Blood Collection Rules and Regulations
Setting Blood Draw Standards in USA
The Clinical and Laboratory Standards Institute (CLSI) sets phlebotomy standards that apply to those who draw blood either as full and part-time phlebotomists, medical assistants, healthcare providers and personnel with blood collection responsibilities in the United States of America.
Blood collection takes place in various inpatient and ambulatory care (outpatient) settings. A safe work environment and appropriate training in a clinical laboratory reduces the risk of accidents, infections, and trauma. The fact that 800,000 health care workers report needle stick or sharp object injuries annually is mindboggling. To address this issue, the College of American Pathologists (CAP) Press recently published the 13th Edition of "So You’re Going to Collect a Blood Specimen: An Introduction to Phlebotomy", which outlines ways to diminish risks and reinforces the importance of the phlebotomist’s role in health safety.
Blood Collection Rules
Most blood tests are performed on anticoagulants whole blood, plasma, or serum. Blood specimens must be collected in the proper collection tubes and containers and in the right order of draw. The collection tubes must also be correctly labeled, and promptly transported to the laboratory. Needless to say, blood specimens should be refrigerated until placed in the courier box for transport to the laboratory.
If coagulation testing is the only laboratory work that needs to be drawn the phlebotomist should first draw a plain red top tube to remove tissue fluid contamination. This tube is then discarded into the biohazard receptacle. The next step is to draw the blood sample into a sodium citrate collection tube which must be filled to the proper level (filled to complete vacuum volume) and is then gently inverted to mix.
If additional laboratory work is ordered, including coagulation testing, the second tube would be the sodium citrate collection tube. Remember that all of the processes involved in specimen collection, from ordering supplies, to selecting the proper collection devices, to proper collection site and technique, to adhering to all in-house and legal requirements when handling and shipping the specimens are all important steps of obtaining valid and timely laboratory test results.
Phlebotomists in California
Phlebotomists in California are heavily monitored by the state and must be licensed with the California State Medical Board in order to work as part of the allied healthcare professional team.
Phlebotomists in California have several levels of licensing! Those wishing to work in phlebotomy in California must first complete an unpaid 40-hour internship where 50 successful blood draws on patients via venipuncture and 10 finger/heelsticks must be properly performed and logged. All this must be done before entering the phlebotomy career, because CA regulation mandates that you cannot work as a phlebotomist without a license. This rule also applies to medical assistants and other allied health professionals with blood drawing responsibilities in the state of California.