Phlebotomist Duties and Responsibilities

In general terms, a phlebotomist is a health care worker who is responsible for performing venipuncture on patients in a medical environment such as a hospital, lab, or doctor’s office. A phlebotomist assists other medical workers by focusing entirely on the collection of blood, tissue, and fluid samples. The duties of a phlebotomist can be divided into four general functions:

  • Prepares and maintains necessary equipment and supplies.
  • Performs venipuncture, arterial puncture, capillary puncture, and other fluid collection. procedures on patients, and ensures specimens are appropriately labeled and identified.
  • Assists the patient before, during, and after collection of the specimen.
  • Must maintain patient confidentiality, keep necessary records, and document results.

Each portion of the process is equally important, and is often performed in addition to other medical office responsibilities and laboratory functions.

Preparation and Maintenance of Equipment and Supplies

Before a phlebotomist can begin collecting samples, they must first assure that all collection instruments and environments are sterile and ready for use. While it may seem that the phlebotomist is primarily concerned with the needle used to draw blood, the phlebotomist works with a large number of supplies. Gauze, bandages, tubing and collection devices are part of each blood draw, and the phlebotomist must ensure that an adequate amount of each supply is on-hand and ready for use.

Additionally, security supplies such as labels for blood tubes must be available. After collection, the phlebotomist is responsible for the proper disposal of sharps and the disposal or cleaning of any items contaminated with fluid or tissue samples. The phlebotomist must ensure the area where they collect samples is adequately sterile and safe for patients and employees alike.

Fluid Specimen Collection

After receiving direction from a physician or other licensed medical professional, the phlebotomist is responsible for collecting samples of blood and other fluids from patients. Depending on where an individual phlebotomist is employed, he or she may perform urine collection and other tests such as electrocardiography (EKG)s, however, the primary responsibility of the phlebotomist is the collection and proper handling of blood samples. The phlebotomist must correctly puncture or incise the patient’s skin to collect blood or tissue samples.

Based on the orders from the physician, the phlebotomist must ensure that the correct amount of blood or tissue is taken to perform the specified test. In order to collect a blood sample, the phlebotomist first finds a suitable vein to puncture with a needle. Most often, the phlebotomist will use the median cubital vein, located on the inner part of the forearm, just inside the bend of the elbow. The median cubital vein lies close to the surface of the skin in an area where there are not very many nerves present. If the phlebotomist is not able to obtain a sufficient sample from the median cubital vein, they must then attempt to find another suitable vein.

After the sample is collected, the phlebotomist is responsible for correctly labeling the container used for the fluid collection with necessary patient information used for identification. The phlebotomist is also responsible for completion and submission of documentation used to trace the sample from collection through lab work to final analysis and diagnosis, and finally, proper disposal of the sample.

Errors made by the phlebotomist can result in serious complications ranging from misdiagnosis or sample contamination. In order to prevent such errors, the phlebotomist must accurately label each sample, whether the sample is for donation or lab testing. The phlebotomist is also responsible for sending samples to the laboratory after collection, requiring the phlebotomist to ensure the correct sample is sent to the correct laboratory.

While this may seem like a small part of the phlebotomist’s duties, it is also one of the most important. Phlebotomists are at high risk for exposure to blood borne disease, and therefore their level of expertise is vitally important for both their own safety as well as that of others who may be exposed to the samples they collect. The phlebotomist must ensure samples are correctly handled to prevent contamination of the sample that can result in inaccurate results.

Patient Care – Before and After

The process of having blood drawn can be both uncomfortable and scary for patients. Some patients have a fear of needles, which may further complicate the phlebotomist’s job. In order to ensure proper specimen collection and to reduce patient anxiety, the phlebotomist must be reassuring, patient, and ready and able to answer questions the patient might have. Prior to specimen collection, the phlebotomist must ensure that the correct patient is receiving treatment by verification of the patient’s identity. This is vital to ensure the correct test is performed and the correct results are returned to the patient. During the blood draw, the phlebotomist must also monitor the patient to ensure they do not move or faint during the process, potentially causing injury to the patient or contamination.

The 2003 revision of the patient bill of rights entitled “The Patient Care Partnership” lists the first responsibility of all healthcare professionals, including phlebotomists, “as the provision of high-quality health care in a clean and safe environment while maintaining the patient’s personal rights regardless of any cultural, religious, racial, gender, age, or any other differences.” One way that phlebotomists ensure a “clean and safe environment” is by practicing adequate infection control protocols. The infection control program is “responsible for protecting patients, employees, visitors, and anyone doing business within healthcare institutions from infection (McCall, 2008).” For the phlebotomist, this includes correct hand washing techniques, wearing appropriate personal protective equipment (PPE), and proper disposal or cleaning of items contaminated by blood or other biological material.

Patient Confidentiality and Documentation

As in all areas of healthcare, the phlebotomist must recognize and respect the rights of the patient, which include the right to confidentiality of medical records. “Patient confidentiality is seen by many as the ethical cornerstone of professional behavior in the healthcare field (McCall, 2008).” The 1996 Healthcare Privacy and Portability Act (HIPPA) underscored the commitment of those in the healthcare field to maintaining the private information of patients, and provided for stiff penalties as a result of unauthorized release of personally identifiable information. It is the responsibility of the phlebotomist to ensure information is released only to those individuals who require it in order to provide patient care (Price, 1999).

The medical record is the most important document both in terms of patient care and for legal and financial accountability for the health care practitioners involved. The phlebotomist is responsible for accurately documenting specimen collection, tests ordered, and results of tests. The phlebotomist ensures that correct documentation is provided to the laboratory to ensure the tests ordered by the physician are performed and results are returned to the patient. Records of the collection and the results become an important part of the medical record, and can be used in diagnosis and development of treatment plans for the patient.

Conclusion of Phlebotomist Duties

While the duties of a phlebotomist may vary, the primary job of the phlebotomist is to collect, label, and submit samples of blood, urine, or tissue for donation or analysis in a laboratory. The phlebotomist plays a vital role in the healthcare setting by focusing on the collection of samples for testing, freeing doctors and nurses to perform other duties. The information provided by the analysis of samples collected by phlebotomists has many implications in the health outcome of the patient.

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