Scope of Practice

                                     
Scope of  Practice for Phlebotomy Technician Professionals 2021

The NAPTP has developed the scope of practice for Phlebotomy Technicians on the basis of evidence in the health care field, in the hopes of benefiting and promoting the patient’s health and well being.

Provision 1.  The Phlebotomist shall at all times provide and employ therapeutic communication skills for the purpose of showing compassion, lowering anxiety levels and being able to unmask more serious issues that may need to be reported to the supervisor.  Therapeutic communication includes active listening, use of positive body language and making appropriate eye contact.

Provision 2.  The Phlebotomist shall not reveal, explain or elude to a patient’s lab results or tell a patient a result is good or bad.  This conversation is the physicians responsibility only.

Provision 3.  The Phlebotomist will at all times maintain a clean environment, recognize that there are 3 main sources of infection, the patient, the environment and the phlebotomist.

Provision 4. The Phlebotomist will employ the 5 rights of patient identification prior to any blood draw; Patient’s name (first and last), patient must spell name, both first and last; verify correct laboratory test, correct time of test, correct equipment, correct vein, and correct order of draw.

Provision 5. The Phlebotomist will at all times ask patients permission first prior to performing a blood draw.  If the patient says, “No”, then the phlebotomist will  NOT draw their blood.

Provision 6.  The Phlebotomist will not draw in any vein other than the medial cubital, basilic or cephalic.

Provision 7.  The Phlebotomist will understand the order of draw.

Provision 8.  The Phlebotomist will perform both urine drug screens, and collect stool cultures by proper collection methods.

Provision 9.  The Phlebotomist will understand how to collect blood cultures, keep the vials out of direct sunlight, and never shake but instead swirl the vials.  Never use alcohol on the site but use instead chlorohexidine.

Provision 10.  The Phlebotomist will at all times wash hands before and after each blood draw in front of the patient if possible.

Provision 11.  The Phlebotomist will at no time take a physician orders.

Provision 12.  The Phlebotomist is able to tell the patient what labs are being drawn, however they cannot tell the patient why.

Provision 13.  The Phlebotomist will not discriminate against any patients race, religion, beliefs, age, weight, gender, handicap or physical appearance.

Provision 14.   The Phlebotomist will apply all infection control procedures for isolation such as, respiratory precautions, droplet precautions, contract precautions and understand what a negative pressure room entails.

Provision 15.  The Phlebotomist will understand Maslow’s Hierarchy of needs of each patient, and Erikson’s psychosocial developmental theory for each patient:

Erik Erikson was an ego psychologist who developed one of the most popular and influential theories of development. While his theory was impacted by psychoanalyst Sigmund Freud’s work, Erikson’s theory centered on psychosocial development rather than psychosexual development.

 

The stages that make up his theory are as follows:

Provision 16.  The Phlebotomist will at all times obtain permission from the patient, if the phlebotomist is unable to communicate with the patient due to being in an obtunded or coma state, then the Phlebotomist will obtain the patients information from the nurse in charge and will speak to the patient and ask the patient the questions just as if they patient is able to hear. (Evidence based reasoning: Patients in coma states are able to hear.  Hearing is the last sense to leave before death.)

Provision 17.  The Phlebotomist will not draw from any other veins other than those in the antecubital fossa.

Provision 18.  The Phlebotomist will not turn off any machines attached to patient or remove tubing, ie IV pump or drip, feeding tube, chest tube.  The Phlebotomist must ask the nurse to do this prior to a blood draw.

Provision 19.   The Phlebotomist will at all times report all witnessed abuse to their supervisor and if unable to move forward with action, proceed to the hospital supervisor.  (Use chain of command)

Provision 20.  The Phlebotomist will understand centrifugation and how to centrifuge both micro tubes and regular SSTs.

Provision 21.  The Phlebotomist will perform both infant heel sticks and finger sticks according to their hospital guidelines, but never put a hot compress on an infants heal due to chance of burning their skin. (Infants skin is very thin and is sensitive to heat.)