Phlebotomy 2015 Conference [Summary]

conf-2015-04-meeting-challenges Mayo Medical Laboratories Phlebotomy 2015 Conference: Meeting the Challenges of a Changing Health Care System will be held from April 23-24 in Rochester, Minn. The conference is packed full of lectures and information from the leading voices in the field of phlebotomy. Follow along as we live blog the Phlebotomy 2015 Conference. We will be posting presentation summaries, photos and other multimedia throughout the conference. If you are on Twitter, follow the conference hashtag at #2015Phleb.


Posted on April 24 at 2:30 p.m. “Improving Pediatric Specimen Quality” by Darci Block, Ph.D. and Nicole Kang

Darci Block, Ph.D., Mayo Clinic Consultant, Clinical Core Laboratory Service Division, and Nicole Kang, Mayo Clinic Outpatient Laboratory Supervisor, discussed the quality of pediatric specimen collections during their breakout session. Key points of the presentation included:

  • 70% of testing errors occur in pre-analytical phase
  • Use of sucrose solution in heel stick prior to blood collection is recommended for pain management
  • Venipuncture by experienced phlebotomist is less painful for heel stick and may have less adverse events such as bruising
  • In the NICU, it’s important to pause infusions whenever possible and to pay attention to tube inversions to reduce clotted samples
  • In patients with recurrent hemolysis, hand carry samples to the laboratory and collect blood in non-gel tubes
Nicole Kang, and her physician partner Darci Block, Ph.D., shared the Mayo Clinic experience of improving pediatric phlebotomy practices.
Nicole Kang, and her physician partner Darci Block, Ph.D., shared the Mayo Clinic experience of improving pediatric phlebotomy practices.

Posted on April 24 at 12:30 p.m. “A Patient’s View of Customer Service” by Al Dalbello

Al Dalbello
Al Dalbello

Al Dalbello described the patient’s view of customer service during his presentation, which touched on the basics of customer service, challenges of customer service in healthcare, patient expectations, and the practical reality of what we can do to help. Key points of the presentation included:

  • Patient experience is defined as “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”
  • Patients are directing more of their personal care and defining how and when it is delivered, including:
    •  Immediate availability
    • Broad range of hours
    • High-quality service
    • Convenient location and hours
    • Clear pricing vs. EOB a month later
    • Positive clinical outcomes
  • Creating the patient experience is everyone’s responsibility, and includes attentiveness, patience, and a calming presence

Posted on April 24 at 11:00 a.m.“Capillary Lipid Screening: Challenges and Opportunities” by Leslie Donato, Ph.D., DABCC

During her breakout session, Leslie Donato, Ph.D., DABCC, Mayo Clinic Consultant, Clinical Core Laboratory Service Division, discussed lipid testing basics, guidelines for testing adults and pediatrics, challenges for pediatric testing, and capillary testing pros and cons. Key points of the presentation included:

  • Total cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol are all lipids measured in the laboratory
  • 40 percent of overweight children will have a lipid abnormality
  • Screening overweight children can identify mild to moderate dyslipidemia that is generally responsive to lifestyle changes or genetic dyslipidemia
  • POC lipid testing has less “needle fear,” more compliance, and provides immediate interpretation
  • Capillary sampling is used if arterial sampling is not possible, or for blood gas testing
  • Lipid measurements should be performed on adults and children to screen for dyslipidemia
  • POC lipid testing could improve compliance with universal screening in pediatrics

Posted on April 24 at 9:00 a.m.

“Top Gun Phlebotomy” by Brad Karon, M.D., Ph.D.

Brad Karon, M.D., Ph.D.
Brad Karon, M.D., Ph.D.

Day two opened with a presentation by Brad Karon, M.D., Ph.D., Mayo Clinic Consultant,Clinical Core Laboratory Service Division. Dr. Karon outlines technical issues involved in the collection of blood specimens during intravenous starts and discussed what we know about this practice and spoke to the quality of intravenous start blood collection. His presentation discussed:

  • Why pseudohyperkalemia (K) is too high
  • Appropriate use of butterfly
  • How to take a blood sample of patients with Fistula in one arm and mastectomy in the other arm
  • How to draw blood from a patient suffering from second/third degree burns

Key points of the presentation included:

  • Reduce rate of K by preventing fist pumping, preventing temperature extremes during transport, and centrifuge whole blood onsite
  • Butterfly usage increases hemolysis rates and rates of percutaneous needle exposures
  • The best place to draw blood on a patient with Fistula in one arm and mastectomy in the other arm is on the arm on the side of mastectomy
  • In patients with burns over most of exposed body, no vascular access, the best way to draw blood in emergency is to collect through burned area with butterfly

Posted on April 23 at 4:00 p.m. “Overview of Physical Ergonomic and Cognitive Human Factors Issues in Phlebotomy Practice” by Val Halling, M.Ed., SSBB, and Sandra Woolley, Ph.D., CPE

