Phlebotomist | Urban Institute

COMPETENCY-BASEDOCCUPATIONALFRAMEWORKFORREGISTEREDAPPRENTICESHIP

PhlebotomistONETCode:31.9097.00

RAPIDSCode:2036

Created:November2018

Updated:February2019

Thisprojecthasbeenfunded,eitherwhollyorinpart,withFederalfundsfromtheDepartmentofLabor,Employment

andTrainingAdministrationunderContractNumberDOL-ETA-15-C-0087.Thecontentsofthispublicationdonot

necessarilyreflecttheviewsorpoliciesoftheDepartmentofLabor,nordoesmentionoftradenames,commercial

products,ororganizationsimplyendorsementofthesamebytheU.S.Government.

ForMoreInformation,Contact:

DianaElliott,SeniorResearchAssociate,UrbanInstitute:[email protected]

RobertLerman,PhD,InstituteFellow,UrbanInstitute:[email protected]

ACKNOWLEDGMENTS I I

ABOUTTHEURBAN INSTITUTE ThenonprofitUrbanInstituteisdedicatedtoelevatingthedebateonsocialandeconomicpolicy.Fornearlyfivedecades,Urbanscholarshaveconductedresearchandofferedevidence-basedsolutionsthatimprovelivesandstrengthencommunitiesacrossarapidlyurbanizingworld.Theirobjectiveresearchhelpsexpandopportunitiesforall,reducehardshipamongthemostvulnerable,andstrengthentheeffectivenessofthepublicsector.

AcknowledgmentsWearegratefultoRebeccaMalbergvonLoewenfeldtandNeelanGuptaoftheHealthcareCareer

AdvancementProgram(“H-CAP”)fortheirhelpwiththisdocument.Wealsothanktherepresentativesofthe

healthandmedicalfieldwhocontributedtothiseffort,includingthefollowingprofessionals.

MichelleBlack,DirectorofEducationNationalPhlebotomyAssociationDennisErnst,ExecutiveDirector,CenterforPhlebotomyEducationHelenMaxwell,ExecutiveDirectorAmericanSocietyofPhlebotomyTechnicians

DianeCrawford,CEONationalPhlebotomyAssociationLauraLemenca,InstructorDelmarCollegeAaronRock,PhlebotomistQuest

CONTENTS I I I

ContentsCompetency-BasedOccupationalFrameworks iv

ComponentsoftheCompetency-BasedOccupationalFramework vUsingtheCompetency-BasedOccupationalFrameworktoDevelopaRegisteredApprenticeship

Program vi

PhlebotomistOccupationalOverview 1OccupationalPurposeandContext 1PotentialJobTitles 1ApprenticeshipPrerequisites 1OccupationalPathways 2AttitudesandBehaviors 2Certifications,LicensureandOtherCredentialRequirements 3JobFunctions 3StackablePrograms 4OptionsandSpecializations 4Levels 5

WorkProcessSchedule 6RelatedTechnicalInstructionPlan 9

Cross-CuttingCompetencies 10

DetailedJobFunctions 12JOBFUNCTION1:PerformClericalFunctions 12JOBFUNCTION2:PerformPhlebotomy 14JOBFUNCTION3:ProcessSpecimens 17JOBFUNCTION4:TransportandHandleNonbloodSpecimens 19JOBFUNCTION5:PerformandAssistwithClinicalLaboratoryImprovementAmendments(CLIA)-Waived

Testing 20JOBFUNCTION6:MaintainSafeEnvironment 21JOBFUNCTION7:ContinueProfessionalDevelopmentEducation 23

References 24

StatementofIndependence 25

I V COMPETENCY -BASED OCCUPAT IONAL FRAMEWORKS

Competency-BasedOccupationalFrameworksTheUrbanInstitute,undercontractbytheU.S.DepartmentofLabor,hasworkedwithemployers,subject

matterexperts,laborunions,tradeassociations,credentialingorganizationsandacademicstodevelop

Competency-BasedOccupationalFrameworks(CBOF)forRegisteredApprenticeshipprograms.These

frameworksdefinedthepurposeofanoccupation,thejobfunctionsthatarecarriedouttofulfillthat

purpose,thecompetenciesthatenabletheapprenticetoexecutethosejobfunctionswell,andthe

performancecriteriathatdefinethespecificknowledge,skillsandpersonalattributesassociatedwithhigh

performanceintheworkplace.Thisorganizationalhierarchy–JobPurpose–JobFunctions–Competencies–

PerformanceCriteria–isdesignedtoillustratethatperformingworkwellrequiresmorethanjustacquiring

discreteknowledgeelementsordevelopingaseriesofmanualskills.Toperformajobwell,theemployee

mustbeabletoassimilateknowledgeandskillslearnedinvarioussettings,recallandapplythatinformation

tothepresentsituation,andcarryoutworkactivitiesusingsoundprofessionaljudgement,demonstratingan

appropriateattitudeordisposition,andachievingalevelofspeedandaccuracynecessarytomeetthe

employer’sbusinessneed.

ThetablebelowcomparestheterminologyofFunctionalAnalysiswiththatoftraditionalOccupationalTask

Analysistoillustratetheimportantsimilaritiesanddifferences.Whilebothidentifythekeytechnicalelements

ofanoccupation,FunctionalAnalysisincludestheidentificationofbehaviors,attributesandcharacteristicsof

workersnecessarytomeetanemployer’sexpectations.

