PHLEBOTOMY AND

THE HEALTH CARE

DELIVERY SYSTEM
Medical Laboratory Science Program
College of Allied Medical Professions
Lyceum of the Philippines University - Batangas
 COPYRIGHT NOTICE
This material has been reproduced and communicated to you or on behalf of

Lyceum of the Philippines University- Batangas pursuant to

PART IV: The Law of Copyright of Republic Act 

RA 8293 or the "Intellectual Property Code of the Philippines".

The University does not authorize you to reproduce or communicate this material.
The material may contain works that are subject to copyright protection under RA 8293.
Any reproduction, and/or communication of the material
by you may be subject to take legal action against such infringement.

Do not remove this notice.

This material is prepared by the Faculty of the Department of Medical Laboratory Science,
LPU-Batangas College of Allied Medical Professions,
solely for the use of students enrolled in PRIN 2 for 2nd semester, A.Y. 2021-2022.

Please do not distribute without permission.

 “Phlebotomy”
Derived from the words:
Phleb/o – vein
-tomy – to cut or make an incision
Literal meaning is to cut a vein or make an
incision into a vein
One of the oldest medical procedures
known to man
 History of Phlebotomy
• In the early times people believed that four body fluids (humors)
represent four elements of the universe.
• Blood
• Phlegm
• Yellow bile
• Black bile
• Hippocrates believed that diseases are caused by an excess of any of
these body fluids and that removal of the excess would cause the body
to return to its healthy state.
• Thus, bloodletting (removal of blood) procedures had been their only
means to cure diseases and maintain the body in a state of well-being.
 History of Phlebotomy

oBlood letting techniques include:

1.Suction cup devices with lancets used to form an incision;
2.Application of blood-sucking worms called “leeches” to an
incision;
3.Barber surgery in which blood from an incision produced
by barber’s razor was collected in a bleeding bowl
Bloodletting Set of a Barber
Surgeon
 Phlebotomy
THEN
• Performed by a cut into a vein with
a sharp instrument to drain blood
• Performed by “barber-surgeons” or
trained persons
• Aseptic practices were not known,
so the lancet was reused for several
patients
NOW
• Performed using a variety of sterile
needle and lancets
• Performed by trained phlebotomist
• Standards of practice set by the
Clinical and Laboratory Standards
Institute (CLSI)
Who & What is a Phlebotomist?

◦ A phlebotomist is a trained medical personnel to

collect blood samples for laboratory analysis.
◦ Phlebotomists are skilled in this field and should
develop the necessary knowledge and skills and
proper attitude to carry out their tasks and
responsibilities as frontliners in allied health.
DUTIES OF A PHLEBOTOMIST
 A phlebotomist is a person trained to obtain blood
samples primarily through venipuncture and
microtechniques.

 In addition to technical, clerical, and interpersonal

skills, the phlebotomist must develop strong
organizational skills to handle a heavy workload
efficiently and maintain accuracy, often under
stressful conditions.
 TRADITIONAL DUTIES OF A
PHLEBOTOMIST
1. Correct identification and preparation of the
patient before sample collection.
2. Collection of the appropriate amount of blood by
venipuncture or dermal puncture for the specified
tests.
3. Selection of the appropriate sample containers for
the specified tests.
4. Correct labeling of all samples with required
information.
5. Appropriate transportation of samples back to the
laboratory in a timely manner.
 TRADITIONAL DUTIES OF A
PHLEBOTOMIST
6. Effective interaction with the patients and hospital
personnel.
7. Processing of samples for delivery to the appropriate
laboratory departments.
8. Performance of the computer operations and record-
keeping pertaining to phlebotomy.
9. Observation of all safety regulations, quality control
checks, and preventive maintenance procedures.
10. Attendance at continuing education programs.
 ADDITIONAL DUTIES OF A
PHLEBOTOMIST
1. Training other health-care personnel to
perform phlebotomy
2. Monitoring the quality of samples collected on
the units
3. Evaluation of protocols associated with sample
collection
4. Performing and monitoring point-of-care
testing (POCT)
 ADDITIONAL DUTIES OF A
PHLEBOTOMIST

