Competency Checkup: What’s in it for you?
Do you dread your annual evaluation? Does it make you anxious to have your technique scrutinized? There are many reasons you should welcome the experience, and embrace what it means to your professional stature.
By having your work performance formally assessed on a routine basis, you create for yourself and your employer documentation that places you in a favorable light. You may already be great at what you do, but is it documented that you consistently collect blood samples according to established standards? If not, you might not be able to prove your expertise if your knowledge and technique were ever called into question.
Like an annual physical examination that determines the current status of your health, regular competency assessment activities serve as a checkup of your current knowledge and skill as a phlebotomist. Checkups have two purposes: to either verify all is well or to spot and address problems early on.
Tips for Successful Assessments
Each January, many of us participate in the New Year’s ritual of making resolutions. So for 2010, why not resolve to be the best phlebotomist you can be? Annual evaluations won’t automatically protect an employee from legal liability should a patient injury occur, but when a facility shows it’s serious about maintaining competent personnel, it can only help. So, if having your phlebotomy skills evaluated makes you feel ill, consider the process as an insurance policy that helps protect your credibility and career by proving you’re fit to perform the task.
[Editor’s Note: a sample competency checklist is included in the Center for Phlebotomy Education’s Manager’s Toolbox.]
Center Posts Free Hemolysis Article
In keeping with our tradition of providing high-quality technical content for free, the Center for Phlebotomy Education recently uploaded a new Needle Know-How article on its web site. “The Art of Hemolysis” discusses how cells ruptured during sample collection and handling can significantly alter test results, especially potassium levels. The most common causes of hemolysis are listed along with preventative measures specimen-collection personnel can take. A link to the free article appears on the Center’s home page at www.phlebotomy.com.
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:
For subscription rates and to subscribe to Phlebotomy Today, click here. The current month’s issue will be emailed to you immediately upon subscribing.
Q: Our nurses start an IV, they attach a tube holder and draw a red top. We’re finding these specimens frequently hemolyzed. Is hemolysis expected in this circumstance?
A: Vascular access devices are notorious for hemolyzing red blood cells. Every facility that draws blood during an IV start has a hemolysis problem. Guaranteed. The best way to prevent hemolysis is to avoid using an IV for the purpose of drawing blood. Statistics show they’re 10 times more likely to hemolyze a specimen than drawing by venipuncture.
Even though IV cannulas may be of the same gauge as a blood collection needle, they’re not made for drawing blood. Therefore, they have a design that doesn’t consider the fragility of red blood cells. We know that the interior of a blood collection needle is smooth and without interruption, but assuming the same for any other vascular access device is overly presumptuous.
Each month, PT-STAT! will publish an excerpt from our newly released book Blood Specimen Collection FAQs. For a preview and for information on obtaining your copy, click here.
Our latest survey asked Phlebotomy Today STAT! readers three questions about their use of blood collection devices. The results are as follows:Do you ever use non-safety needles for venipunctures (i.e., those without safety features)?
A sample comment: “The only non-safety needle we ever use is our 25-gauge needle. It's great for doing venous draws on very difficult veins and infants. It's a 5/8" needle, which is nice and short for those tiny veins. I haven't been able to find a replacement I like w/the safety feature in this size needle, the only reason I continue using it. All our other needles have safety features. I hate the fact I can't let these 25-gauge needles go, I've tried and nothing else seems to work as good.”
Do you ever use non-retractable skin puncture devices?
Do you reuse tube holders?
Readers should keep in mind that an answer of “Yes” to any of the three questions posed places the collector at greater risk for occupational exposure to bloodborne pathogens and in the U.S. represents a direct violation of OSHA regulations. Healthcare workers in other countries are no less vulnerable to accidental exposures, and should take precautions voluntarily to reduce their risk.
This month’s survey question: Does your facility formally evaluate competence of all staff who performs phlebotomy procedures? If so, how frequently are competency evaluations conducted and what methods are used?
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.
According to our respondents, this type of negative patient reaction is not uncommon. Of those who would encounter patients with this attitude toward blood specimen collection, 64% indicated that their approach would be to attempt to calm and reassure the patient. Many readers expressed that such patient hostility is often rooted in previous phlebotomy experiences gone bad. After reassuring the patient of their technical abilities, 36% stated they would then ask for the patient’s consent, while 36% would also offer the patient the option of having someone else perform the draw.
However, 29% of our readers stated they would not attempt to persuade or draw the patient, with 21% noting they would inform the attending nurse or physician. Some readers expressed concern for their own personal safety (14%), while 7% of readers would apprise their supervisor of the situation.
Because a patient’s cognitive status has great bearing on how he/she should be managed, those who perform blood specimen collection should be familiar with and follow their facility’s specific policies to ensure their own safety while respecting the rights of their patients.
We particularly liked the response given by Kathleen D., of Arizona, below:
For her detailed approach to diffuse a hostile situation and regain the patient’s trust, Kathleen will receive a free download from the Center for Phlebotomy Education’s To the Point® library of articles.
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