FrameworkTerminology TraditionalTaskAnalysisTerminology

JobFunction–theworkactivitiesthatarecarriedouttofulfillthejobpurpose

JobDuties–rolesandresponsibilitiesassociatedwithanoccupation

Competency–theactionsanindividualtakesandtheattitudeshe/shedisplaystocompletethoseactivities

Task–aunitofworkorsetofactivitiesneededtoproducesomeresult

PerformanceCriteria–thespecificknowledge,skills,dispositions,attributes,speedandaccuracyassociatedwithmeetingtheemployer’sexpectations

SubTask–theindependentactionstakentoperformaunitofworkoraworkactivity

Althoughdesignedforuseincompetency-basedapprenticeship,theseCompetency-BasedOccupational

Frameworksalsosupporttime-basedapprenticeshipbydefiningmoreclearlyandpreciselywhatan

apprenticeisexpectedtolearnanddoduringtheallocatedtime-period.

COMPETENCY -BASED OCCUPAT IONAL FRAMEWORKS V

CBOFsarecomprehensivetoencompassthefullrangeofjobsthatmaybeperformedbyindividualsinthe

sameoccupation.Asemployersorsponsorsdeveloptheirindividualapprenticeshipprograms,theycan

extractfromoraddtotheframeworktomeettheiruniqueorganizationalneeds.

ComponentsoftheCompetency-BasedOccupationalFramework

OccupationalOverview:Thissectionoftheframeworkprovidesadescriptionoftheoccupationincludingits

purpose,thesettinginwhichthejobisperformedanduniquefeaturesoftheoccupation.

WorkProcessSchedule:Thissectionincludesthejobfunctionsandcompetenciesthatwouldlikelybe

includedinanapprenticeshipsponsor’sapplicationforregistration.Theseframeworksprovideapointof

referencethathasalreadybeenvettedbyindustryleaderssosponsorscandevelopnewprogramsknowing

thattheywillmeetorexceedtheconsensusexpectationsofpeers.Sponsorsmaintaintheabilitytocustomize

theirprogramstomeettheiruniqueneeds,butomissionofasignificantnumberofjobfunctionsor

competenciesshouldraisequestionsaboutwhetherornottheprogramhascorrectlyidentifiedthe

occupationofinterest.

Cross-cuttingCompetencies:Thesecompetenciesarecommonamongallworkers,andfocusonthe

underlyingknowledge,attitudes,personalattributesandinterpersonalskillsthatareimportantregardlessof

theoccupation.Thatsaid,whilethesecompetenciesareimportanttoalloccupations,therelativeimportance

ofsomeversusothersmaychangefromoneoccupationtothenext.Theserelativedifferencesareillustrated

inthispartoftheCBOFandcanbeusedtodesignpre-apprenticeshipprogramsordesigneffectivescreening

toolswhenrecruitingapprenticestotheprogram.

DetailedJobFunctionAnalysis:Thisportionoftheframeworkincludesconsiderabledetailandisdesignedto

supportcurriculumdesignersandtrainersindevelopingandadministeringtheprogram.Thereisconsiderable

detailinthissection,whichmaybeconfusingtothoseseekingamoresuccinct,higher-levelviewofthe

program.Forthisreason,werecommendthattheWorkProcessSchedulebethefocusofprogramplanning

activities,leavingthedetailedjobfunctionanalysissectionstoinstructionaldesignersastheyengageintheir

developmentwork.

a. RelatedTechnicalInstruction:Undereachjobfunctionappearsalistoffoundational

knowledge,skills,toolsandtechnologiesthatwouldlikelybetaughtintheclassroomtoenable

theapprentice’son-the-jobtrainingsafetyandsuccess.

V I COMPETENCY -BASED OCCUPAT IONAL FRAMEWORKS

b. PerformanceCriteria:Undereachcompetency,weproviderecommendedperformancecriteria

thatcouldbeusedtodifferentiatebetweenminimally,moderatelyandhighlycompetent

apprentices.Theseperformancecriteriaaregenerallyskills-basedratherthanknowledge-based,

butmayalsoincludedispositionalandbehavioralcompetencies.

UsingtheCompetency-BasedOccupationalFrameworktoDevelopaRegisteredApprenticeshipProgram

Whendevelopingaregisteredapprenticeshipprogram,theWorkProcessScheduleincludedinthisCBOF

providesanoverviewofthejobfunctionsandcompetenciesanexpertpeergroupdeemedtobeimportantto

thisoccupation.TheWorkProcessScheduleinthisdocumentcanbeuseddirectly,ormodifiedandusedto

describeyourprogramcontentanddesignaspartofyourregistrationapplication.

Whendesigningthecurriculumtosupporttheapprenticeshipprogram–includingonthejobtrainingand

relatedtechnicalinstruction–themoredetailedinformationinSection5couldbehelpful.Thesemore

detailedjobfunctiondocumentsincluderecommendationsforthekeyknowledgeandskillelementsthat

mightbeincludedintheclassroominstructiondesignedtosupportagivenjobfunction,andtheperformance

criteriaprovidedundereachcompetencycouldbehelpfultotrainersandmentorsinevaluatingapprentice

performanceandinsuringinter-raterreliabilitywhenmultiplementorsareinvolved.