5. Performing electrocardiograms (ECG)

6. Performing measurements of patient’s vital
signs
7. Collection of arterial blood samples
8. Collection of samples from central venous
access devices (CVADs)
 Professional and Personal
Characteristics for Phlebotomists
• Phlebotomists are part of a service-oriented
industry, and specific personal and professional
characteristics are necessary for them to be
successful in this area.
• Phlebotomists must always be professional at all
times.
 PROFESSIONALISM
•Professional image
• Appearance
• Attitude
• Dependable, cooperative, committed
• Compassionate, courteous, respectful
• Integrity, honesty, competence
• Organized, responsible, flexible
• Communication skills
• Bedside manners
 APPEARANCE
• Appearance makes a statement of who you are.
• Lab coats should protect clothing underneath.
• Shoes should be conservative (closed-toe) and
clean.
• Avoid dangling jewelries, facial piercings and
tattoos.
• Make-up should be conservatively applied.
 APPEARANCE
• Close attention to personal.
• Hair must be pulled back (tied).
• Fingernails should be kept short.
• Perfume and cologne must only be kept to a
minimum.
• CDC guidelines – when in contact with patients,
no artificial nails or extenders
 ATTITUDE
Dependability
• Able to be relied upon
• Self-directed in the importance of work
• Arrives on time, motivated to work, asset of the lab

Cooperative
• Plays an active role as a part of the health care team.

Committed
• Attends staff meetings, reads pertinent memos, observes
notices placed on bulletin board
 ATTITUDE
Compassionate
• deep awareness of distress of others and a desire to alleviate it.
• sensitive to patient’s needs and willing to offer reassurance

Courteous
• always ask permission when entering patient’s room
• Introduce yourself before doing any procedure
• ask permission for any procedure that you will be performing to the
patient

Respectful
• understand individual and cultural diversities
• use polite words and thank the patient after doing the procedure
 ATTITUDE
Integrity and Honesty
• doing what is right regardless of circumstances
• able to admit a mistake and takes corrective actions
• Respect for patient confidentiality

Competence
• Demonstrate competence in every procedure.
• Avoid overconfidence which can lead to serious error.
• Consult standard operating procedures (SOP) when you
had doubts on the methods.
• Never perform procedure that you have not been trained
to perform.
• Do not hesitate to ask assistance from more experienced
staff.
 ATTITUDE
Organized
• Maintain an organized and well-stocked collection tray
• Know which task should be of main priority
• Organize requisition forms

Responsible
• Performing assigned task with proper observance of turn-
around time

Flexible
• Can work on variable shifts without sacrificing the quality of
results
• Can work as a generalist if circumstances arise
COMMUNICATION SKILLS
• Good communication skills are needed by
phlebotomists because they will be the liaison
officer between the laboratory and their
patients, family, visitors and other health care
personnel.

• 3 components of communication
• Verbal skills
• Non-verbal skills
• Listening skills
 COMMUNICATION SKILLS
1. VERBAL SKILLS enable phlebotomists to:

a. Introduce themselves
b. Explain procedure
c. Assure and reassure the patient that the procedure is
being competently performed
d. Always use easily understood vocabulary.
COMMUNICATION SKILLS
2. NON-VERBAL SKILLS include:

a. Facial expressions, posture and eye contact

b. Always ensure positive body language
(knock, walk into the room, smile and look
directly to the patient while talking)
c. Allow patients to maintain their zones of
comfort.
American Zones of Contact
ZONE AMOUNT OF
DISTANCE
Intimate 2 feet
Personal 2 to 4 feet
Social 4 to 12 feet
Public > 12 feet
COMMUNICATION SKILLS
3. LISTENING

oFoundation for good interpersonal communication

oImportant for the establishment of rapport
oLook directly and attentively to the patient
oEncourage patient to express feelings, anxieties and
concerns.
oProvide feedback to appropriate responses
oEncourage patient communication by asking questions.
 Communication Barriers
Barrier Methods to Overcome

Hearing impairment Speak loudly and clearly.

Look directly at patient to facilitate lip-
reading.

Patient emotions Speak calmly and slowly.

Do not appear rushed or disinterested.
 Communication Barriers
Barrier Methods to Overcome
Age and education Avoid medical jargon, you are collecting
levels a blood sample rather than performing a
phlebotomy.
Use age appropriate phrases.
Non- English- Locate a hospital-based interpreter.
speaking Use hand signals, show equipment, etc.
Remain calm, smiling, and reassuring.
 General Cultural Diversity Guidelines
for Phlebotomists
1. Approach all patients with a smile and use a friendly
tone of voice.
2. Be alert to patient reactions . Do not force your style
on them.
3. Do not stereotype a particular culture; not all people
of same ethnic culture react in the same manner.
 General Cultural Diversity Guidelines
for Phlebotomists
4. Remember the amount of personal space varies not
only among people but also among cultures. Certain
cultures are not as welcoming to touching as we might
expect them to be.
5. Plan to spend additional time explaining procedures
and patient instructions.
6. Above all, show respect for their diversity.
TELEPHONE SKILLS
• Answer the phone promptly and politely, stating the name of
the department and your name.
• Return to calls that are on hold as soon as possible.
• Keep writing materials beside the phone to record
information.
• Provide accurate and consistent information by keeping
current with laboratory policies.
• Speak clearly and make sure you understand what the caller
is asking and that he or she understands the information you
are providing. This is done by repeating what the caller has
asked and asking the caller to repeat the information you had
given.
BEDSIDE MANNERS
• Interpersonal communication with
relatives / visitors
• Family members can offer
help/assistance especially to those
non-cooperative patients like
(children, those with special needs,
elders)
 Basic Phlebotomy Etiquette
• Proper patient identification is MANDATORY. If an
inpatient is able to respond, ask for the full name and always
check the armband for confirmation. DO NOT DRAW
BLOOD IF THE ARMBAND IS MISSING.
Proper Identification Is a Three-Step Process