Val Halling
Val Halling

Val Halling, M.Ed., SSBB, Mayo Clinic Project Manager, and Sandra Woolley, Ph.D., CPE, Mayo Clinic Ergonomist, described the basic principles of ergonomics, primary risk factors, and methods to reduce these risk factors in phlebotomists. Key points of the presentation included:

  • It’s natural for people to make errors and for people to miss a defect
  • Human error generally comes from deficits of attention, working memory, decision making, strong pattern recognition, similarity between different tasks, and “automaticity” in task performance
  • Common culprits of human error include equipment, task, policies/procedures,
    Sandra Wooley
    Sandra Wooley

    environment, teamwork and collaboration, and culture

  • The goal of ergonomics is to design the job to fit the worker, not make the worker fit the job
  • Phlebotomists are prone to back sprains and strains, and wrist injuries
  • To modify your job, look at equipment, work practices, scheduling and training

Posted on April 23 at 1:30 p.m. “The Stressful, the Combative, and the Days You Wished You Would Have Just Stayed Home” by Danny Grabau

Danny Grabau
Danny Grabau

Danny Grabau, Mayo Clinic Phlebotomy Education Assistant, discussed how to deal with angry patients, family members and co-workers, and how to effectively manage a stressful situation during his breakout session. Key points of the presentation included:

  • Identify upset patients, family members, and staff by assessing body language, verbal and non-verbal cues
  • Be proactive with upset individuals by doing the following:
    • Smile
    • Relaxing demeanor
    • Eye contact
    • Respect personal space
    • Engage in calm conversation
    • Listen
  • Manage a stressful situation by remaining calm, listening carefully, and showing support and respect
  • Look out for your own safety by analyzing the individual’s state, including emotions, verbal, physical, and environmental conditions
  • Take care of yourself by recognizing when your “normal” changes, either emotionally or physically

Posted on April 23 at 12:00 p.m. “Reducing Emergency Department Redraws” by Twyla Rickard and Laurie Griesmann

Laurie Griesmann, kicks off her section of the presentation, "Reducing Emergency Department Redraws." She co-presented with Twyla Rickard.
Laurie Griesmann, kicks off her section of the presentation, "Reducing Emergency Department Redraws." She co-presented with Twyla Rickard.

During their breakout session, Twyla Rickard, Mayo Clinic Operations Manager, and Laurie Griesmann, Mayo Clinic Quality Specialist, discussed blood collections in the Emergency Department. The presentation examined the practice of collecting blood from IV starts. Key points of the presentation included:

    • IV starts under ideal conditions will have a redraw rate
    • IV start blood collections are inherently problematic
    • Using a vacutainer device with a 2 ml discard has limited ability to improve redraw rates
    • Limiting IV start blood collections has the greatest impact

Posted on April 23 at 11:30 a.m. “Butterflies: Does Usage Match the Need?” by Shannon Newberg

Shannon Newberg, Mayo Clinic Phlebotomy Education Assistant, delivered a presentation that discussed phlebotomists’ use of butterfly, and whether its usage matches the need for it. Key points of the presentation included:

  • Butterfly is over 3-times the collection costs compared to the evacuated system
  • Phlebotomists in the outpatient areas are using the butterfly device appropriately
  • Physical limitations influence butterfly usage
  • For inpatient laboratory services, phlebotomists use a butterfly more than a vacutainer
  • Specimen quality is not compromised when butterfly equipment is used properly
Shannon Newberg presenting, "Butterflies: Does Usage Match the Need?"
Shannon Newberg presenting, "Butterflies: Does Usage Match the Need?"

Posted on April 23 at 10:00 a.m. Keynote Address: “Difficult Situations: Handling Them With Confidence”

Louellen N. Essex, Ph.D., provides instructions to the conference attendees during one of many table discussions.
Louellen N. Essex, Ph.D., provides instructions to the conference attendees during one of many table discussions.

The keynote address for this year’s conference was, “Difficult Situations: Handling Them With Confidence.” The presenter was Louellen N. Essex, Ph.D., who is an organization learning and development consultant specializing in leadership, communication, team building and conflict resolution. Key points of the presentation included:

  • Identify what makes a situation challenging
  • Understand how to think through a challenging situation in a calm and open-minded manner
  • Learn how to communicate effectively by clearly stating what you are trying to convey without getting frustrated or angry
  • Active listening can help you understand a difficult situation better and without jumping to conclusions

 

Conference attendees share their table's discussion during the keynote presentation by Dr. Essex.
Conference attendees share their table's discussion during the keynote presentation by Dr. Essex.

Posted on April 23 at 8:00 a.m. Phlebotomy 2015: Meeting the Challenges of a Changing Health Care System  The MML Phlebotomy 2015 Conference, Meeting the Challenges of a Changing Health Care System, is now in session!


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Kelley Schreiber

Kelley Schreiber is a Marketing Channel Manager at Mayo Medical Laboratories. She is the principle editor and writer of Insights and leads social media and direct marketing strategy. Kelley has worked at Mayo Clinic since 2013. Outside of work, you can find Kelley running, traveling, playing with her new kitten, and exploring new foods.