OCCUPAT IONAL OVERV I EW 1

PhlebotomistOccupationalOverview

OccupationalPurposeandContextPhlebotomistsareMedicalLabTechnicianswhodrawandprocessbloodandotherbiologicalsamplesfor

tests,transfusions,donations,orresearch.Theymayexplaintheproceduretopatientsandprovideassistance

ifpatientshaveadversereactionsaftertheirbloodisdrawn.

Phlebotomistsworkinhospitals,medicalanddiagnosticlaboratories,blooddonorcenters,doctors’offices,

andmobilephlebotomyservices.

Becauseallbloodsampleslookthesame,phlebotomistsmustcarefullyidentifyandlabeleachbloodsample

theyhavedrawnandenteritintoadatabase.Inordertoavoidcausinginfectionandothercomplications,

phlebotomistsmustkeeptheirworkareasandinstrumentscleanandsanitary.

Phlebotomistsarespecialistsattheircraftandoftenrepresentthe“faceofthelaboratory”.

PotentialJobTitlesPhlebotomist,PhlebotomyTechnician,RegisteredPhlebotomyTechnician,CertifiedPhlebotomist,Patient

ServiceTechnician,MedicalLabAssistant,PhlebotomyDirector/ProgramCoordinator/Supervisor

ApprenticeshipPrerequisites

Phlebotomistsmustcompletepost-secondarytrainingwithaminimumof200totalhoursofinstruction.This

instructionmustincludetraininginmedicalterminology(minimumof8hours),anatomyandphysiology

(minimumof40hours),essentialcommunicationforhealthcareprofessionals(minimumof24hours),anda

phlebotomyclinicalofatleast100hours.Precertificationtrainingincludesanumberof“sticks”thatvariesby

stateandcertificationtype.Forexample,formoststatestheNationalCenterforCompetencyTestingspecifies

25venipunctureand5capillarysticksarerequiredforRegisteredPhlebotomyTechnician(RPT)certification.

Participationinatrainingprogramrequiresacompletebackgroundcheck,documentationofcurrent

required-immunizationsandcurrentHealthcareProviderCardiopulmonaryResuscitation(CPR)certification.

Phlebotomyprogramstudentsmustundergodrugscreeningpriortoemployment.

2 OCCUPAT IONAL OVERV I EW

OccupationalPathwaysPhlebotomiststypicallyentertheoccupationwithon-the-jobclinicaltraining.Someenterwithapostsecondarynon-degreeawardfromaphlebotomyprogram.Programsareavailablefromcommunitycolleges,vocationalschools,proprietaryschools,ortechnicalschools.Theseprogramsusuallytakelessthan1yeartocompleteandleadtoacertificate.Certificationprogramsinvolveclinicalexperienceandclassroominstructioninsuchareasasanatomy,physiology,andmedicalterminology.SomestatesmayseparatelycertifyPhlebotomiststodoskinpuncturesonly,orskinandvenipuncture,orskinandvenipunctureandarterialpuncturebloodcollection.Mostphlebotomistsentertheprofessionwithahighschooldiplomaandaretrainedtobeaphlebotomistonthejob.Nomattertheireducationlevel,phlebotomistsalsoreceiveinstructionsonhowtoidentify,label,andtrackbloodandbiologicalsamples.

Healthcareoccupationsthatphlebotomistsoftenprogressintoincludethefollowing:phlebotomyspecialist,medicallabassistant,travelingphlebotomist,donorphlebotomyspecialist,phlebotomysupervisor,patientcaretechnicianandotherclinicalmedicine,healthcare,andlaboratorypositions.

AttitudesandBehaviorsPersonswhoaresuccessfulinbecomingphlebotomistspossessdexterityandhand-eyecoordination,using

theirequipmentefficientlyandproperlyanddrawingbloodsuccessfullyontheirfirstattemptwhenever

possible.Successfulphlebotomistsarealsodetail-oriented,sothatwithnoerrorstheycandrawblood

samplesinamannerthatdoesnotaltertestresultsintheprocess,doesnotharmpatients,anddoesnotrisk

exposingthemselvestobloodbornepathogens.Phlebotomistsmusthavethestaminatoworkontheirfeetfor

longperiodsandmaintaintheirperformancethroughouttheday.Lastly,successfulphlebotomistsare

compassionateandcaringwithclientsorpatientswhoareafraidofhavingtheirblooddrawn.

OthertermslistedinDACUMs(DevelopingaCurriculum)todescribeattitudesandbehaviorsofphlebotomists

include:Mentallyalert,maintainingapositiveattitude,desiringtoexpandskillsandabletotakeconstructive

criticism,honest,patient,ethical,independent,reliable,andconfident.


