Each month, the Center for Phlebotomy Education posts a survey question inviting readers and visitors to its website and Facebook page to participate, and then publishes the results in the following issue of Phlebotomy Today-STAT! This month, we summarize responses from some of the more intriguing surveys conducted over the past 14 months. Topics include bullying, conflicts between phlebotomists and techs, gossips, laboratory/nursing relations, and more. Links are provided to the archived issue of Phlebotomy Today-STAT! that discusses the survey results at length.
We asked facilities what their policy is on patient/sample misidentification. Nearly two-thirds (64%) of respondents specifically stated sample recollection would be necessary. Twelve percent said that the specimen would have to be rejected/discarded, while 7% mentioned extenuating circumstances where testing of irretrievable samples, such as CSF is allowed. Twenty-one percent described the disciplinary action taken against the collector, which ranged from verbal notification to immediate termination. Almost one-fifth (18%) referenced how the error would be investigated and/or documented via an incident report.
November, 2012 Phlebotomy Today STAT!
Can’t We All Just Get Along?
We conducted four surveys in the last year about inter- and intradepartmental relations.
Have you ever been bullied at work?
Verbal abuse and outbursts were the most frequent form of bullying respondents noted, but profanity and work sabotage also made the list.
Have you ever witnessed bullying of another employee while at work?
If you don’t read the full article in any of the surveys summarized here, you should read this one. Not because you need it, but because you need to hear the astounding testimonials people provided.
December, 2012 Phlebotomy Today STAT!
Are you aware of any instances in which patient care was directly affected by strife between the laboratory and nursing department? How do you and/or your facility work to overcome barriers to cooperation between the laboratory and nursing departments?
In fact, 53% of those who took our survey admitted that patient care has been directly affected because of interdepartmental strife. Most involved delayed results.
February, 2013 Phlebotomy Today STAT!
Is there friction in your laboratory between those who draw samples and those who test them that affects morale and cooperation? What behaviors have you experienced that keep this barrier to cooperation in place?
A whopping 81% of those who participated in the survey admitted to friction between the analytical and the preanalytical professions. Fifty-two percent could state examples of it affecting patient care. The most common impacts were delayed test results.
March, 2013 Phlebotomy Today STAT!
Is There a Gossip in Your Midst?
We asked the following questions: Is gossip a problem where you work? How do you personally react to gossip? How does management respond? How would you like management to respond?
Not surprisingly, 69% said gossip was a problem. Those who responded expressed frustration, disgust, and hopelessness that the problem will ever go away. Others felt their employers curtailed gossip effectively. Those who participated in the survey reported a wide variety of strategies they use personally when confronted with gossip in the workplace. Respondents also had plenty to say about how their managers handle gossip, most of it unfavorable.
April, 2013 Phlebotomy Today STAT!
Reducing Pediatric Pain
Approximately one-third (33%) of survey participants indicated that no pain reduction strategies are used when drawing this from patient population. Interestingly, 17% of respondents reported using no pain reduction methods on older pediatric patients. For those who do, parental holding was the clear favorite (83%), followed by distraction methods, such as toys, music or TV (58%), the use of anesthetic cream (25%), and application of an ice pack/vibration device (8%).
For adult patient draws, 50% of those surveyed indicated that no pain reduction methods were necessary, while 50% reported using distraction techniques such as music or TV. Eight percent reported using an ice pack/vibration device. When it comes to infant bottle- or breastfeeding during blood collection procedures, the survey responses were evenly split on the subject. Almost half of the facilities represented allow infant feedings during venipuncture procedures (46%), while just over half permit infants to nurse or bottle-feed during capillary collections (56%).
January, 2013 Phlebotomy Today-STAT!
Permission and Risks
Does your facility policy require you to ask patients for their verbal or written permission to draw blood? Are you required to tell patients about the risks of a venipuncture?
Sixty-three percent of those who responded to the first question said that they are not required to solicit consent from patients in their facilities, but that consent was assumed. Thirty-seven percent work in facilities that do not require the collector to obtain consent. Of those who work in facilities that require phlebotomists to solicit patient consent, 20 percent obtain verbal permission while 17 percent require written permission.
March, 2013 Phlebotomy Today STAT!
Do you work in a state that requires certification for phlebotomists? If not, does your employer require certification? Are certified phlebotomists at your facility paid more than non-certified phlebotomists?
Twenty-six percent of those who responded in non-certification states said their employer requires certification even though the law does not.
Sixty-four percent of those who responded said that their employers do not pay certified phlebotomists any more than non-certified phlebotomists.
June 2013 Phlebotomy Today STAT!
Sixty-three percent of those responding indicated they work in a facility that has a single-use policy for tourniquets. We also asked “after how many patients or shifts do you typically discard a tourniquet?” Fourteen percent said “I can’t remember the last time I threw away a tourniquet.” Eleven percent indicated they discard after one shift. In response to our question about what type of tourniquet was in use where they worked. The majority said nitrile (60%) followed by latex (15%), elastic fabric (13%) and vinyl (11%).
July, 2013 Phlebotomy Today STAT!
Labeling Tubes Someone Else Draws
If someone were to send you or hand you filled blood collection tubes and labels (unattached), under what circumstances would you label them?
Overwhelmingly, those who responded are on the right side of the issue. It’s the others we worry about. A full 55 percent responded they would not label a sample drawn by someone else under any circumstance. Every patient should hope their samples are drawn by someone like-minded. Forty-seven percent said they would label the sample if they witnessed the collection, including proper patient identification. Five respondents (1.7%) indicated they would label a sample “if the person handing me the samples and labels was reliable.” Three (1.0%) said they would label the samples under most circumstances.
August, 2013 Phlebotomy Today STAT!
Mechanism for Monitoring Blood Draws on Infants
According to the survey results nearly half of those who responded do not comply with the standards (47%). Only 11 percent indicated they monitor blood volumes drawn from susceptible patients and have triggers in place that prompt action when limits are met. All others indicated they take some action to prevent iatrogenic anemia, but don’t monitor volumes.
September, 2013 Phlebotomy Today STAT!
In your capacity as a healthcare professional with blood collection responsibilities with any employer, are you aware of any patient ever having serious complications from a blood draw? If so, what was the nature of the complication?
Nearly fifty-seven percent said they were aware of complications. The majority of complications observed were nerve injuries (53%) and non-fatal injuries from passing out (41%). Other injuries include massive hematomas that required medical attention (23.5%), improper medical diagnosis, medication, and/or treatment due to sample or patient misidentification (17.6%), improper medical diagnosis, medication, and/or treatment for reasons other than sample or patient misidentification (17.6%), non-fatal transfusion reaction (12%), and fatal injuries from passing out (6%).
October, 2013 Phlebotomy Today STAT!