21st Century Instructional Guide for Career Technical Education

EKG/Phlebotomy

Health Science Education Cluster

Title: / EKG/Phlebotomy (0720)
Standard Number: HSE.S.EKP.1 / Health Care Delivery System
Students will
·  demonstrate knowledge of the health care delivery system.
·  understand the roles and qualifications of phlebotomist and EKG technicians.
Essential Questions: / Considering the roles of the phlebotomist and the EKG technician, what are the relationships of these two careers to the health care team?
Objectives: / Students will / Learning Plan & Notes to Instructor:
HSE.O.EKP.1.1 / examine departments found within hospitals
and healthcare facilities including the
function of each. / healthcare facility departments
·  name
o  anesthesiology
o  cardiology
o  emergency room
o  intensive care unit
o  internal medicine
o  obstetrics/gynecology (Ob/Gyn)
o  oncology
o  orthopedics
o  pathology/laboratory
o  pediatrics
o  physical medicine
o  psychiatry/neurology
o  radiology/medical imaging (diagnostic imaging)
o  surgery
·  function
o  description of services
o  amount of patient contact
Student Learning Activity: obtain department listings from several healthcare facilities and compare availability of departments and services.
HSE.O.EKP.1.2 / determine healthcare providers working
within hospitals, clinics, and physician’s
offices. / healthcare providers
·  physician (MD)
·  physician’s assistant (PA)
·  registered nurse (RN)
·  nurse practitioner (NP)
·  licensed practical nurse (LPN)
·  certified nursing assistant (CNA)
·  anesthesiologist
·  pharmacist
·  pharmacy technician
·  respiratory therapist
·  physical therapist (PT)
·  occupational therapist (OT)
·  radiologist
Student Learning Activity: check with the local hospitals, clinics, and/or physician’s offices for other examples of employed healthcare workers.
HSE.O.EKP.1.3 / characterize the organizational structure of
a hospital. / types of organizational structure
·  complex
·  simple
lines of authority/chain of command
·  areas of responsibility
Student Learning Activity: obtain healthcare facilities’ organizational charts to look at structure and compare facilities.
HSE.O.EKP.1.4 / examine the role of the clinical laboratory
and the electrocardiography departments. / clinical laboratory
·  biochemistry
·  blood bank
·  cytogenetics
·  cytology
·  hematology
·  histology
·  immunology
·  microbiology
·  phlebotomy
·  serology
·  virology
electrocardiography
HSE.O.EKP.1.5 / relate the phlebotomist’s role in clinical
laboratory medicine. / primary responsibility
·  collection of blood samples
additional responsibilities
·  expedient collection and transport of specimens
·  patient contact with lab
·  ensures integrity of draw
·  maintains patient comfort and safety
HSE.O.EKP.1.6 / differentiate the roles and qualifications of
clinical laboratory personnel. / Student Learning Activity: research job titles and qualifications of the following:
·  laboratory director/pathologist
·  laboratory manager
·  medical technologist (MT) or clinical laboratory scientist (CLS)
·  medical laboratory technicians (MLT) or clinical laboratory technician (CLT)
·  phlebotomist
·  clinical laboratory clerical staff
levels of training
·  high school diploma
·  in-house training
·  accredited training program (i.e. phlebotomy technician)
·  two year associate degree
·  four year bachelor’s degree
·  master’s degree
·  doctoral degree
HSE.O.EKP.1.7 / recognize the EKG technician’s
qualifications and role in the clinical facility. / qualifications
·  skills required
·  training
·  education
·  responsibilities
HSE.O.EKP.1.9 / examine professionalism as it relates to the
phlebotomist and EKG technician. / professionalism
·  define
·  characteristics
·  conduct required
·  maintaining knowledge and skills
·  maintaining standard of care
·  professional association membership
Standard: 2
HSE.S.EKP.2 / Laboratory and EKG Departments in a Health Care System
Students will demonstrate knowledge of common procedures performed by the laboratory and EKG departments including how they are used to assess body function and disease.
Essential
Questions: / From the phlebotomist’s and EKG technician’s perspective, why is it important to know and understand all procedures performed by the laboratory and EKG departments?
Objectives: / Students will / Learning Plan & Notes to Instructor:
HSE.O.EKP.2.1 / examine the types of laboratory procedures
performed in the Clinical Laboratory and
EKG departments. / laboratory procedures
·  serum testing for chemical characteristics
·  karyotyping of blood and other cells for prenatal diagnosis and cancer diagnosis
·  cell smear examination for cancer and other conditions
·  whole blood and citrated plasma for blood counts, blood films, and coagulation investigations.
·  examination of cellular detail from solid tissue processing
·  antibody and antigen testing as well as immune responses (cell-mediated and humoral aspects of immunity/immune responses) of the human body
·  checking for pathogenic microbes from bacteria, viruses, protozoa, and fungi.
