COURSE DESCRIPTION

The student will demonstrate skill development in the performance of a variety of blood collection methods using proper techniques and standard precautions. Collection methods include vacuum collection devices, butterfly needles, capillary skin puncture, syringes and blood culture, with specimen collection on adults, children, and infants. Emphasis is placed on infection control and prevention, proper patient identification, labeling of specimens, quality assurance, specimen handling, processing, and accessioning.

PREREQUISITES

1. Successful completion of PLAB 1323 with a grade of “C” or better.
2. Successful completion of PLAB 1023 with a grade of “C” or better, taught by ACC MLT faculty.
3. Submission of all pre-clinical paperwork, ACC Health Data/Physical Exam form, documentation of negative TB test on ACC Initial Program TB Test Form, and flu shot (if required).
4. Documented review and acknowledgement of the Phlebotomy Student Handbook.
5. Compliance with ACC’s Urine Drug Screening Policy.
6. Compliance with ACC’s Criminal Background Policy.
7. Compliance with ACC’s Health Insurance Policy.

COURSE MATERIALS REQUIRED

1. Teal Scrubs – must adhere to College policy. Refer to the ACC Phlebotomy Student Handbook found at: https://sites.austincc.edu/health/programs/handbooks/#plab
2. Face covering, if applicable
3. Neck shield, if applicable
4. Face shield or goggles, if applicable
5. ACC Student Photo Identification Badge – MUST be worn daily in clinical
6. Pen and/or sharpie
7. One (1) inch binder with dividers
8. Small (pocket size) note pad for taking notes during clinical.
9. Clinical paperwork packet: ACC provides the packet to the student at the Clinical Orientation.
10. Lecture guide and laboratory notebooks from PLAB 1323/1023 class.

ATTENDANCE POLICY

You MAY NOT make changes to your clinical schedule without the approval of your ACC professor. As soon as you are aware that ANY change to your clinical schedule may be needed, contact your ACC professor. Changes must also be approved and coordinated with your clinical site.

ALWAYS be on time! Arrive at the clinical site a few minutes prior to your scheduled time to give yourself some “breathing space” for getting lost or encountering unexpected traffic delays. Regular and punctual attendance on all clinical days is required. Absences or tardies from clinical for reasons other than health or emergencies will not be tolerated, and the student may be subject to withdrawal from the program if more than two absences or tardies are recorded. Vacation requests will not be accepted or approved during the time the student is scheduled for practicum. All absences, regardless of excuse, must be made up by the student. The student must coordinate the make-up day with the ACC professor and the clinical site. The student must notify the clinical site and the professor of all absences or tardies as far in advance as possible or at least within the first hour they are scheduled. A student who is late by 10 minutes or more will be considered officially tardy. The clinical site reserves the right to hold the student to the same attendance policy as employees and may ask that a student be removed from their site for violating their attendance policy.

This syllabus serves as the verbal warning for any absence or tardy. A second absence and/or tardy will result in a formal conference. A third absence and/or tardy will result in probation. Illnesses of several days’ duration or emergency situations resulting in several consecutive days of absence will be

considered one absence event. The time must be made up regardless of reason for absence.

TARDY - If you are going to be late CALL THE SITE. They may be waiting for you before leaving to go on their rounds or will arrange the work at hand with you in mind. A courtesy call will allow them to get started on time.

ABSENCE - If you must be absent CALL THE CLINICAL SITE AND YOUR ACC Professor. The clinical instructor will know you are not coming and will redistribute the collections set aside for you.  ACC Professor’s routinely visit students at the clinical site during the rotation. The ACC professor will rearrange the site visit schedule when they know you are there.

Any ACC student or employee with symptoms or exposure to the COVID-19 virus should inform their ACC professor(s) before attending clinicals.

Penalties for No Call/No Show

Failure to notify clinical faculty and ACC instructor of an absence one hour prior to the scheduled arrival time, or as soon as the clinical site is open for the day (no call/no show) will result in immediate probation and a 10-point deduction from the Final Clinical Evaluation grade. A second “no call no show” will result in an additional 20-point deduction from the Final Clinical Evaluation grade, and withdrawal from the course. If the deadline for withdrawal has passed the student will receive a grade of “D”.

