BEST PRACTICES :: IMPROVING THE PATIENT EXPERIENCE
“Establishing effective coordination and partnerships between nursing and phlebotomy staff has been essential to the successful implementation of VADs for routine inpatient blood draws in our institution” says Jaime Noguez, PhD, DABCC, UHCMC’s Director of Chemis- try and Toxicology. “Raising awareness of the unique skills and needs of each member of the patient manage- ment team facilitated the development of sustainable workflows as well as an improvement in the patient experience regarding laboratory testing.”
The regulatory myth
Though many think there are regulations against phlebotomists touching IVs, it’s more myth than reality. “The FDA considers a prefilled syringe for saline flushes as a device, not a medication,” says Christopher Bland, PharmD, FCCP, FIDSA, BCPS, a Clinical Associate Professor at the University of Georgia College of Phar- macy. “The Joint Commission and the pharmaceutical industry at large agree. So, there’s no need for that mis- conception to prevent managers from giving phleboto- mists more vascular-access responsibilities with proper training except in those few states that impose other restrictions.” While it’s true phlebotomists cannot decide if an IV is necessary or assess an existing IV, regulations in three quarters of the United States either expressly allow or do not restrict unlicensed assistive personnel from insert- ing a VAD or flushing it with pre-filled saline if properly trained and delegated by a nurse.
Conclusion
A more holistic view of phlebotomists’ skills clearly shows phlebotomy professionals can be better utilized as venous-access specialists when they are given proper support from leadership, coordination with nursing, and the requisite education and training. Having expertise in reducing preanalytical errors, no professional is bet- ter suited to collect high quality blood samples by any method or with any device, including line draws. As the role of the phlebotomists breaks new ground and the necessity of a partnership with nursing becomes more obvious, the real winners of this practice change are the patients. By cutting the number of venipunctures in half or greater, patient satisfaction scores can rise to new levels in facilities bold enough to change the way they draw blood specimens.
Please visit
mlo-online.com for references.
Dennis J. Ernst MT(ASCP), NCPT(NCCT), is the Director of the Center for Phlebotomy Education and a consultant for Velano Vascular. A well-known speaker and author on preanalytics, Ernst is a passionate advocate of the phlebotomy profession and the prevention of preanalytical errors. He invites MLO readers to subscribe to Phlebotomy Today at
www.phlebotomy.com.
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