PowerPoint ® Presentation to Accompany
Phlebotomy:
A Competency-Based
Approach
Booth and Mundt
Chapter 6:
6-2
Patient Identification and
Specimen Requirements
McGraw-Hill
©2013 by McGraw-Hill Education. All rights reserved.
6-3
Upon completion of this chapter, you should
be able to:





Identify the parts and functions of a laboratory
requisition.
Identify the professional communication techniques of
the phlebotomist.
Comply with ethical and legal standards for
professional communication.
Carry out proper patient identification.
Recognize patient factors that may affect specimen
quality and test results.
McGraw-Hill
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6-4
Upon completion of this chapter, you should
be able to:


Describe the phlebotomist’s role in collecting,
transporting, and processing laboratory specimens.
Explain the phlebotomist’s role in maintaining accurate
and secure blood collection documentation.
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6-5
Orders for Laboratory Tests
(LO 6.1)

Inpatient
Chart
 Electronic health record (EHR)


Outpatient
Prescription
 Telephone
 Fax

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6-6
Laboratory Requisitions
(LO 6.1)
Entered in HIS or LIS
 Documentation of tests ordered
 Computer provides accession number

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6-7
Laboratory Requisitions (cont.)
(LO 6.1)

Required content
Patient’s name
 Patient’s date of birth
 Patient’s MRN
 Ordering physician’s name
 Type of test
 Test status
 Date and time test is to be performed

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6-8
Laboratory Requisitions (cont.)
(LO 6.1)
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6-9
Apply Your Knowledge
(LO 6.1)
Who can order a laboratory test?
Answer: Only physicians and other
licensed healthcare practitioners can order
laboratory tests on patients.
GOOD JOB!
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6-10
Greeting the Patient (LO 6.2)
Smile
 Behave professionally
 Identify yourself
 Outpatient setting



Reduce anxiety
Inpatient setting

McGraw-Hill
Knock and wait for
response
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6-11
Life Span Considerations (LO 6.2)

Pediatric patients
Talk directly to child
 Never lie
 Keep distracted


Geriatric patients
Repeat questions or
instructions as
necessary
 Be compassionate

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6-12
Sleeping Patients (LO 6.2)
Awaken gently
 Try not to startle
 Talk softly
 Inform patient before
turning on lights

Never attempt to collect a
specimen from a sleeping
patient!
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6-13
Apply Your Knowledge
(LO 6.2)
Why might an elderly patient
be confused?
Answer: Elderly patients may have some
memory loss, not understand their
situation, or be on medications that affect
their thinking ability.
GREAT!
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6-14
Code of Ethics (LO 6.3)

Ethics
Set of written rules, procedures, or
guidelines
 Helps determine right from wrong
 Varies by individual, religion, social status,
and heritage


Law

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Rule of conduct or action enforced by
controlling authority
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6-15
Legal Terms to Know (LO 6.3)
Respondeat superior
 Assault
 Battery
 Negligence/malpractice

Duty
 Derelict
 Direct cause
 Damages

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6-16
Preventing Malpractice (LO 6.3)
Burden of proof is
on plaintiff
 Follow guidelines to
prevent malpractice

Caring
 Communication
 Competence

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6-17
Patient’s Rights (LO 6.3)

Patients have the right to:
Refuse care
 Be treated with respect
 Have all records and information classified
as confidential
 Be informed about the purpose and
expected results of treatments
 Have access to their medical records

McGraw-Hill
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6-18
Informed Consent (LO 6.3)
Explain the procedure
 Interpret if necessary
 Gain the attention of distracted patients
 Get parent’s consent for minor children
 Inform the nurse or healthcare provider if
patient refuses

McGraw-Hill
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6-19
Apply Your Knowledge
(LO 6.3)
What are the three Cs to avoiding
malpractice lawsuits?
Answer: Caring, Communication, and
Competence
GOOD JOB!
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6-20
Patient Identification (LO 6.4)
Ask
 Compare
 Validate

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6-21
Inpatient Identification (LO 6.4)
Check ID band
 Compare with
requisition
 Ask nurse for
verification if
patient is sedated

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6-22
Outpatient Identification (LO 6.4)
Ask the patient’s name
 Ask for formal ID
 Ask the patient to verify information on
the requisition form
 Use at least two or three verification
items

McGraw-Hill
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6-23
Apply Your Knowledge
(LO 6.4)
What are the three steps to proper
patient identification?
Answer: Ask, compare, validate.
Excellent !!
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6-24
Labeling the Specimen (LO 6.5)

Label specimens immediately
After collection
 Before leaving the patient
 Apply label properly