Certifications,LicensureandOtherCredentialRequirementsCREDENTIAL OfferedBy Before,DuringorAfter

Apprenticeship

PhlebotomyTechnician(NCPT)

NationalCenterforCompetencyTesting After(inmostbutnotallstates)

PhlebotomyTechnician(PBT)

AmericanSocietyforClinicalPathology After(inmostbutnotallstates)

RegisteredPhlebotomyTechnician(RPT)

AmericanMedicalTechnologists After(inmostbutnotallstates)

CertifiedPhlebotomyTechnologist

NationalPhlebotomyAssociation After(inmostbutnotallstates)

CertifiedPhlebotomistTechnician

AmericanSocietyofPhlebotomyTechnicians,Inc. After(inmostbutnotallstates)

CertifiedPhlebotomyTechnician(CPT)

NationalHealthcareerAssociation After(inmostbutnotallstates)

CertifiedPhlebotomyTechnician(CPT)

AmericanCertificationAgency After(inmostbutnotallstates)

CertificationforPhlebotomists

AmericanMedicalCertificationAssociation After(inmostbutnotallstates)

JobFunctions

JOBFUNCTIONS CoreorOptional

1. PerformClericalFunctions Core

2. PerformPhlebotomy Core

3. ProcessSpecimens Core

4. TransportandHandleNonbloodSpecimens Optional

5. PerformandAssistwithClinicalLaboratoryImprovementAmendments(CLIA)-WaivedTesting

Core

6. MaintainSafeEnvironment Core

7. ContinueProfessionalDevelopmentEducation Core

4 OCCUPAT IONAL OVERV I EW

StackableProgramsThisoccupationalframeworkisdesignedtolinktothefollowingadditionalframework(s)aspartofacareer

ladderingpathway.

StackablePrograms BaseorHigherLevel

Stacksontopof

1. BaseProgram

2.

3.

4.

OptionsandSpecializationsThefollowingoptionsandspecializationshavebeenidentifiedforthisoccupation.TheWorkProcess

Scheduleandindividualjobfunctionoutlinesindicatewhichjobfunctionsandcompetenciesweredeemedby

industryadvisorstobeoptional.WorkProcessSchedulesforSpecializationsareincludedattheendofthis

document.

OptionsandSpecializations Option Specialization

NotApplicable


LevelsIndustryadvisorshaveindicatedthatindividualsinthisoccupationmayfunctionatdifferentlevels,basedon

thenatureoftheirwork,theamountoftimespentinanapprenticeship,thelevelofskillsorknowledge

mastery,thedegreeofindependenceinperformingthejoborsupervisory/managementresponsibilities.

Level DistinguishingFeatures AddedCompetencies

AddedTimeRequirements

NotApplicable

6 WORK PROCESS SCHEDULE

WorkProcessScheduleWORKPROCESSSCHEDULE

Phlebotomist

ONETCode:31-09097.00RAPIDSCode:2036

JOBTITLE:Phlebotomist

LEVEL: SPECIALIZATION:

STACKABLEPROGRAM____yes______no

BASEOCCUPATIONNAME:

CompanyContact:Name

Address:

Phone Email

ApprenticeshipType:

_______Competency-Based

_______Time-Based_______Hybrid

Prerequisites

Lessthan1-yearaccreditationprogram

BackgroundCheck

DocumentationofImmunizations

CurrentHealthcareProviderCardiopulmonaryResuscitation(CPR)certification

CurrentTuberculosis(TB)andHepatitisTest

JOBFUNCTION1:PerformClericalFunctions

Competencies Core RTI OJT

A. Identifypatientandobtainpatientinformation Core

B. Transmitinformation Core

C. Schedulepatientappointments Optional

D. Enterdataandmaintainclientconfidentiality Core

E. Maintainsupplies Core

WORK PROCESS SCHEDULE 7

JOBFUNCTION2:PerformPhlebotomy


A. Readphysician’srequisitionandprepareforprocedures Core

B. Tietourniquetandobtainsamplesinpropervials Core

C. Collectarterialbloodgasspecimens Core

D. Completethebloodcollectionprocedure Core

E. Preparesamplesforprocessing Core

F. Provideage-appropriatepost-careinstructions Core

G. Disposehazardousmaterialsandrestoreworkarea Core

JOBFUNCTION3:ProcessSpecimens


A. Receivespecimens Core

B. Prepareandlabelspecimensforprocessing Core

C. Transportandstorespecimens Optional

D. Cleananddisinfectarea Core

JOBFUNCTION4:TransportandHandleNonbloodSpecimens


A. Collectforensicspecimens Optional

B. Collectchain-of-custodyspecimens Optional

JOBFUNCTION5:PerformandAssistwithClinicalLaboratoryImprovementAmendments(CLIA)-WaivedTesting


A. Performwaivedtesting Core

B. Setupmicro-cultures Core

C. Assistwithperformanceoflabtests Core

8 WORK PROCESS SCHEDULE

JOBFUNCTION6:MaintainSafeEnvironment


A. Maintainuniversalprecautions Core

B. Followergonomicprocedures Core

C. Maintainsecureenvironment Core

D. Handleanddisposeofchemicalandbiologicalhazards Core

E. Performroutineequipmentmaintenance Core

F. Participateindisasterpreparedness Core

JOBFUNCTION7:ContinueProfessionalDevelopmentEducation


A. Maintaincertificationandskills Core

B. Reviewpoliciesandprocedures Core

C. Provideclinicaltrainingtoothers Optional

WORK PROCESS SCHEDULE 9

RelatedTechnicalInstructionPlanCOURSENAME:INTRODUCTIONTOPHLEBOTOMY

CourseNumber

Hours:30total

LEARNINGOBJECTIVES

IntroductiontoPhlebotomyincludesinstructioninthehealthcaresettingandtheroleofthephlebotomist,safetyandinfectioncontrol,basiclaboratoryskills(pipetting,handlinglaboratoryglassware,weightmeasurement,andmetricconversion),laboratoryspecimenrequirements,specimenhandlingandprocessing,medicalterminology,howtoidentifyandworkwithpatientswithspecialneedsormentalhealthproblems,professionalism,ethics,patientconfidentiality,andlegalissues.

