order of draw products, consider the Order of Draw pack, which provides staff with an assortment of items, including an Order of Draw sticky note pad, our popular Order of Draw retractable pen, a pocket-size Phlebotomy Tips Card, and two Order of Draw bookmarks.

Perfect for Lab Week giveaways and staff/student recognition.

Order of Draw Sticky note pads. 

Order of Draw packs. 

This Month in Phlebotomy Today

Here’s what subscribers to Phlebotomy Today, the Center for Phlebotomy Education’s paid-subscription newsletter currently in its 12th year of publication, are reading about this month:

  • Feature Article: How to Become a Better Phlebotomist, Part III: Conquering the Difficult Draw (pediatrics)
  • Phlebotomy in the News: a round-up of articles on phlebotomy and phlebotomists who made Internet headlines in February including these stories:
    • CMS Withdraws Physician Signature Requirement
    • FDA Considers Health Warning for Powdered Gloves
    • Fingerstick Device Reuse Places 53 Patients at Risk
    • MA Hospital Assigns Inpatient Phlebotomy Services to RNs, CNAs
    • Survey Reveals Needlestick Rate among Irish Interns
    • Study Finds Comparable Bacterial Counts for Lab Coats and Laundered Uniforms
  • According to the Standards: Tourniquet Time
  • Tip of the Month: Baby Me!
  • CE 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
Patients bending the arm up after a venipuncture

Q: Most of our phlebotomists have the patient bend the arm up to facilitate clotting. I recently had a nurse comment that she heard it was not appropriate. Who’s right?

A: The nurse is correct. Bending the arm up is not an adequate substitute for pressure and can lead to a hematoma. Besides being unsightly, hematomas can lead to nerve damage by placing pressure on the nerves. According to the CLSI standards, direct pressure is required.

The patient may be recruited to apply pressure, but it is ultimately the collector’s responsibility to assure pressure is adequate. To assure adequate pressure, the collector can observe the nail beds of the patient’s fingers that are applying pressure. If they are whitish, it’s a strong indication that he/she is pressing down hard enough. If the nail beds of the finger(s) applying pressure remain pinkish, pressure is probably inadequate. The collector must, therefore, be prepared to take over if the patient doesn't seem to be applying enough pressure.

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 website. For information on joining Phlebotomy Central, click here.

 

Survey Says

Our latest survey polled visitors to our website regarding their primary reason for choosing a winged blood-collection set (butterfly) over a straight needle when drawing blood. The results are below:

  • The patient’s veins are fragile: 41%
  • The patient is a child or infant:16%
  • The patient requests it: 5%
  • I use butterfly sets on all patients: 3%
  • Other: 5%

Approximately 29 percent of those surveyed gave two or more of the reasons above for selecting a butterfly to draw blood, with 48 percent of this group indicating that their device selection is based on the patient being a child or infant, and the fragile nature of the patient’s veins.

Sample Comments

  • “I use butterfly sets on all patients. A winged blood collection set is the preferred needle in our facility.”
  • “If there are more than 4-5 tubes to be drawn, it is easier to switch tubes without moving the needle in the arm.”
  • “I use butterfly sets on all patients. I work in a Cancer Care Center.”
  • “When vein access is difficult, e.g., patient in bed at home/hospital, limited range of arm movement.”
  • “Butterflies offer flexibility, where straight needles don't.”
  • “I use a butterfly when collecting blood cultures prior to tubes.”
  •  “I like to see the "flash" to know I'm in the vein.”
  • “The patient's veins are fragile and I have more tubes than a syringe will easily allow.”

