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Phlebotomy Today

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August, 2015

Infant Scalded in Heel Prewarming
Trade Show Sightings

Two Training Arms For Sale
The Empowered Healthcare Manager: When the bully is a patient
Product Spotlight: new anatomy poster
YouTube Channel on Steroids 
This month in Phlebotomy Today
What Should We Do?: Summoning patients by name
Tip of the Month
: How to Hemolyze a Blood Sample


Infant Scalded During Heel Prewarming

PrewarmHeelAccording to news reports, a Houston-area nurse prewarmed a newborn's heel in anticipation of the baby's newborn screen collection by wetting a diaper and warming it in a microwave. KFOR-TV in Houston reported the infant is being treated for second-degree burns.A news report showing a graphic image of the injury has been posted on KFOR's web page.

The CLSI standards limit the temperature for prewarming capillary puncture sites to 42-degrees Celsius. 


Trade Show Sightings

Last week we spent three days walking around at the world's largest clinical laboratory trade show, the AACC Clinical Lab Expo in Atlanta. The sightings we encountered constitute a Who's Who that collectively drive the industry forward. Thought leaders, innovative companies, and forward-thinking organizations dominated the trade show floor to comprise the largest collection of change agents in the clinical laboratory industry.

Though in vitro diagnostic instruments and devices dominated the Georgia World Congress, products designed to solve preanalytic problems were at every turn, Here's a rundown of some we found new to the market in the last 12 months or so.

OwenMumfordTinyTouch copyOwen Mumford's Unistik TinyTouch™---a heel-incision device designed to quickly and comfortably sample neonatal blood with minimal pain and discomfort. The device is available in Premie (0.85mm depth) and Full Term (1.0 mm depth) models.

TubeWriter360_900wTubeWriter---The TubeWriter 360™ ink-delivery system prints directly onto any tube making secondary transfer) tubes easier and quicker to identify without paper labels that are often misapplied. Representatives at the booth created tubes within seconds for those who passed by. The instrument is capable of imprinting on glass or plastic tubes (including caps), Petri dishes, slides and other sample containers and plates.

RTI_butterflyVanishPoint Blood Collection Set---Vanish Point made improvements to its blood collection (butterfly) set making visualization of the "flash" easier, gripping more secure, and adding a color-coded arrow indicating precisely where to activate the device. The blood collection set is one of only two on the market we are aware of that activate while still in the vein.

454084&asst_tubes_on_greyGreiner Bio-One---New this year, Greiner's low volume tubes come in draw volumes of 1mL to 2.5mL while maintaining the standard 13x75mm tube size. The new line is intended to reduce the risk of iatrogenic anemia and minimize the volume of biological samples entering the healthcare waste stream. The low-volume PET plastic tubes are available in a wide variety of additives, and have functional compatibility with instrumentation.

PlatinumCode_Logo_Color_w_Tagline_RasterPlatinumCode---New this year from the Minneapolis laboratory supplier are bariatric tourniquets and Acculine™ notched blood-tube labels for use on BD Vacutainer® Plus tubes. The v-shaped notch accurately lines up with the color-coded "V" on BD's tube label to ensure accurate placement, eliminating the necessity to relabel. PlatinumCode also introduced non-latex bariatric, infant, and pediatric tourniquets

Fritsma Factor---Also sighted this year was coagulation guru George Fritsma, MS MLS, purveyor of the popular blog The Fritsma Factor. Improvements to the blog include a jazzy new skin, an updated database, and a simpler "Cheat Sheet" delivery system.

Dan the Lab Safety Man---Dan Scungio, MT(ASCP), SLS, CQA (ASQ) was also mingling around the exhibit hall. Dan's latest blog, "The Role of the Role Model," discusses one of the secrets of a successful lab safety professional. Dan's site allows visitors to pose questions on all aspects of laboratory safety.

Phlebotomy Services International---We also met up with Ed Cutler and his team to explore ways to elevate the phlebotomy profession. PSI assists physicians, scientists, employers and individuals by coordinating, managing and staffing the specimen collection process necessary for biomedical research and health screenings internationally. Healthcare professionals interested in signing up as contracted phlebotomists can sign up here.


Training Arms for SaleIVarms

The Center for Phlebotomy Education has two phlebotomy and IV training arms for sale. The Advanced Venipuncture Training Arms (Model #00290), purchased from VATA in 2013, have been opened and assembled, but never been used. One model is medium pigmented while the other a darkly pigmented version. Details on the product can be found on the VATA web site. The Center will sell the models for $595 each plus shipping. They sell for almost $850 brand new. For information, contact the Center for Phlebotomy Education at support@phlebotomy.com or call 866-657-9857.

(Click image to view full size.)


The Empowered Healthcare Manager:  When the bully is a patient 

Every month, Phlebotomy Today-STAT! reprints one of the prior month's posts to The Empowered Healthcare Manager blog, written by Dennis Ernst. 

The empowered healthcare manager refuses to let one employee bully another. If they have a bully on board, they warn, reprimand, then terminate. Their reaction is swift and decisive.

When the bully is a customer,---such as a patient, physician or external customer---it's no different. A bully is a bully regardless of what end of the transaction they're on. To the staff, being bullied feels the same. 

