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Read the case studies part abc provided and answer all of the questions

Read the case studies part abc provided and answer all of the questions

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Read the case studies part abc provided and answer all of the questions
Case Studies CASE STUDY 2-1: QUALITY ASSURANCE IN A COW LABORATORY The Cow laboratory in a large internal medicine group practice performed over 50 waived tests a day. The medical assistants and the phlebotomists who performed the waived testing were all trained on the job. It was obvious from the inconsistent results recorded on the cumulative report that everyone's technique differed somewhat. When notification came from CLIA that they would be visiting the site within the next month, the lead physician decided that a QA pro- cess had to be put into place. The laboratory staff were directed to the CLIA website for instructions on waived testing stan dardization in the form of GLPs issued by CLIAC. Questions 1. What are CLIA and CLIAC? 2. Why is CLIA visiting their site? 3. What are the GLPs, and what makes them valuable in standardizing the waived testing process? 4. What are other examples of QC components that could be put in place in this laboratory setting? CASE STUDY 2-2: BLOOD DRAW FAILS DELTA CHECK It was a busy day in the hospital laboratory since two phle- botomists were out for medical reasons. An order came from the fourth floor for a timed draw. A phlebotomist from a tem- porary agency, who was supposed to have gotten off 2 hours earlier, was still there. No one else was there to collect the specimen. Knowing how important it was, the temp decided to go ahead and collect it. The patient was seated in a chair between the beds. The phlebotomist asked the patient for his last name and bed number. When the seated patient answered with the right last name and pointed to the cor- rect bed, the phlebotomist proceeded to collect the specimen while the patient sat in the chair. The phlebotomist labeled the specimen tubes at the nursing station while noting the draw on the desk clipboard. When a second specimen was drawn from the patient later that morning, it failed the delta check. The second specimen was recollected, and the results showed the specimen that was drawn by the temporary phle- botomist had been drawn in error. Questions 1. What is a delta check? 2. What do you see that could have caused this discrepancy? 3. What should the phlebotomist have done differently? 4. What were the phlebotomist's obligations to the laboratory after the assigned shift was over? 5. If the patient was injured as a result of the phlebotomist's action, what would it be called in legal terms? 6. Who is ultimately responsible for the temporary phlebotomist's actions while at work? CASE STUDY 2-3: NERVE INJURY A phlebotomist prepares to draw three tubes of blood from an outpatient. The only vein that is visible is the basilic vein on the right arm. The phlebotomist was taught that the basilic vein is the last choice for venipuncture because it is hard to anchor and a major nerve and artery lie close to it. However, the vein is so large the phlebotomist decides that it can be drawn without a problem. When the needle is inserted, sure enough, the vein rolls and the needle slips beside the vein. The patient cries out in pain, and jerks that arm. The needle goes even deeper, but blood begins to flow into the tube, so the phlebotomist contin- ues the draw. The patient says it is hurting and to pull the nee- dle out, but the tubes are filling quickly, so the phlebotomist continues to fill all three before ending the draw. The patient is still in pain and the arm begins to swell in the area of the draw. The phlebotomist quickly wraps a pressure bandage around the arm and dismisses the patient. The patient is later diag- nosed with permanent nerve injury and sues the clinic. Questions 1. Can the phlebotomist be held liable for the patient's injury? 2. What tort might be involved in this case? 3. Do you think the standard of care was breached? Why or why not?
Transcribed Image Text:Case Studies CASE STUDY 2-1: QUALITY ASSURANCE IN A COW LABORATORY The Cow laboratory in a large internal medicine group practice performed over 50 waived tests a day. The medical assistants and the phlebotomists who performed the waived testing were all trained on the job. It was obvious from the inconsistent results recorded on the cumulative report that everyone's technique differed somewhat. When notification came from CLIA that they would be visiting the site within the next month, the lead physician decided that a QA pro- cess had to be put into place. The laboratory staff were directed to the CLIA website for instructions on waived testing stan dardization in the form of GLPs issued by CLIAC. Questions 1. What are CLIA and CLIAC? 2. Why is CLIA visiting their site? 3. What are the GLPs, and what makes them valuable in standardizing the waived testing process? 4. What are other examples of QC components that could be put in place in this laboratory setting? CASE STUDY 2-2: BLOOD DRAW FAILS DELTA CHECK It was a busy day in the hospital laboratory since two phle- botomists were out for medical reasons. An order came from the fourth floor for a timed draw. A phlebotomist from a tem- porary agency, who was supposed to have gotten off 2 hours earlier, was still there. No one else was there to collect the specimen. Knowing how important it was, the temp decided to go ahead and collect it. The patient was seated in a chair between the beds. The phlebotomist asked the patient for his last name and bed number. When the seated patient answered with the right last name and pointed to the cor- rect bed, the phlebotomist proceeded to collect the specimen while the patient sat in the chair. The phlebotomist labeled the specimen tubes at the nursing station while noting the draw on the desk clipboard. When a second specimen was drawn from the patient later that morning, it failed the delta check. The second specimen was recollected, and the results showed the specimen that was drawn by the temporary phle- botomist had been drawn in error. Questions 1. What is a delta check? 2. What do you see that could have caused this discrepancy? 3. What should the phlebotomist have done differently? 4. What were the phlebotomist's obligations to the laboratory after the assigned shift was over? 5. If the patient was injured as a result of the phlebotomist's action, what would it be called in legal terms? 6. Who is ultimately responsible for the temporary phlebotomist's actions while at work? CASE STUDY 2-3: NERVE INJURY A phlebotomist prepares to draw three tubes of blood from an outpatient. The only vein that is visible is the basilic vein on the right arm. The phlebotomist was taught that the basilic vein is the last choice for venipuncture because it is hard to anchor and a major nerve and artery lie close to it. However, the vein is so large the phlebotomist decides that it can be drawn without a problem. When the needle is inserted, sure enough, the vein rolls and the needle slips beside the vein. The patient cries out in pain, and jerks that arm. The needle goes even deeper, but blood begins to flow into the tube, so the phlebotomist contin- ues the draw. The patient says it is hurting and to pull the nee- dle out, but the tubes are filling quickly, so the phlebotomist continues to fill all three before ending the draw. The patient is still in pain and the arm begins to swell in the area of the draw. The phlebotomist quickly wraps a pressure bandage around the arm and dismisses the patient. The patient is later diag- nosed with permanent nerve injury and sues the clinic. Questions 1. Can the phlebotomist be held liable for the patient's injury? 2. What tort might be involved in this case? 3. Do you think the standard of care was breached? Why or why not?
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