COURSENAME:PHLEBOTOMYTECHNIQUES

CourseNumber

Hours:75total

LEARNINGOBJECTIVES

InPhlebotomyTechniques,studentsdevelopskillsinvenipuncture,capillarypuncture,andotherskillsrequiredtoperformsuccessfulbloodtechniques.Thiscourseincludesa45-hourclinicalexperience.

Theaboveisasampleofcourserequirementsforinitialcertificationasaphlebotomist.Alternately,this

sectioncouldbepopulatedwithexamplecoursecontentforcontinuingeducationcoursesrequiredforannual

recertification.Examplesincludeskillreviewsindermalpunctureandcapillarybloodcollection,Human

ImmunodeficiencyVirus(HIV)safety,laboratoryergonomics,medicalerrorprevention,minimizingpre-

analyticalvariability,bloodbornepathogens,challengesincapillarybloodcollectionandtesting,reviewof

routinevenipuncture,tuberculosisawareness.

1 0 CROSS -CUTT ING COMPETENC I ES

Cross-CuttingCompetenciesCOMPETENCY** 0 1 2 3 4 5 6 7 8

Person

alEffe

ctiven

ess

InterpersonalSkills

Integrity

Professionalism

Initiative

DependabilityandReliability

AdaptabilityandFlexibility

LifelongLearning

Acad

emic

Reading

Writing

Mathematics

Science&Technology

Communication

CriticalandAnalyticalThinking

BasicComputerSkills

Workp

lace

Teamwork

CustomerFocus

PlanningandOrganization

CreativeThinking

ProblemSolving&DecisionMaking

WorkingwithTools&Technology

Checking,Examining&Recording

BusinessFundamentals

Sustainable

Health&Safety

CROSS -CUTT ING COMPETENC I ES 11

**Cross-cuttingcompetenciesaredefinedintheCompetencyModelClearinghouse:

https://www.careeronestop.org/CompetencyModel/competency-models/buidling-blocks-model.aspx

Cross-cuttingcompetenciesidentifytransferableskills–sometimescalled“softskills”or“employabilityskills”

–thatareimportantforworkplacesuccess,regardlessofaperson’soccupation.Still,therelativeimportance

ofspecificcross-cuttingcompetenciesdiffersfromoccupationtooccupation.TheCross-CuttingCompetencies

table,above,providesinformationaboutwhichofthesecompetenciesismostimportanttobesuccessfulina

particularoccupation.Thisinformationcanbeusefultoemployersorintermediariesinscreeningand

selectingcandidatesforapprenticeshipprograms,ortopre-apprenticeshipprovidersthatseektoprepare

individualsforsuccessfulentryintoanapprenticeshipprogram.

Thenamesofthecross-cuttingcompetenciescomefromtheU.S.DepartmentofLabor’sCompetencyModel

Clearinghouseanddefinitionsforeachcanbeviewedat

https://www.careeronestop.org/CompetencyModel/competency-models/building-blocks-model.aspx.

Thescoringsystemutilizedtoevaluatethelevelofcompetencyrequiredineachcrosscuttingskillalignswith

therecommendationsoftheLuminaFoundation’sConnectingCredentialsFramework.Theframeworkcanbe

foundat:http://connectingcredentials.org/wp-content/uploads/2015/05/ConnectingCredentials-4-29-30.pdf.

Cross-cuttingcompetencyscoresweredevelopedfromtextanalysisoftheO*NETweblinkforPhlebotomist.

1 2 DETA I L ED JOB FUNCT IONS

DetailedJobFunctions

JOBFUNCTION1:PerformClericalFunctionsRelatedTechnicalInstruction

KNOWLEDGE SKILLS TOOLS&TECHNOLOGIES

• Administrativeandclericalprocedures

• Customerandpersonalservice• Deductivereasoning• Englishlanguagereading

comprehensionandwriting• HealthcareCommonProcedure

CodingSystem(HCPCS)• HIPAAcomplianceandotherlegal

aspectsofhealthcare• HowInsuranceWorks/Insurance• Medicalterminology• MedicationSpelling

• Abilitytolearnsoftwareprograms• Assessingappropriatenessof

multipletestsandavoidingduplicatebilling

• Enteringpatient,specimen,insurance,andbillinginformationintocomputer

• Maintainingmedicalrecords• Passwordmanagement• Plottingandinterpretingcharts• Printinglabels• Recordingandcommunicating

messages• Researchingundefinedtests• Scheduling• Telephoneetiquette• Timemanagement• Understandingphysician

schedules

• Creditcardmachines• ElectronicMedical

Record/ElectronicHealthRecordandBillingsoftware,suchasVelociDoc,PracticeFusion,Medisoft,NextGen,Centricity,EPIC,Intergy,AmazingCharts,eClinicalWorks,andCerner

