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 begin recapping responses from some of the more intriguing surveys conducted over the past 18 months. Topics include Internet and cell phone use on the job, limits on the number of venipuncture attempts, circumstances for drawing a discard tube prior to a coag sample, and measures taken to reduce blood draw volumes in susceptible patients. Links are provided to the archived issue of Phlebotomy Today-STAT! that discusses the results at length.
Facility Policies: Help or Hindrance?
When asked how policies at their facilities impact personal job performance, 83 percent of respondents said that the protocols in place help them perform at their highest level, while 17 percent consider facility policies a deterrent to carrying out their duties. In terms of adhering to their facilities’ policies, 94 percent of survey participants believe in playing (and working) by the rules, affirming that they follow facility policy without exception. Nearly two-thirds of respondents stated that policies at their facilities are strictly and consistently applied. In contrast, 35 percent indicated that violations often go unaddressed or policies are randomly enforced.
Phlebotomy Today-Stat! 6/11
This survey provided insight about cell phones and Internet surfing in the workplace, and whether or not employers have established policies against them. Eight percent of those surveyed indicated that they read or send personal text messages while on the clock. Six percent stated that they place or accept personal calls during work time, with 16 percent browsing non-work-related websites while on the job. The majority of those surveyed reserve such activities for break time, with over a third of respondents stating they do not engage in these pursuits in the workplace. When asked if specific policies against such activities exist, the results were as follows:
- Policies against texting
- Policies against cell phone calls
- Policies against surfing the Internet
Phlebotomy Today-Stat! 8/11
Duties Beyond Phlebotomy
This survey confirmed what we’ve long suspected: those who draw blood wear a lot of hats and have quite a few job titles. The overall results are provided, along with responses by job title.
At your place of employment, is blood specimen collection your primary duty?
|Medical or Lab Assistant
|Clinical Lab Scientist/Medical Technologist
|Medical Laboratory Technician
Phlebotomy Today-Stat! 10/11
Reducing Blood Draw Volumes
Our survey about efforts to reduce blood-draw volumes from patients susceptible to anemia showed that over 41 percent of facilities responding have not yet taken action. However, of this group, 27 percent noted that their facility does use previously collected samples for “add-on” tests, where appropriate.
At facilities where measures have been instituted to prevent oversampling, considering previously collected samples was the most prevalent practice reported (62%), followed by use of pediatric-size evacuated tubes for susceptible patient populations (41%). Education also plays a role with 24 percent of survey participants indicating that in-services on phlebotomy overdraws are/were conducted for clinicians. Monitoring blood volumes drawn from susceptible patients (required by CLSI) and having triggers in place that prompt action when blood volume limits are exceeded were noted by only 14 percent of respondents. The collection of capillary samples was reported by 10 percent of survey participants as a means to decrease blood sampling volumes.
Phlebotomy Today-Stat! 9/11
When it comes to the faint of heart, we asked survey participants three questions: 1) is every outpatient asked if he/she has a history or fainting?; 2) are ammonia inhalants are being used in outpatient draw stations?; and 3) is a reclining phlebotomy chair, cot or gurney available for those outpatients who feel faint?
Do you ask every outpatient if he/she has a history of fainting?
Are your outpatient draw stations stocked with ammonia inhalants?
In your outpatient drawing area, do you have a reclining phlebotomy chair, cot or gurney for patients who feel faint?
Phlebotomy Today-Stat! 12/11
When to Don Gloves
For this survey, we asked visitors to our website and our Facebook page what their facility’s written procedure says about gloving in relation to drawing blood, and at what point they actually put on their gloves.
For non-isolation patients, when in the sequence of blood specimen collection does your facility's written procedure instruct you to don gloves?
The majority of survey participants indicated that their facility policy requires gloving to occur after identifying the patient (42%). Ten percent of respondents reported that their facility provides no written instruction on gloving. Of this group, 20 percent represent facilities outside the U.S.
We also asked survey participants to share their actual gloving practices. Overall, the habits reported by survey participants mirror facility policy. Interestingly, approximately 6 percent of respondents whose policies call for gloving before the cleansing step reported they choose to glove earlier in the procedure, after identifying the patient. Of the 4 percent who responded that they do not wear gloves during phlebotomy procedures, 3 percent represent facilities outside the U.S.
Phlebotomy Today-Stat! 11/11
Limits on Venipuncture Attempts
This survey set out to determine if a “statute of limitations” exists in facilities for the number of times a venipuncture may be attempted.
Where you work, does facility policy limit the number of venipuncture attempts?
We also asked survey participants about the maximum number of venipuncture attempts one collector is permitted:
- 87% indicated that two sticks is the individual limit
- 6% reported three attempts are allowed
- 4% stated a maximum number of attempts per collector is not defined
In terms of the total number of venipuncture attempts allowed per patient, 44 percent said this is not defined in facility policy. Of those with a limit in place, 19 percent reported four sticks is the maximum, with 13 percent stating the per-patient limit is two attempts.
Phlebotomy Today-Stat! 2/12
Drawing a Discard Tube
Participants had a lot to say about the circumstances for drawing a discard tube prior to collecting a sodium citrate (coag) tube on their patients. Nearly half (46%) responded that they only draw a discard tube prior to collecting a coag tube when using a butterfly set in combination with a tube holder. Two percent of those surveyed indicated that they only draw a discard tube for special factor assays, while 21 percent reported that they draw a discard tube for special factors assays and also when using a butterfly with a tube holder. For 15 percent of survey respondents, always drawing a discard tube prior to filling a coag tube is standard practice. At the other end of the spectrum, 13 percent stated that they do not draw discard tubes for coag samples under any conditions.
Phlebotomy Today-Stat! 7/11