The privilege extraccionistasdisfrutan patient trust , since they are allowing performing an invasive procedure that ordinarily offer any healthy individual suffering , The axiom "first, do no harm " (3 ) applies to doctors as to phlebotomists . In fact , the etymology of the word "safe" is "saved " meaning " free from harm "
During phlebotomy errors can cause serious harm to patients , and even death , directly or indirectly. This statement might seem radical to us to investigate the many possible errors that might occur while performing the procedure for the collection of a blood sample . It is therefore essential to ensure that they perform and manage quality practice during phlebotomy . The phlebotomist , which usually works independently without direct supervision in the hospital or that is available to the outpatient must take personal quality management in their own work. Quality management is to promote intentional results in real time , with the use of materials and methods of practice.
At first let us take a look at a list of typical errors that can occur during phlebotomy (4 )
- Identification of the patient .
- Communication with the patient
- Selecting the venipuncture site
- sites capillary skin puncture
- Selecting the right equipment
- Special considerations related to patients.
Patient Identification
The reliable identification of the patient is not indefensible. The phlebotomists must be trained from day to recognize the importance of accurately identifying patients.
The phlebotomists must also know the possible result of not following the protocol easy identification of patients . Failure to follow established protocol identification could lead to a treatment or lack of treatment of the patient. If the patient has not been identified correctly by the phlebotomist Blood Bank and Transfusion Medicine Service the end result could be fatal.
The physician relies on the characterization of the clinical laboratory to provide accurate test results that allow the diagnosis of disease and / or for monitoring the course of a disease or treatment.
Each activity should have a written protocol that establishes the procedure as it applies to the identification of hospital patients and outpatients practice glove . Must be at least two identifiers for both types of patients. ( May )
Typically, the primary identifier for a hospital patient is the hospital identification bracelet found on the wrists of children and adults and elderly patients or ankles of neonatal patients . The secondary identifier should be established and should be used by all employees who need to identify the patient. In putting outpatient primary identifier is usually writing practice physician while the secondary identifier may be the date of birth or social security number . To check drug or other legally a photograph sensitive test that identifies the patient may be required to practice. (This is the case of blood donors , which must inevitably submit the photo identification ) .
The staff needs to be trained phlebotomists in their identification protocol . If they understand the importance of complete patient identification and know what can happen to a patient if they ignore the rules, and will probably meet more closely the rules. You need to " put teeth " in its identification protocol using corrective action when a staff member chooses not to follow the protocol.
Patient Communication
Communication is the means by which information is exchanged or transferred between the phlebotomist and patient. Communication involves three components : verbal , non - verbal , and listening. (6)
There will always be the opportunity for error when a phlebotomist does not communicate properly with him or her patients.
When a phlebotomist comes to a patient, or that enters its box, the first thing he should do is identify , stating his name and that he is the laboratory and inform him that he will draw blood for laboratory studies requested by your doctor . He is informing the patient and is getting the patient's permission to advance. Patients are achieved by the AHA Patient Bill of Rights. (7 ), the patient has the right of refusal for any procedure. If a phlebotomist does not seem to listen to your patient and / or ignores a verbal or non-verbal refusal , he is guilty of harassment and assault . If the patient has the perception that the phlebotomist is ignoring its negative and think forward to perform the procedure , this is the intent ( attack). If the phlebotomist should lay a hand on the patient , this is the test of aggression although there is no harm done to the patient.
When the phlebotomist comes to the patient's room the first activity to be performed is to correctly identify the patient.
If the patient is asleep , day or night , the phlebotomists must awaken . If the phlebotomist tries to extract blood from a patient asleep, identification errors may occur or physical injury to the patient. This would also prevent the patient give appropriate informed consent and could produce a legal action for harassment or assault .
The attack can be defined as unjustified effort to touch another person or threatened to do so, causing the perception in the other person, that this will take place .
Aggression is the intentional touching of another person without their consent. Aggression includes the attack because the two words are combined in the assault and battery (8 )
Selecting the venipuncture site
When a phlebotomist chooses to ignore the selection rules for venipuncture site , he or she runs the risk of causing harm to their patients. See Table 1 for a selection guide venipuncture site .
If a phlebotomist has chosen to use the basilar vein when usable antecubital or cephalic vein and the patient suffers arterial puncture or nerve damage - with the possibility of loss of arm movement or bleeding in the arm - the action can legally be taken by both the patient and the doctor of it.
If there is no written order from the physician and the phlebotomist performs the extraction of one foot complications occur when you get up there will be no possible defense in the courtroom when the patient or doctor take legal action.
If a phlebotomist uses the bottom of the wrist which is an area extraction , there is the possibility of puncturing the radial or ulnar nerve or artery . Clicking the nerve in the bottom of the wrist can cause temporary nerve damage or permanent and the patient may lose the ability to open and close your hand.
Sites capillary skin puncture
When a phlebotomist makes the mistake of ignoring the appropriate site for capillary skin puncture , they may harm the patient . See Table 2 for a guide to the sites for capillary skin puncture .
The callus develops thumb daily use with the index finger as opposed fingers . It may be impossible to restore adequate blood sample of a thumb . Certain occupations lead to proliferation in callus growth , such as sailors and cowboys who work with rope or seamstresses who work with rough fabrics like burlap.
Puncturing the index finger can be painful due to the numerous threads on this finger nerve , and the pain may intensify and may be extended through the use of this finger hand with the thumb .
Finger sticks when performed on the small little finger contact can occur with the bone.
The phlebotomist who choose to ignore the right places on a newborn 's heel and use the toes or the middle of the race behind the heel bone puncture risk . Drilling in these areas can cause osteomyelitis and / or osteoarthritis . If these baby foot areas come into contact with the dirty diaper poop may get an infection which in turn lead to septicemia.
Selecting the right equipment
The phlebotomist must choose used venipuncture venipuncture. Properly fit into the syringe needle . Failing this procedure could derail the process and cause harm to the patient.
Comments on Technical Aspects and Procedure
Each phlebotomist must be knowledgeable of the various phlebotomy techniques recommended (See Table 4 ) . They also must maintain knowledge about the possibility of different complications if they do not follow the technique properly . The phlebotomist needs to recognize the possibility of certain problems of a procedural and legal .
As you have read , there are many opportunities for error in the arena of phlebotomy . There are also opportunities for learning and knowledge that can prevent these errors are a fact.
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