• Faxmachines• Forms• MaterialSafetyDataSheets

(MSDSs)• Notebookcomputers• OfficeApplicationsSoftwarefor

calendarandscheduling,electronicmail,wordprocessing,andspreadsheets

• Personalcomputers• Photocopiers• Physician’sDeskReference• Policiesandproceduremanuals• Printers• Postalmachineandmeter

CompetencyA:Identifypatientandobtainpatientinformation CoreorOptional

PERFORMANCECRITERIA

1. Identifypatient Core

2. Obtainpatientdemographics Optional

3. Obtainphysicianorders Core

4. Obtainbillingandinsuranceinformation Optional

DETA I L ED JOB FUNCT IONS 13

CompetencyB:Transmitinformation CoreorOptional

PERFORMANCECRITERIA

1. Enterphysicianorders Core

2. Providespecimencollectioninstructionsandmaterials Core

CompetencyC:Schedulepatientappointments CoreorOptional

PERFORMANCECRITERIA

1. Useschedulingsoftware Optional

2. Arrangeandconfirmappointmentwithpatientorco-worker Optional

CompetencyD:Enterdataandmaintainclientconfidentiality CoreorOptional

PERFORMANCECRITERIA

1. Enterdataintoalaboratoryinformationsystem Optional

2. Maintainqualityassurancedatalogs Core

3. Maintainclientconfidentiality Core

CompetencyE:Maintainsupplies CoreorOptional

PERFORMANCECRITERIA

1. Maintainsupplystocks Core

2. Submitreorderrequestsforsuppliesasneeded Optional


JOBFUNCTION2:PerformPhlebotomyRelatedTechnicalInstruction


• Anatomyandphysiology• CardiopulmonaryResuscitation

(CPR)• CurrentProceduralTerminology

(CPT)• Properdisposaltechniquesfor

bloodorotherbiohazardfluidsortissue

• Properdisposaltechniquesforcontaminatedsharps

• Readingandinterpretationofvitalsigns

• Steriletechnique

• Administeringsubcutaneousorintramuscularinjects,inaccordancewithlicensingrestrictions

• Assemblingandmaintainingmedicalinstruments

• Assessingpatientduringandafterprocedures

• Calibratingandmaintainingbloodplasmacollectionmachines/othermachines

• Collectingfluidandtissuesamples,usingappropriatecollectionprocedures(specificprocedures?)

• Collectingvitalsigns• Conductingglucosescreening/oral

glucosetolerancetests• Conductinghemoglobinteststo

ensuredonorironlevelsarenormal

• Determiningdonorsuitability,accordingtointerviewresults,vitalsigns,andmedicalhistory

• Followingcomplexinstructions• Identifyingandworkingwith

clientswithmentalhealthproblems

• Identifyingandworkwithclientswithspecialneeds

• Interpersonalskills:Translatingmedicaltermstolayterms,Gender/CulturalDiversity,talkingtopatientsanddonorsnervousabouthavingblooddrawn,explainingfluidortissuecollectionprocedurestopatients

• Keepingworkareascleanandsanitary

• Matchinglaboratoryrequisitionformstospecimentubes

• Mathskills:Dosagecalculation,unitconversion

• Monitoringbloodandplasmadonorsduringandafterprocedures

• Organizingandcleaningblooddrawingtrays,ensuringall

• Alcohol/AlcoholWipes• AntisepticHandSanitizingSolution• Bandaids• Betadine• Bloodcollectiontubes:vacuum

tubes,aliquottubes,bloodculturebottles,sterilescrew-capglass/plastictubes

• Bloodglucosemonitor/teststrips• Bloodplasmacollectionmachines• Bloodpressurecuffs• Breathalyzer• ChemicalSterilant• Digitaltimer• Drawingchair• Gauzepads• Gloves,sterile• Glucosemonitors/meters• Lancets• Micro-capillaryhematocrittubes

(akamicro-hematocritcapillarytubes)

• Needleholders• Needles,includingbutterfly

needles• Occultbloodkitsandslides• Phlebotomycarts• Pinwormpaddles• PulseOximeter• Radiographicveinlocators• Sharpscontainers• Spillkits• Sputumcups• Sterilespecimencontainers• Stoolkits• Syringe• Thermometer• Tourniquets• VacutainerTube


instrumentsaresterileandallneedles,syringes,orrelateditemsareoffirst-timeuse

• Papersheetingexamtables• Performingsalineflushesor

dispensinganticoagulantdrugssuchasHeparinthroughintravenous(IV)lines,inaccordancewithlicensingrestrictionsandunderthedirectionofamedicaldoctor