·  handling, transportation, and processing of specimens
·  serum sampling to examine evidence of diseases such as hepatitis or HIV
·  DNA analysis
HSE.O.EKP.2.2 / determine how laboratory testing and
cardiography is used to assess bodily
functions and disease. / Note: Using the criteria from objective 2.1, determine how each procedure helps to assess abnormalities and normalcy.
HSE.O.EKP.2.3 / interpret medical terms and abbreviations
commonly used in the laboratory and
cardiography departments. / Student Learning Activity: Check with local healthcare facilities to obtain list of used medical abbreviations and terms.
See Dean Vaughn Medical Terminology.
See online medical websites for accepted abbreviations and terms.
Standard Number:
HSE.S.EKP.3 / Legal Responsibilities
Students will
·  understand the legal responsibilities, limitations, and implications of their actions within the healthcare delivery setting.
·  perform their duties according to regulations, policies, laws, and legislated rights of clients.
Essential
Questions: / How can the lack of knowledge and understanding of the legalities of the healthcare system affect the roles of the phlebotomist and/or EKG technicians?
Objectives: / Students will / Learning Plan & Notes to Instructor:
HSE.O.EKP.3.1 / determine the meaning of negligence,
malpractice, assault, battery, liability, and
Respondent Superior. / negligence
·  negligence torts
·  duty of care
·  burden of proof
o  conditions that must exist
▫  duty
▫  breach of duty
▫  causation-injury sustained
▫  damages-injury caused by acts R/T breach of duty
malpractice
·  burden of proof
torts
·  assault
·  battery
liability
·  strict
Respondent Superior
HSE.O.EKP.3.2 / examine legal responsibilities and actions
given sample scenarios. / Note: use definitions from Objective 3.1 to determine correct and incorrect actions given in sample scenarios.
HSE.O.EKP.3.3 / interpret the scope of practice of the
phlebotomist and EKG technician. / Student Learning Activities: Contact credentialing agencies for acceptable practices.
Research local, state, and national requirements for licensing of phlebotomists and EKG technicians.
Interview local healthcare facility for job descriptions of phlebotomist and EKG technician.
HSE.O.EKP.3.4 / recognize common ethical standards within
the healthcare profession. / ethics
·  values
·  morals
ethical code principals
·  saving lives and promoting health
·  provide comfort for the patient/client
·  preserve life whenever possible
·  respect patient’s/client’s choice to die peacefully and with dignity
·  treat all patients/clients the same, no matter race, religion, social or economic status, sex, or nationality
·  provide care for all to the best of you ability
·  maintain competency of your skills
·  stay informed, up-to-date with CEUs
euthanasia
·  by consent
o  voluntary
o  involuntary
·  by means
o  passively
o  non-actively
o  actively
HIV/AIDS issues
abortion issues
HSE.O.EKP.3.5 / interpret patient confidentiality, recognizing
common threats to confidentiality. / confidentiality
·  sharing patient/client information
o  who may know
o  who may not know
threats to confidentiality
·  gossiping
·  immoral, unethical, and illegal practices
·  negative or derogatory statements
·  disrespect
·  defamation of character
o  libel
o  slander
violating confidentiality
·  personal ramifications
·  patient/client damages such as personal and/or financial suffering
HSE.O.EKP.3.6 / examine the Patients’ Bill of Rights as it
applies to clinical laboratory personnel and
the EKG technician. / Patient Care Partnership (April 2003)
·  patient expectations of care
o  high quality care
o  clean and safe environment
o  involvement in patient care
§  right to discuss medical condition
§  right to discuss diagnosis, treatment, and prognosis
§  right to receive necessary information to give informed consent for treatment/procedure
§  right to refuse treatment and consequences of refusal
§  right to expect all communications/records treated as confidential
§  compliance to patient’s reasonable requests for services
§  notification of any human experimentation affecting their care or treatment (may refuse to be involved in research projects)
§  responsibility to give accurate information (patient/client)
§  responsibility to share health care goals and values (patient/client)
§  responsibility to notify caregivers of Durable (Medical) Power of Attorney (patient/client)
§  right to know rules and regulations that applies to patient conduct
o  protection of patient privacy
o  instruction and aid in preparation for discharge
o  assistance in filing insurance claims/other billing matters
Student Learning Activity: obtain a copy of the Patient’s Bill of Rights from hospitals, clinics, and physician’s offices and have students to examine them for similarities/differences.
Speak with clinical personnel to determine Patient Rights protocol for their agency.
Standard Number:
HSE.S.EKP.4 / Infection Control and Safety
Students will demonstrate an understanding of infection control and safety policies and procedures.
Essential
Questions: / In terms of disease transmission and prevention, are clinical facilities safer for patients than home care?
Objectives: / Students will / Learning Plan & Notes to Instructor:
HSE.O.EKP.4.1 / determine policies and procedures for
maintaining safety in the laboratory and
during EKG procedures. / See Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recommendations.
