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Phlebotomy Today

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November, 2016

Webinar Offers "Needle-Fear Friendly" Certificate

Need Fear Friendly SealPhlebotomists and other healthcare professionals interested in becoming "Needle-Fear Friendly" can learn from the industry's leading authority on needle pain in December.

Dr. Amy Baxter and MMJ Labs are hosting a free one hour webinar titled Needle Fear Friendly on December 1. Following the webinar is an optional online test that, if passed, earns the participant designation as a "Certified Needle Fear Friendly."

In the past two decades needle fear has increased 252 percent. Because fainting and vasovagal symptoms increase with fear, Dr. Baxter will discuss research-proven ways to identify those prone to this response, and decrease its frequency. She will also explore new strategies to reduce needle pain, including pharmacological, physiologic, and psychological approaches.

After this lecture, participants will be able to:

  • explain current theories on why needle fear is increasing;
  • demonstrate at least two ways to decrease vasovagal symptoms;
  • demonstrate three ways to decrease pain;
  • explain the Pain-Fear-Focus approach for pediatric patients.

To reserve your spot for the event, email webinar@mmjlabs.com. 

Ernst to Chair Patient ID Standard

Standard on blocksThe Clinical and Laboratory Standards Institute recently appointed Center for Phlebotomy Education director, Dennis J. Ernst MT(ASCP), NCPT(NCCT), to chair the committee revising the industry standard on patient identification and sample labeling. Ernst has previously chaired several CLSI standards and guidelines, most recently the forthcoming revision of the venipuncture standard and a guideline titled "Essential Elements of a Phlebotomy Training Program." Both documents are due to be released in early 2017.

"To be chosen to chair this important standard is a true honor," says Ernst. "Patient identification and tube labeling is at the very heart of the preanalytic process. If those who draw blood samples get either step wrong, everything else that happens to the tube, including the test results that come from it, is either irrelevant or potentially catastrophic to the patient."

Ernst's co-chair for the committee is Anne-Marie Martel, recently featured in Phlebotomy Today-STAT! as an industry mover & shaker. "Anne-Marie is a rock start in standards development," says Ernst. "She's the voice of reason on every committee we've shared, and knows the importance of attaining consensus."

Ernst and Martel recently finalized their selection of committee members from dozens of volunteers around the globe who expressed an interest. "We were really taken aback by the number of applicants who wanted to participate in this document, and the depth of their expertise," says Ernst. 

Patient identification and sample labeling errors committed by laboratory personnel result in over 160,000 negative patient outcomes each year in the U.S. Eleven percent of all transfusion deaths occur because the phlebotomist either misidentified the patient or mislabeled the sample. 

Product Spotlight: DVD Blowout

LectureCollection_6set_1000wIf you've been waiting for our industry-leading DVDs to go on sale, your patience is being rewarded. The complete set of the Applied Phlebotomy Lecture series is now half price! Until December 31, 2016, you'll save $777 when you purchase the following titles as a set:

  • Seizing Control of Blood Culture Contamination Rates
  • Ending Hemolysis in the ED... and Everywhere Else
  • Mastering Pediatric Phlebotomy
  • Potassium Results Your Physicians Can Trust 
  • Delivering World-Class Customer Service
  • Successful Strategies for Difficult Draws

The six-set Applied Phlebotomy Lecture Collection is a series of studio-recorded adaptations of presentations given by Dennis J. Ernst MT(ASCP), NCPT(NCCT), the Center for Phlebotomy Education's director. The DVDs were produced in 2014 and 2015, and are in use at healthcare facilities and educational institutions around the world. All titles reflect the current industry standards. According to Ernst, these titles will not be affected by the upcoming revision of the CLSI venipuncture standard, expected to be released in the spring. 

"The information on these DVD is timeless, and represents the body of knowledge for each subject," says Ernst. "Being immersed in the preanalytic realm, we have spared no expense to make these as accurate and comprehensive as possible. We know budgets are tight, and want to make sure every educator and manager has access to this critical information. There's no better way to spend down at the end of the year than investing in DVDs from the industry's most trusted source."  

Each DVD provides access to an online CE exercise educators can use to assess comprehension as an in-house CE exercise. P.A.C.E. continuing education credit is also available for a nominal additional fee.

More information.

What Should We Do?: NICU staff questioning our heelsticks

Babies (24)The nurses in our NICU have recently become critical of the placement of our heelsticks on newborns, the frequency of bruising, and the volume of blood we can collect from one stick. Our staff is very well trained and most of the phlebotomists have 5+ years' experience. I have had our trainer observe the staff and confirm they are placing the lancet correctly. Heelsticks are going to bruise, so I don't think there's any way around that. As for volume, the unit manager is stating that there should be a limit to how much blood can be obtained from one skin puncture, beyond which we need to perform a venipuncture, but still put the blood into microcapillary containers rather than collection tubes. It seems to me as long as the blood is flowing we should be able to continue collecting. What should we do?

Our response: We wonder why the nurses seem to think your trainer's assessment isn't acceptable. If the criticism is only recent, could it be originating from a new staffer who is misinformed about proper heelstick locations, and is spreading his/her misperceptions? Perhaps you need to show him/her the image in the CLSI skin puncture standard showing the acceptable areas of the heel. Support for his/her perception of the correct location should also be pursued.