• Phlebotomyskillsforarteriesusingarterialcollectiontechniques

• Phlebotomyskillsforcapillariesbydermalpuncture:heelorfingerstickmethods

• Phlebotomyskillsforveins:vacuumtube,syringe,orbutterflyvenipuncture

• Servingrefreshmentstodonorstoensureabsorptionofsugar

• Verifyingpatientordonoridentity

CompetencyA:Readphysician’srequisitionandprepareforprocedures

CoreorOptional

PERFORMANCECRITERIA

1. Readphysician’srequisition Core

2. Putonpersonalprotectiveequipment(goggles,gloves,andlabcoat) Core

3. Assessmedicalrequirements Core

4. Verifyphysicianorders Core

5. Identifypatient Core

6. Assesspatientneeds Core

CompetencyB:Tietourniquetandobtainsamplesinpropervials CoreorOptional

PERFORMANCECRITERIA

1. Selectanatomicalsite Core

2. Assemblephlebotomysupplies Core

3. Prepareanatomicalsite Core

4. Tietourniquetonpatient’sarm Core

5. Obtainbloodsamplesinpropervials Core


6. Assesspatientcondition Core

CompetencyC:Collectarterialbloodgasspecimens CoreorOptional

PERFORMANCECRITERIA

1. Demonstrateproperandsafeuseofarterialbloodgasequipment Optional

2. Collectarterialbloodgasspecimens Optional

3. Assesspatientcondition Core

CompetencyD:Completethebloodcollectionprocedure CoreorOptional

PERFORMANCECRITERIA

1. Removetourniquetfrompatient’sarm Core

2. Removeneedle Core

3. Applypressurewithcottonballorgauze Core

4. Checksiteandbandagestickarea Core

CompetencyE:Preparesamplesforprocessing CoreorOptional

PERFORMANCECRITERIA

1. Labeltubes Core

2. Packageandtransportsamples Core

CompetencyF:Provideage-appropriatepost-careinstructions CoreorOptional

PERFORMANCECRITERIA

1. Knowdifferencesinage-appropriatepost-careactivities Core

2. Communicateinstructionseffectivelytopatientsofdifferentages Core

CompetencyG:Disposehazardousmaterialsandrestoreworkarea

CoreorOptional

PERFORMANCECRITERIA

1. Properlydisposeofbiohazardousmaterials Core

2. Cleanworkarea Core

3. Assureequipmentisfunctioningandaccessible Core

4. Replaceusedequipmentfromstockasneeded Core


JOBFUNCTION3:ProcessSpecimensRelatedTechnicalInstruction


• Basicbiologyandbiochemistry• Reading,writing,andarithmetic

skills

• Conductingbloodalcoholtests• Conductingbloodculturetests• Conductingpeakandtroughdrug

leveltests• Conductinggramstaintests/tests

involvingbloodsmears• Documentingrouteofspecimens

fromcollectiontolaboratoryanalysisanddiagnosis

• Enteringpatientinformationandspecimeninformationintocomputers/databases

• Goodnearvisionandfingerdexterity

• Labelingbloodsamplesafterdrawing

• Matchinglaboratoryrequisitionformstospecimentubes

• Operatinganincubator• Operatingacentrifuge• Printinglegibly• Processingbloodorotherfluid

samplesforfurtheranalysisbyothermedicalprofessionals

• Providingsampleanalysisresultstophysicianstoassistdiagnosis

• Recordingtemperatureonrefrigerators

• Transportingspecimensorfluidsamplesfromcollectionsitestolaboratories

• Apron• Arterialbloodgasmonitorsand

kits• Asbestosgloves• Autoclave/autoclavebags• BalanceScales• Barcodeprinter• Barcodereader• Biotest• Centrifuge• Cultureplates• DiluentSolution• FaceMask• Gramstainsupplies• Hood• Labslidesandcoverslips• Medicalreferencebooks• Phenolsolution• Potassiumhydroxide• Transfer/volumetric/ESRpipettes• Unopettemicrocollectionsystems

CompetencyA:Receivespecimens CoreorOptional

PERFORMANCECRITERIA

1. Receivespecimens Core

2. Recordandconfirmreceiptofspecimens Core


CompetencyB:Prepareandlabelspecimensforprocessing CoreorOptional

PERFORMANCECRITERIA

1. Preparespecimens(i.e.vials)correctly Core

2. Labelspecimenscorrectly Core

3. Confirmcorrectpreparationbyinspection Core

CompetencyC:Transportandstorespecimens CoreorOptional

PERFORMANCECRITERIA

1. Transportspecimens Optional

2. Storespecimensappropriately,intheappropriatearea(e.g.LabSectionsorReferenceLab) Optional

3. Arrangeforpickupofspecimens Optional

CompetencyD:Cleananddisinfectarea CoreorOptional

PERFORMANCECRITERIA

1. Cleanarea Core

2. Disinfectarea Core


JOBFUNCTION4:TransportandHandleNonbloodSpecimensRelatedTechnicalInstruction


Thissectionmayincludecertainknowledge,skills,tools,andtechnologiesspecifiedunderjobfunctions2and3.



CompetencyA:Collectforensicspecimens CoreorOptional

PERFORMANCECRITERIA

1. Collectforensicspecimens Optional

2. Knowandprovideappropriatedocumentationandsecurityforforensiclabspecimens Optional

CompetencyB:Collectchain-of-custodyspecimens CoreorOptional

PERFORMANCECRITERIA

1. Collectchain-of-custodyspecimens Optional

2. Knowandprovideappropriatedocumentationandsecurityforchain-of-custodyspecimens Optional


JOBFUNCTION5:PerformandAssistwithClinicalLaboratoryImprovementAmendments(CLIA)-WaivedTestingRelatedTechnicalInstruction


