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A Coalition is Pushing for Phlebotomy Personnel Standards
by Dennis Ernst, MT (ASCP)
Director, Center for Phlebotomy Education, Inc.
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Since its founding in 2003, the Coalition for Phlebotomy Personnel Standards (CPPS) has been bringing attention to the need for minimum training standards for specimen collection personnel, and the winds of change are starting to stir. Today, California is the only state with minimum training requirements for all phlebotomists, in almost every other state, you need a license to style hair, but if you want to stick a needle into someone's arm to draw blood, no minimum training requirements exist. The Coalition would like to change that.
CPPS was founded to address the impact that poorly collected specimens have on patient care not only in the form of inaccurate laboratory test results and patient injury, but on specimen collection systems and laboratory instrumentation as well. A large percentage of instrumentation problems are caused by poor specimen quality. If we can improve the quality of the samples that laboratories test, we can drastically reduce technical instrumentation problems that manufacturers have to deal with, including those caused by fibrin formation, hemolysis, clots and inadequate centrifugation. If you want to improve the quality of specimens the laboratory receives, you improve the education of those who draw the blood.
But reducing instrumentation problems is only one of the benefits of an improved specimen collection workforce. Another is a reduction in erroneous results that are unknowingly reported when specimens are altered during the collection process. These are phlebotomy's "invisible errors."
No matter how sophisticated the testing instrument is or how well trained the testing personnel may be, no combination of technology and expertise can extract an accurate result out of a poorly collected specimen. In most cases, the individual performing the assay has no way of knowing the specimen was altered and that the results don't accurately represent the patient's physiology. The next thing you know, the patient is the victim of a medication error that leaves everyone scratching their heads.
The Coalition has developed a position paper which articulates the organization's belief that improving the quality of collected specimens reduces medical errors that are based on inaccurate results, prevents patient injury, and improves the performance of laboratory instrumentation. All of these will contribute to improved patient care.
Since its first meeting, the Coalition has developed into a diverse group of representatives from specimen-collection product manufacturers, certification agencies, professional clinical laboratory membership associations and government agencies.ÿOne of the Coalition's objectives is to identify individuals in all states who are interested in promoting minimum training requirements and certification for specimen collection personnel through legislation.
The response has been phenomenal. Individuals in 30 states have stepped up to advance minimum personnel standards in their legislatures so far. There really has been a groundswell of support from all corners of the phlebotomy community. The industry seems anxious to advance the phlebotomy profession for the greater good.
Since the Coalition formed in 2003, bills addressing personnel standards for phlebotomists and other specimen collection personnel have been introduced in Kentucky, Connecticut, Massachusetts and Missouri. Bills are also being drafted for introduction in Utah and Michigan. The Connecticut bill died in committee in May, but we encourage the sponsors and supporters to reintroduce a revision in the next session.
The Coalition seeks to assist individuals in each state by preparing a model bill that can be modified to suit the preferences of those promoting legislation in their states and by providing a general strategy outline for bringing legislation to the attention of their legislators. Raising public awareness is also important to motivating legislators. We've already seen NBC affiliates in Detroit and Boston airing investigative reports on their evening news about the lack of regulations for phlebotomists, so when it comes to raising public awareness, the horse is already out of the barn. In addition to these investigative reports, I have been interviewed by the Washington Post and approached for an interview by the syndicated talk show Air America about phlebotomy personnel standards.
The Coalition's position has been endorsed by the American Medical Technologists, the National Health Career Association, the National Credentialing Agency for Laboratory Personnel, Phlebotomy Legislation, LLC, the Center for Phlebotomy Education, and RAM Scientific. We actively seek new endorsements and participants at our semiannual meetings and recruit individuals to advance minimum training requirements in their states. Participation in Coalition meetings is open to representatives from manufactures of specimen collection products/systems and clinical laboratory instrumentation, professional clinical laboratory organizations, governmental agencies, certification organizations and patient/consumer advocacy groups who endorse the Coalition's position paper, which can be accessed on our web site at www.phlebotomy.com/CPPS/home.htm. Interested parties are encouraged to contact me by email at phlebotomy@phlebotomy.com or by calling the Center for Phlebotomy Education at 812-633-4636.
It took a California phlebotomist to be caught rinsing and reusing needles on multiple patients for California to enact sweeping legislation mandating minimum training requirements for specimen collection personnel. That was six years ago and not one state has followed suit. Will it take similar catastrophes in every state to get legislators to act? We hope not; but we're moving forward just in case.
The United Kingdom is light years ahead of the US when it comes to having phlebotomy recognized as a formal profession that requires specific skills and training. But without their membership organization, the National Association of Phlebotomists, they would be in the same boat as US phlebotomists. Instead, they enjoy professional recognition. We desperately need a membership organization in the US.
I encourage anyone interested in forming a membership organization to contact the Center for Phlebotomy Education, and we will put those interested in contact with each other to begin the process. We also encourage existing laboratory membership organizations to consider establishing a separate membership entity for phlebotomists and other specimen collection personnel. Too many phlebotomists feel like the neglected step-children of the laboratory.
Note: Mr. Ernst is the director of the Center for Phlebotomy Education, Coordinator of the Coalition for Phlebotomy Personnel and editor of Phlebotomy Today. For more information, visit www.phlebotomy.com.
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A Coalition is Pushing for Phlebotomy Personnel Standards
by Dennis Ernst, MT (ASCP)
Director, Center for Phlebotomy Education, Inc.
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