Muhammad Asim Ansari, Manager Laboratory/Blood Bank, Kulsum International Hospital, Islamabad
Medical laboratory technology is one of the most rapidly expanding health care fields. Even the practice of modern medicine would be impractical without the analysis performed in the clinical laboratory. With increasing automation and the use of computer technology, the work of technologists and technicians has become less hands-on and more analytical but it is often observed that emphasis is being given to analytical work almost cent percent in every laboratory. Because of this unfair division and focus the real face of any laboratory, Phlebotomy, has been neglected. Keeping in mind a myth; first impression is the last impression, would direct us to think about this neglected yet crucial part. It has been noticed from the patient feedback survey that most of them were predominantly concerned with the painless and pleasant phlebotomy rather anything else such as speedy and accurate results or quality control etc. As far as patient’s satisfaction is concerned, a good phlebotomy section could earn a good repute for the laboratory.
Phlebotomy is not only the venipuncture technique. It also involves interior designing, sitting plan, visuals, reading stuff, paintings, staffing and attitude of the phlebotomist. It is the human psychology that bad experiences last for longer period than good ones. Therefore one bad phlebotomy on a patient can render worse effects rather an incorrect result. In addition, the predominant errors arising in the laboratory are pre-analytical but they are usually underestimated in routine practice. The pre-analytic phase is an important component of total laboratory quality. A wide range of variables affect the result for a patient, the most important being the collection of specimen or phlebotomy. As Physicians generally depend on the results of laboratory testing to provide definitive answers to their clinical impression, phlebotomy should be regarded as the back bone of the analytical process. Considering an example, if a phlebotomist fails to paste correct barcode label (with patient particulars) on a definite specimen and/or barcode sticker are being swapped, no one can spot and anticipate this mistake.
Bioethical aspect should also be covered on the phlebotomy counter. Phlebotomist should be able to clearly describe all the procedural steps and potential hazards to the patient/client. He should also liaise to the patient/client that what kind of diagnostic tests your laboratory is going to perform on this specimen and also how it would be treated afterwards. A formal (either written or verbal) consent pertaining to all the procedures ought to be taken before venipuncture. It might be a new topic for most of the people but it has its own importance and professional value at this point since blood is also a tissue (a type of connective tissue) that is going to be taken out from a human body during phlebotomy. Practically speaking, it is very difficult to comply with this clause at the moment but if some of the professional readers get sensitized regarding this new angle my efforts would get their optimum.
Professional and effective phlebotomy also contributes a lot in enhancing the work efficiency and reputation of any laboratory. Least possible Turn-Around-Time (TAT) for investigations is the success key of any laboratory and in vogue. A trained phlebotomist can consume least possible time on his task by practicing advanced tips such as concise pre-phlebotomy counseling, swift but crystal clear venipuncture and post-phlebotomy parley.
A phlebotomist must create an atmosphere of trust and confidence with patients while drawing blood specimens in a skillful, safe, and reliable manner. Female phlebotomist is preferred over male since women are more polite, interactive and precise to this responsibility. Proper training of personnel who do phlebotomy procedures regardless of whether the staff is phlebotomists or other healthcare professionals remains crucial as institutions look to improve patient care and decrease collection errors while keeping an eye on the bottom line. They must also be accurate, work well under pressure, and communicate effectively. They must also act as the “eyes and ears” of the clinicians, nurses, and laboratory professionals. The phlebotomy technician must notice and relay any important information gathered during interaction with patients.
Many developed countries offer professional diplomas and/or bachelors’ degree programmes in Phlebotomy. These certificates/degrees cover all theoretical as well as practical aspects of the subject. Unfortunately in our country there is no such academic recognition and training institutes for this activity are in insufficient. This is the reason we have good “self-trained” phlebotomists rather qualified. Medical Laboratory Technology (MLT) diplomas and even degrees offered across the country has no a single credit hour course and or practical activity of the subject. Thus one can easily evaluate that how we are focusing and concentrating on this vital invasive procedure of the laboratory. Our phlebotomists in the market do not know the logic and philosophy behind this science that’s why they could not console the patient in a professional way. Therefore it is strongly recommended that there must be an entire course or part of course in the syllabus of every MLT diploma and degree. Here, I request the readers particularly related to healthcare/diagnostic academic institutions to think over this domain of diagnostic sciences.
May God bless the noble professionals in this field of healthcare, who have continued to give their best with small or no recognition at all for their indispensable services