• CLIA-WaivedTests



CompetencyA:Performwaivedtesting CoreorOptional

PERFORMANCECRITERIA

1. Performwaivedtesting Core

2. Recognizenon-waivedtests Core

CompetencyB:Setupmicro-cultures CoreorOptional

PERFORMANCECRITERIA

1. Setupmicro-cultures Core

2. Followsteriletechniquetoavoidcontamination Core

CompetencyC:Assistwithperformanceoflabtests CoreorOptional

PERFORMANCECRITERIA

1. Recognizeandfollowinstructionsfromcolleagues Core

2. Assistwithperformanceoflabtests Core


JOBFUNCTION6:MaintainSafeEnvironmentRelatedTechnicalInstruction


• Bloodbornepathogensafety• ElectricalSafety• Emergencyprotocolsofworkplace• FireSafety• Handlingofsharps• Hazardousmaterialsprotocols• Patientsafety• StateandFederalRegulations/

OccupationalSafetyandHealthAdministration(OSHA)

• Communicationskills• Evaluatinginformationtoensure

compliancewithstandards• Standardproceduresofinfection

control

• CrashCart• Spillkit

CompetencyA:Maintainuniversalprecautions CoreorOptional

PERFORMANCECRITERIA

1. Removegloves Core

2. Washhands Core

3. Practiceneedle-sticksafety Core

CompetencyB:Followergonomicprocedures CoreorOptional

PERFORMANCECRITERIA

1. Knowergonomicprocedures Core

2. Useergonomicproceduresinappropriatecircumstances Core

CompetencyC:Maintainsecureenvironment CoreorOptional

PERFORMANCECRITERIA

1. Maintainphysicalsecurity Core

2. Complywithinfectioncontrolrequirements Core


CompetencyD:Handleanddisposeofchemicalandbiologicalhazards

CoreorOptional

PERFORMANCECRITERIA

1. Handlechemicalhazards Core

2. Disposeofchemicalhazards Core

3. Handlebiologicalhazards Core

4. Disposeofbiologicalhazards Core

CompetencyE:Performroutineequipmentmaintenance CoreorOptional

PERFORMANCECRITERIA

1. Performroutineequipmentmaintenance Core

2. Identifyequipmentneedingreplacementandreportorrestock Core

CompetencyF:Participateindisasterpreparedness CoreorOptional

PERFORMANCECRITERIA

1. Knowandfollowgeneralactionsappropriatefordisastersituations Core

2. Knowbuildingevacuationandemergencyprotocols Core


JOBFUNCTION7:ContinueProfessionalDevelopmentEducationRelatedTechnicalInstruction


• Stateregulationsonthescopeofpractice

• Developingandbuildingteams• Engagingandcompletingspecial

assignments• Trainingothermedicalpersonnel

inphlebotomyorlaboratorytechniques

• Continuingandrecertificationprograms

• Nationallyavailableresourcestokeepcurrentinthephlebotomyfield

• Phlebotomypracticearms• Phlebotomypracticeblocks• Phlebotomypracticeheels• Staffmeetings

CompetencyA:Maintaincertificationandskills CoreorOptional

PERFORMANCECRITERIA

1. Maintaincertificationandlicensure Core

2. MaintainCardiopulmonaryResuscitation(CPR)certification Core

3. Maintainannualcompliances Core

4. Maintainannualcompetencies Core

CompetencyB:Reviewpoliciesandprocedures CoreorOptional

PERFORMANCECRITERIA

1. Reviewpolicies Core

2. Updateanddocumentpoliciesthatareoutofdate Core

CompetencyC:Provideclinicaltrainingtoothers CoreorOptional

PERFORMANCECRITERIA

1. Communicateinaprofessionalandeducationalmannerwithtrainees Optional

2. Knowtheappropriateprocedurestobetrained Optional

2 4 REFERENCES

ReferencesAmericanMedicalTechnologists,ontheInternetathttps://www.americanmedtech.org/(visitedJanuary2018).

AmericanSocietyforClinicalPathology,ontheInternetathttps://www.ascp.org/content/board-of-certification(visited

January2018).

CenterforPhlebotomyEducation,ontheInternetatwww.phlebotomy.com(visitedJanuary2018).

DepartmentofLaborOccupationalOutlookHandbook:Phlebotomists

https://www.bls.gov/ooh/healthcare/phlebotomists.htm(visitedJanuary2018).

NationalCenterforCompetencyTesting,accessedathttps://www.ncctinc.com/Certifications/(visitedJanuary2018).

O*NETonlinesummaryreportfor31-9097.00–Phlebotomists.OntheInternetat

https://www.onetonline.org/link/summary/31-9097.00(visitedJanuary2018).

STATEMENT OF INDEPENDENCE

TheUrbanInstitutestrivestomeetthehigheststandardsofintegrityandqualityinitsresearchandanalysesandintheevidence-basedpolicyrecommendationsofferedbyitsresearchersandexperts.Webelievethatoperatingconsistentwiththevaluesofindependence,rigor,andtransparencyisessentialtomaintainingthosestandards.Asanorganization,theUrbanInstitutedoesnottakepositionsonissues,butitdoesempowerandsupportitsexpertsinsharingtheirownevidence-basedviewsandpolicyrecommendationsthathavebeenshapedbyscholarship.Fundersdonotdetermineourresearchfindingsortheinsightsandrecommendationsofourexperts.Urbanscholarsandexpertsareexpectedtobeobjectiveandfollowtheevidencewhereveritmaylead.

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www.urban.org

Phlebotomist | Urban Institute

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