ASK
 COMPARE

 VALIDATE
 PHLEBOTOMY EDUCATION
AND CERTIFICATION
CERTIFYING ORGANIZATION PHLEBOTOMIST DESIGNATION

1. American Medical Technologists (AMT) Registered Phlebotomy Technician, RPT

(AMT)

2. American Society for Clinical Pathology Phlebotomy Technician , PBT, (ASCP)

(ASCP)

3. American Society of Phlebotomy Certified Phlebotomy Technician, CPT,

Technicians (ASPT) (ASPT)

4. National Phlebotomy Association (NPA) Certified Phlebotomy Technician, CPT,

(NPA)

5. National Healthcareer Association (NHA) Certified Phlebotomy Technician, CPT,

(NHA)
 HOSPITAL SERVICES AND
DEPARTMENTS
Area Description
Emergency Immediate Care
department (ED)
Intensive care unit Critically ill patients
(ICU)
Cardiac care unit Patients with acute cardiac
(CCU) disorders
Pediatrics Children
Nursery Infants
Neonatal intensive care Newborns experiencing difficulty
nursery (NICU)
 HOSPITAL SERVICES AND
DEPARTMENTS
Area Description
Labor and Delivery (L&D) Childbirth

Operating Room (OR) Surgical procedures

Recovery Room (RR) Postoperative patients

Psychiatric unit Mentally disturbed patients

Dialysis unit Patients with severe renal disorders

Medical/surgical units General patient care

 Support and Fiscal Services
Departments
Department Primary Functions
Engineering and Maintains hospital’ s physical plant
Maintenance including communications and clinical
equipment
Housekeeping/ Maintains a sanitary and safe hospital
Environmental Services including laundry, cleaning of patient rooms,
and disposal of biological waste

Dietary/ Food Service Prepares and serves food and provides

nutrition care and education

Business office Performs daily business functions including

patient accounts, paying bills, and payroll
 Support and Fiscal Services
Departments
Department Primary Functions
Admitting Processes patient admissions and
discharges
Marketing/ Public Promotes hospital services to the
relations community

Health information Maintains patient records and hospital

Management legal and regulatory documents

Human resources Recruits, interviews, and orients new

employees. Provides employee benefit
and salary information
 Professional Services Departments

Professional Services Functions

Department

Radiology and Diagnostic Uses radiant energy to diagnose diseases

Imaging (CT-scan, X-rays, MRI, mammogram)

Radiation Therapy Uses high energy radiation to stop the

growth of cancer cells
Nuclear Medicine Uses radioisotopes in the diagnosis of
diseases
Occupational Therapy Enable patients with physical, mental, or
emotional disabilities to function within
their limitations
Pharmacy Dispenses medications prescribed by
physicians
 Professional Services Departments
Professional Services Functions
Department

Physical therapy Provides treatment to patients who had

been disabled as a result of illness or injury

Respiratory Therapy Provides treatment in breathing disorders

to evaluate lung function; perform arterial
puncture and arterial blood gas analysis

Cardiovascular Testing Performs ECG’ s, stress tests and imaging

techniques for cardiac diseases

Clinical Laboratory Provides analysis of body fluids for

diagnosis and treatment of diseases
 Miscellaneous Health Care
Facilities
Health Care Facilities Description
Physician Office Laboratories laboratory where the tests performed
(POL’ s) are limited to those done for the
physician’ s own patients that are
seeking medical consultation.

Health Management Provides medical insurances for

Organizations (HMO’ s) members

Reference Laboratories also known as referral laboratories

gets specimens from many different
places such as doctor’ s offices,
hospitals and clinics and performs
special tests not performed on
ordinary clinical laboratories
 Miscellaneous Health Care
Facilities
Health Care Facilities Description
Point-of-Care Testing laboratory testing near the site
(POCT) of patient care rather than in the
clinical laboratory

Government and Public health care facilities

Hospital Clinics
Home Health Care Health care services rendered
outside a hospital facility (e.g.
nursing homes)