There are those in this world who go around testing the rest of us to see if we will tolerate their incivility. Whether he's a patient, physician, just because the bully has customer status doesn't mean he gets to assault your team. The empowered manager protects the herd, defends the front line, and shelters those without authority from those with it, those who consider it their license to be mean.

Of course, you go to great lengths to resolve any and all issues, but after all your Magic Customer Service Dust is spent,your spirit and that of your staff is bruised and bloodied, and the bully is still rabid, you treat him like you would any bully on staff. You warn, reprimand, then terminate.

Some customers just need to be fired.

 Subscribe to The Empowered Healthcare Manager.


Product Spotlight:   Anatomy poster revised  

AnatomyPoster2015_400wThe Center for Phlebotomy Education has updated its popular Blood Collection Sites and Precautions wall atlas. The poster replaces the original, which came out in 2005.

This revised full-color laminated poster now depicts the two most common anatomical variations of veins as they pass through the antecubital, i.e., the "H" and the "M" configurations. Approximate locations of nerves, veins, and the brachial artery as they pass through the antecubital area are identified and accompanied by detailed text that discusses the precautions all specimen collection personnel must know when drawing blood for clinical testing to prevent patient injury.

A section on alternative venipuncture sites discusses mastectomy patients, foot/ankle veins, and other alternatives. All text and illustrations reflect the current standards of the Clinical and Laboratory Standards Institute and the Infusion Nurse's Society. This 17" x 22" laminated poster is designed to be posted in classrooms, laboratories, medical offices, healthcare facilities, and other specimen collection environments.

The poster can be ordered here.


Center's YouTube Channel on Steroids

YouTubeScreenShotTwo months ago, the Center for Phlebotomy Education administered an overdose of steroids to its YouTube channel. With new clips uploaded weekly and total views approaching 4000, it's muscling its way to become the go-to channel for free phlebotomy education. Current titles include:

  • Nightmare on Phlebotomy Street*
  • Why physicians order blood cultures
  • Pumping the fist: a really bad idea
  • Line draws and potassium results: mutually incompatible?
  • Positioning pediatric patients
  • Preventing iatrogenic anemia
  • What impressions are you giving your patients?
  • Is that tube full?
  • How to prevent newborn screening cards from being rejected by the lab.
  • The order of draw: why you MUST follow it.*
  • Something's lurking in our shipping room
  • How to draw blood using a tube holder
  • How to perform a venipuncture using a syringe
  • Performing a venipuncture using a butterfly needle*
  • How to perform a Modified Allen Test
  • Proper patient identification: make no exceptions!
  • Preanalytical Errors Real People Real Suffering.*


*Most frequently viewed.

Subscribe to the Center's YouTube channel.


This Month in Phlebotomy Today:  

Here's what subscribers to Phlebotomy Today, the Center for Phlebotomy Education's flagship newsletter currently in its 15th year of publication, are reading about this month:

Feature Article
Phlebotomy, Australian Style

On the Front Lines
Heelstick versus fingerstick

Sticks, Staph, and Stuff
CRE and Y-O-U

From the Editor's Desk
The party to end all parties

The Empowered Manager
The Art of the Interview

Submitting hemolyzed samples

CE questions
Institutional subscription only

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Survey Says:

Survey Says takes a vacation this month. Please consider completing our ongoing survey about your own personal hand hygiene practices. 

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What Should We Do?: Summoning patients by name

Right way wrong way sign 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.

This month's case study: In our hospital outpatient lab area, our policy is to call the patient by first and last name and then have them verbally confirm with date of birth after they are away from the public. Some patients say that is a violation of HIPPA privacy. We often have a full waiting area and there could be multiple "Roberts", "Marys" etc. This is a dilemma for us. What should we do?

Our response: Calling patients from a waiting room by their first and last name is not a HIPPA violation. According to the HIPAA Privacy Rule incidental disclosures such as sign-in sheets and calling out patient names in waiting rooms are permitted.1 However, they're permitted only when "reasonable safeguards and the minimum necessary standard" have been implemented where appropriate. Sign-in sheets cannot display medical information not required for the purpose of signing in. A sign-in sheet that requests the medical condition for which patients are seeking treatment would violate HIPAA regulations.

So addressing outpatients by their full name while in waiting rooms is acceptable. However, that isn't to say your facility can't implement another method for summoning patients that does not disclose their full name to others present, placating their concerns. One way would be to implement the "take a number" system as used in many customer service areas, or providing outpatients with a pager or disc that lights up and vibrates similar to restaurant pagers.


1) U.S. Department of Health & Human Services. HIPAA Frequently Asked Questions. http://www.hhs.gov/ocr/privacy/hipaa/faq/incidential_uses_and_disclosures/199.html. Accessed 8/4/2015.


 Each month, our "What Should We Do?" panel of experts collaborates on a response to one of the many compelling problems submitted by our readers. Panelists include:


Got a challenging phlebotomy situation or work-related question? Answers just ahead sign

Email us your submission at WSWDpanel@phlebotomy.com and you just might see it as a future case study. (Names and identifiers will be removed to assure anonymity.)

Tip of the Month

Click here for this month's featured Tip of the Month: How to Hemolyze a Blood Sample