Bruising, however, is another matter and should not be accepted as the norm. If you can confirm the frequency and degree, then a conversation with your staff on prewarming and applying pressure is in order.

As for volume limits, we feel confident there is no limit to the amount of blood that should be obtained by one skin puncture or incision. The manager will be hard-pressed to provide evidence in the literature to support his/her position. Tell him/her the committees that write and revise the industry standards for skin puncture and venipuncture are comprised of highly regarded authorities in the industry. Tell him you've contacted the chairholder of both documents, and that we've seen no evidence that the volume of blood obtained from a skin puncture should be limited to a level at which a venipuncture should be performed. As long as the blood is flowing well, there is no issue. 

Transferring venous blood into microcapillary containers seems like a clumsy, dangerous, and unnecessary alternative. We would recommend squelching the idea as an approved technique. 


Got a challenging phlebotomy situation or work-related question? 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.)

Center Opens Online Store Just For Phlebotomists

MerchandiseGroupThe Center for Phlebotomy Education is opening a new online store offering merchandise just for phlebotomists.  

Aptly named, Just For Phlebotomists helps phlebotomists promote their profession and proclaim the critical role they play in healthcare. The shop offers a variety of shirts, mugs, hoodies, hats, and other merchandise with images and text that lets phlebotomists show pride in their profession.

"Over the years, we've been almost exclusively an education company," says the Center's Director, Dennis J. Ernst. "But since phlebotomists are the backbone of the laboratory, and so critical to the care of every patient they draw, it's time to shout it from the mountaintops."

The Center is partnering with Cafe Press to host the growing collection of custom designs on a wide variety of clothing and accessories.

Visit Just For Phlebotomists.

The Empowered Healthcare Manager:

EmpoweredManagerWelcomeScreenShot_500wEvery month we run an excerpt from our editor's popular blog, The Empowered Healthcare Manager.

The Burden of Constant Affirmation 

Dawn (name changed) was a medical technologist who required constant affirmation. A good tech, but a time killer for her manager. Every day before going home she'd knock on her manager's door, enter whether invited in or not, and consume 20 minutes of his time. She'd start by giving a full report on everything she accomplished that day---all routine tasks that were expected of her---then sat back for an "attaboy."

After a while, the manager assured her he was pleased with her performance, and suggested a daily report wasn't necessary. He said she should assume her work was acceptable until told otherwise. Still, she squandered over an hour of his time every week, time he didn't have to spare. When it became necessary to reduce staffing, she was the first to go.

Although Dawn was technically proficient, had a solid work ethic, and got along with everyone, she was a liability to her manager. She disrespected his time and defied his request to stop begging for daily praise-biscuits for doing what she was hired to do.

People require affirmation for many reasons. They deserve it when it's earned but requiring daily affirmation is obsessive. It's not the manager's job to make up for parents who never praised their kids.

Salvaging otherwise good employees requires tact and respect. Here's the conundrum: deny the praise-starved employee of his/her daily biscuit and an otherwise top-performer feels perpetually inadequate and disenchanted. Provide daily affirmation and your own productivity tanks. The empowered healthcare manager shows needy employees why their needy-ness is disruptive and establishes boundaries. It's up to the employee to get the balance of their needs met elsewhere.

For Dawn, it's finding satisfaction within, and not depending on external sources for her praise. It's realizing management can never satisfy her hunger for affirmation, and daily attaboys soon become obligatory and insincere.

Recognizing employees for their accomplishments is Management 101. Empowered managers don't wait for accomplishments, but praise consistent performers for their consistency. They nurture, nourish, and recognize excellence. But they don't let needy employees insist they make up for where others in their lives fall short.

 Subscribe to the Empowered Healthcare Manager blog.

Survey Says: Your Magic Wand

 If you could wave a magic wand and solve just one problem in your workplace, what would that problem be?

Lady listeningOur readers couldn't wait to weigh in on this one. For this survey, we separately surveyed managers and staff. Among managers, the most common problem they wish they had a magic wand for was to fix the low wages their staff receives. Second most commonly cited was wishing their magic wand would transform to a team that functions as one cohesive unit. Wishing their own administrators would provide more support was cited as the third most common. Other problems managers thought a magic wand would come in handy for include reducing staff friction and permission to hire more staff.

Among phlebotomists and other front line staff, 29 percent said the problem they wish would go away is working short-staffed. Their second most common wish was that they would get a raise. Third on the list was that "my manager would grow a backbone and start standing up to people." Other problems staff wish they could eliminate with the wave of their magic wand include:

  • My manager would budget more for staff education
  • My coworkers would dress and conduct themselves more professionally
  • My manager would be more selective in who he/she hires
  • Putting an end to gossip among my coworkers
  • People not completing full Phlebotomy courses should not be taking the job of trained professionals.
  • Co-workers would change behaviors to A DUTY of CARE instead of a social circle time to ignore patient care and talk about recipes and knitting
  • Make sure everyone is doing their fair share of the work
  • More inclusive meetings that truly listen and problem solve
  • The CEO and other "heads" of the Health System would quit focusing on the almighty dollar and test scores and focus on outstanding patient care and employee satisfaction
  • Hospital administration would actually come see what the phlebotomists/lab staff do day-to-day before imposing extra rules and standards that hinder our ability to do our jobs well.

This month, we're asking our readers and visitors to our web site about when and how they label  their tubes. Take the survey.