Never label specimens that you did not
collect
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6-25
Required Information (LO 6.5)
Patient’s name
 Patient’s date of birth
 Unique patient identifier
 Collection time and date
 Collector’s identification

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6-26
Applying the Label (LO 6.5)
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6-27
Apply Your Knowledge
(LO 6.5)
What may happen if specimens from
two different patients have their labels
switched?
Answer: Both patients may receive
the wrong treatment; the hospital and
phlebotomist could be sued; the
GOOD
phlebotomist may be fired.
JOB!
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6-28
Factors Affecting Lab Tests
(LO 6.6)
Altitude
Geographical Location
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6-29
Factors Affecting Lab Tests (cont.)
(LO 6.6)
Temperature
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Hydration
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6-30
Factors Affecting Lab Tests (cont.)
(LO 6.6)
Stress
Posture and Exercise
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6-31
Factors Affecting Lab Tests (cont.)
(LO 6.6)

Timing of specimen collection


Specific timing required for some tests
Patient basal state
Fasting for at least 12 hours
 Little or no exercise


Diurnal variation

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Variation in analytes throughout the day
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6-32
Factors Affecting Lab Tests (cont.)
(LO 6.6)
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6-33
Factors Affecting Lab Tests (cont.)
(LO 6.6)

Dietary restrictions
Food
 Liquids
 Smoking


Special diets
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6-34
Medications and Lab Tests
(LO 6.6)

Interfering substances
(medications)
Cause abnormal color
in blood or urine
 Alter the level of
chemicals


Additives in collection
tubes
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6-35
Apply Your Knowledge
(LO 6.6)
Name factors that can alter laboratory
test results.
Answer: Altitude, temperature, hydration,
posture, exercise, stress, timing of
specimen collection, dietary restrictions,
compliance, and interfering substances
such as medications.
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6-36
Transporting Specimens (LO 6.7)

Prompt transportation
STAT tests
 Specimens that must be processed quickly


Off-site transportation
Medical courier service
 May require special handling procedures

McGraw-Hill
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6-37
Apply Your Knowledge
(LO 6.7)
Within what time limit must STAT
tests be performed in the lab?
Answer: Within 1 hour of collection.
GOOD JOB!
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6-38
Specimen Tracking (LO 6.8)
Record identification
 Update lab records

Questions about
specimen quality
 Status of test
collections
 Completion times

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6-39
Confidentiality (LO 6.8)

Health Insurance Portability and
Accountability Act (HIPAA)
National standard for electronic healthcare
transactions
 Protects patient privacy and confidentiality

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6-40
HIPAA Guidelines (LO 6.8)
Close patients’ room doors
 Do not talk about patients in public
places
 Turn computer screens away from public
viewing
 Log off computers when finished
 Close medical records when leaving

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6-41
Electronic Health Records (LO 6.8)

Health Information Technology for
Economic and Clinical Health Act
(HITECH)
Encourages EHRs (EMRs)
 Establishes standards for use

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6-42
Apply Your Knowledge
(LO 6.8)
What is the name of the act passed in
2010 that encourages the use of EHRs?
Answer: Health Information Technology
for Economic and Clinical Health Act.
GREAT!
McGraw-Hill
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6-43
Chapter 6 Summary
Laboratory tests may be ordered only by
a licensed healthcare practitioner.
 Laboratory requisitions must include
doctor’s name; patient’s name, age,
DOB, and ID number; tests to be
performed; and date and time for
specimen collection.

McGraw-Hill
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6-44
Chapter 6 Summary (cont.)
Communicating with patients in a
professional manner helps instill patient
confidence.
 Following a code of ethics during patient
interactions helps prevent accusations of
malpractice.
 Patients must consent and have the right
to refuse any procedures.

McGraw-Hill
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6-45
Chapter 6 Summary (cont.)
Patients must be identified using at least
two unique patient identifiers.
 Specimen labels must include patient’s
name, DOB, and unique patient
identifier; actual specimen collection time
and date; and collector’s ID.

McGraw-Hill
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6-46
Chapter 6 Summary (cont.)
Phlebotomists must document patient
situations that can compromise
specimen quality.
 Patient factors that may affect results
include altitude, geographic location,
temperature, hydration, posture,
exercise, stress, and deviation from
basal state.

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6-47
Chapter 6 Summary (cont.)
Specimens must be handled properly
and delivered to the lab promptly.
 Proper documentation allows for test and
specimen tracking.
 Patient information is stored in hospital
and laboratory computers as part of the
patient’s EHR.

McGraw-Hill
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