See Clinical Laboratory Improvement Association recommendations.
See American College of Cardiology guidelines for ECG interpretation.
OSHA standards and precautions
·  quality Assurance (QA)
·  technical/non-technical procedures
·  staffing
·  staff responsibilities
·  identification of proper patient care procedures
·  corrective actions
written protocols
·  patient prep
·  transportation of specimens
·  ID of the patient
·  reporting results
·  record keeping
·  proper collection techniques
·  proper preservations
·  criteria for specimen rejection
·  panic values
·  retrieval information
HSE.O.EKP.4.2 / examine the modes of transmission of
microorganisms. / mode of transmission
·  direct contact
·  indirect contact
droplet transmission
·  conjunctiva
·  nasal mucosa
·  mouth
airborne transmission
·  droplet nuclei
·  dust particles
vector-borne transmission
·  mosquitoes
·  flies
·  rats
·  other vermin
HSE.O.EKP.4.3 / compare methods for controlling the growth
and spread of microorganisms. / asepsis
·  medical asepsis
o  hand washing
o  disposable gloves
o  good personal hygiene
·  surgical asepsis
·  antisepsis-prevent/inhibit
o  examples
§  alcohol
§  betadine
·  disinfection-destroys/kills
o  examples
§  bleach solutions
§  zephirin
·  sterilization-kills pathogens/nonpathogens
o  examples
§  steam under pressure
§  gas
§  radiation
environmental sanitation
·  disposal of infected waste
·  effective housekeeping practices
·  physical plant procedures
effective ventilation practices
·  HEPA filters
·  personal respirators
·  negative air flow in isolation rooms
reservoir control
·  hand washing
·  appropriate use of barrier precautions
HSE.O.EKP.4.4 / apply infection control and safety proce-
dures based on Occupational Safety and
Health Administration (OSHA) and the
Centers for Disease Control (CDC) (i.e.
Standard Precautions). / Note: Behaviors and characteristics should be exhibited during the work-based clinical experience. Evaluation of these objectives will occur within the clinical setting.
HSE.O.EKP.4.5 / apply proper use of personal protective
equipment (PPE). / personal protective equipment (PPE)
·  gloves
·  latex
·  vinyl
·  nitrile
·  gowns/lab coats/aprons
·  protective face gear
o  masks
o  goggles
o  face shields
conditions for PPE use
·  patient/client condition
·  types of isolation
Note: apply proper PPE usage according to Standard Precautions. Behaviors and characteristics should be exhibited during the work-based clinical experience. Evaluation of these objectives will occur within the clinical setting.
HSE.O.EKP.4.6 / examine nosocomial infections. / Nosocomial
·  place where acquired
o  hospital
o  long-term care facility
o  acute care facility
·  examples
o  Staphylococcus
o  Pseudomonas
o  Enterococci
o  antibiotic-resistant infections
§  (MRSA) Methicillin Resistant Staphylococcus Aureus
HSE.O.EKP.4.7 / determine the electrical, radiation, biological
hazards, and fire safety procedures used in
the hospital, including the clinical laboratory. / Student Learning Activity: Interview Safety Operations Manager at local healthcare facilities as to hazards and safety procedures.
Contact National Fire Protection Association (NFPA) 704 about identification of Hazards of Materials symbol system.
five degrees of hazard
·  rating system
o  4-too dangerous to approach
o  3-extremely hazardous situations
o  2-combustible liquid
o  1-nuisance hazard
o  0-no special hazards
·  color coding system
o  blue-health hazard
o  red-flammability hazard
o  yellow-reactivity (stability) hazard
o  white-other hazards (specific hazard, radioactive or water reactive
classification of fires
·  Class A
·  Class B
·  Class C
·  Class D
·  Class E
types of fire extinguishers
·  Class A
·  Class B
·  Class C
·  Class ABC
HSE.O.EKP.4.8 / illustrate the hazard symbols for radiation,
biohazard, toxic or poison, carcinogen,
corrosive, flammable, and NFPA chemical
hazard. / Student Learning Activities: research hazard symbols online; make drawings poster size to be used in the classroom, contact National Fire Protection Association (NFPA) 704 for posters, brochures, flyers about hazard symbols.
HSE.O.EKP.4.9 / recognize and label biohazard specimens. / Student Learning Activities: using objective 4.8, label given specimens with the correct biohazard symbol; given a sample specimen, name the biohazard label used; during clinical simulations or clinical site training, be able to recognize biohazard labels used.
HSE.O.EKP.4.10 / determine the safety measures followed by
a phlebotomist when collecting or
transporting a specimen. / laboratory hazards
·  biohazards
·  sharps
·  chemical hazards
·  electrical hazards
·  radioactive hazards
·  fire or explosion hazards
laboratory safety