Respondents were also asked to consider all the venipunctures they perform and estimate the percentage of draws that require the number of tubes specified. The results are summarized in Table 1:

Table 1 Percentage Estimates

Blood Draws Requiring 1–5 Tubes

Percent of All Draws

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Survey
Responses

23%

45%

11%

8%

8%

3%

2%

Blood Draws Requiring 6–10 Tubes

Percent of All Draws

100%

90%

80%

70%

60%

5%

40%

30%

20%

10%

Survey
Responses

2%

3%

11%

9%

45%

Blood Draws Requiring 11–20 Tubes

Percent of All Draws

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Survey
Responses

2%

2%

24%

Blood Draws Requiring 21–30 Tubes

Percent of All Draws

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

Survey
Responses

2%

Approximately one-fourth (23%) of survey participants indicated that all blood draws they perform require five tubes or less, with 45 percent of respondents stating that 90% of draws they conduct require one to five tubes, and that 10% of all collections require six to ten tubes. Interestingly, two percent of those surveyed reported drawing 21+ tubes during a single collection, which constituted 10 percent of the total venipunctures performed by this group.

Sample Comments

  • “Very occasionally we draw blood for a Platelet Aggregation which totals approximately 100 ml of blood. Less than 1%.”
  • “A small percentage, probably 2% require more than 10 tubes. These patients usually are oncology patients or infectious disease patients.”
  • “My highest draw was 24 tubes.”

When asked what their routine practice is when advancing tubes into a tube holder, 59 percent of those surveyed stated that they advance the tube as far as it will go into the tube holder and then release pressure. Forty-one percent indicated that they slowly advance the tube into the tube holder to the point where blood enters the tube.

Sample Comments

  • “I watch that the tube doesn't pop off the needle in the holder; sometimes [the] tube must be held in place.”
  • “I advance the tube as far as it will go, and hold pressure, since often the tube will pop off otherwise.”
  • “I slowly advance it as far as it will go, then hold gentle pressure, because sometimes the tubes will pop off slightly beyond the inner needle.”
  • “Set tube in holder, insert needle, and pop tube to see if blood flow starts ASAP.”

Survey participants self-identified as phlebotomists/phlebotomy instructors/phlebotomy supervisors (61%), clinical laboratory scientists/lab techs (32%), nurses (5%), and medical assistants (2%).

This month’s survey question:
Do you ever feel pressured to draw from unorthodox sites?

 

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What Should We Do?

[Editor’s Note: "What Should We Do?" gives you the opportunity to ask our team of technical experts for advice on your most pressing phlebotomy challenges. Whether technical or management in nature, we'll carefully consider solutions and suggestions based on the industry's best practices so that you and those in other facilities with the same problem can benefit, all the while maintaining your facility's anonymity. What Should We Do? is your opportunity to ask us for suggestions on the best way to handle your real-life dilemmas.]

 

Last Month’s Case Study:
Site Selection in Stroke Patients

One reader writes: “One of my phlebotomist colleagues states that an arm affected by a CVA (cerebro-vascular accident, stroke) is not allowed to be used for venipuncture. I've not come across any literature that supports her belief but I’m fully aware of other unacceptable sites repeated in literature e.g., palmar surface of wrist, feet in patients affected by paralysis, palsy or diabetes, post-mastectomy and fistula arms, etc. I would be very grateful if you would advise.”

 

Our Response: Although some publications caution against such draws, CLSI in its venipuncture standard does not prohibit draws from an arm affected by a stroke. To our knowledge, nothing has been published in the literature on the effect of a stroke on blood tests drawn from an affected limb.

However, difficulties encountered when drawing blood from such patients may include veins that are harder to locate, edema, inability to clench the fist and/or hyperextend the arm, and not being able to communicate his/her name during the identification step. According to CLSI, a caregiver or family member should be asked to provide the patient's name when patients can't communicate it themselves. Because of the patient care issues that may come into play, always refer to your facility’s policy.

Reference

  • CLSI. Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; Approved Standard—Sixth Edition. CLSI document H3-A6. Wayne, PA: Clinical and Laboratory Standards Institute; 2007.
  

 

Wanted:

Your most challenging phlebotomy situations and work-related questions.

Send your submission to WSWD@phlebotomy.com and you just might see it as a future case study.

 

 

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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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