COURSE POLICIES

1. Manner - key words “professional, pleasant, confident”

1. On the first day or two the staff may require a period of observation. Make notes of the clinical staff member’s organization of lab requisitions, how the staff interacts with the patients, the proper way to greet and identify the patient, techniques used which may differ from what you did in the student lab on campus.
2. When allowed to perform blood collections, use all the skills practiced in student lab. Greet the patient, identify yourself and the patient, obtain verbal consent to proceed, explain the procedure, and assemble equipment. Be confident and courteous. NOTE: If a student is observed in the clinical setting not identifying themself as a student, the student will be placed on immediate probation.
3. RECOGNIZE YOUR LIMITATIONS. There may be times when a patient does not have good veins, or the veins are not readily apparent. Ask for guidance from your clinical instructors. Observe how they palpate the arm and allow them to show you where the vein is located. Then perform the venipuncture yourself if you feel confident. The greatest confidence builder is when you successfully draw blood on a patient whose veins are difficult.
4. ACC policy allows a student to attempt only ONE venipuncture on any patient. If you are unsuccessful DO NOT attempt a second draw, get your clinical instructor immediately. NOTE: Students that attempt multiple venipunctures on a patient will be placed on immediate probation.
5. Each one of you will occasionally have a “bad day”. You will miss two or more patients in a row and may start to question your ability for the moment. This is NORMAL. When this does occur, it may devastate your self-confidence for the moment. Take a break, go out and take a walk, do whatever you need to do to help you get over it. It is critically important for you to know that this happens to EVERYONE involved in phlebotomy on a routine basis. Do not let it defeat you. Remember, your evaluation is based on your overall performance, not on an isolated incident.
6. Cell phones MUST NEVER be used in the clinical area. Leave them in a secure area with your other belongings. You may make personal phone calls only on your break or at lunch. If child caregivers need to contact you during your scheduled clinical time, give them the phone number for your clinical site as a contact number. NOTE: Students that are observed using a cell phone in the clinical area may be placed on Probation.
7. During the day restock and disinfect your work area as necessary and check and replace the puncture resistant biohazard containers as needed. This must also be done at the end of your shift, prior to leaving. This is not optional. It is a privilege for you to be at the clinical site. The clinical personnel are taking time out of their busy day to allow you to obtain the skills necessary to be a great phlebotomist. This simple courtesy is a very big way to thank them for their time and effort.

STUDENT EVALUATION AND GRADING

1. A student who passes PLAB 1323/1023 but fails PLAB 1166/1066 (grade less than 70%) will NOT receive a certificate of completion and will NOT be eligible to take the national certification examination.

1. The successful completion of the Clinical Practicum course is based on the following criteria:
   1. Graded Final Clinical Evaluation signed and dated by the clinical faculty and student.
   2. Average of grades obtained on the exams of the 4 assigned Medtraining modules.
   3. Average of grades on the discussion board postings to Blackboard.
   4. Perform a minimum of 100 clinical hours (hours of applied experiences) – LUNCH DOES NOT COUNT.
   5. Receive passing marks on all shaded areas on the Clinical Competency Assessment form.
   6. Submission of all required clinical documents, including but not limited to the Clinical Paperwork Packet.
   7. Perform and document a minimum of 100 unaided, successful venipunctures.
   8. Collects and documents a minimum of 80% of assigned patients successfully. Student success rate will be calculated at the conclusion of the clinical practicum.
   9. Perform a minimum of 5 capillary punctures. (This requirement will be met during on-campus activities, either PLAB 1323/1023 or on-site clinical, as applicable, and will be documented on the Blood Collection Log Sheet and the Capillary Puncture - Fingerstick Form.)

1. Competency Assessment Form

Competency assessment is used to determine that the student has the necessary knowledge and skills to perform a basic laboratory test or procedure accurately.  Each competency assessment has a written set of specific criteria which must be performed without error to demonstrate that competency has been achieved.  The student will be provided with the assessment criteria. The Competency Assessment should be done once the student has completed approximately 35 successful venipunctures.
 

1. Competencies are “Pass” or “Fail” and must be completed successfully to pass the course.
2. All competencies with a shaded box under the “fail” column must be achieved successfully.
   1. 1. If a student is initially unsuccessful, the student will notify and meet with their ACC instructor for a documented verbal warning to review the procedure for performing the specific skill. During the conference, remediation and an action plan for improvement will be developed.  The ACC instructor will review the competency form and get additional input from the clinical mentor. The student will provide input as what they will do to be successful. A student may be asked to return to campus for remediation and additional practice under the supervision of an ACC instructor as part of the action plan. This will be documented on the Corrective Actions/Progressive Discipline form.
      2. The student will be allowed to repeat the competency assessment at a specified time.
      3. If the student is unsuccessful after the second attempt, the student will meet with the ACC instructor for a written conference to review the procedure for performing the specific skill. The ACC instructor will review the competency form and get additional input from the clinical mentor. During the conference, remediation and an action plan for improvement will be developed.  The student will provide input as what they will do to be successful. A student may be asked to return to campus for remediation and additional practice under the supervision of an ACC instructor as part of the action plan. This will be documented on the Corrective Actions/Progressive Discipline form.
      4. The student will be allowed to repeat the competency at a specified time.
      5. If the student is unsuccessful after the third attempt, the student will be placed on “Probation” and will meet with the instructor for additional remediation and to review and modify the original action plan for improvement as needed. The ACC instructor will review the competency form and get additional input from the clinical mentor. The student will provide input as what they will do to be successful. A student may be asked to return to campus for remediation and additional practice under the supervision of an ACC instructor as part of the action plan. This will be documented on the Corrective Actions/Progressive Discipline form.
      6. The student will be allowed a final opportunity to repeat the competency assessment.
      7. If the student is unsuccessful on the final attempt, the student will meet with the department chair for an exit interview.
      8. If this occurs before the stated drop date of the college the student must withdraw from the course.
      9.  If the date for withdrawal has passed a grade of “D” will be awarded for the course on the transcript.  If the student has earned less than a “D,” then the grade of record on the transcript will be an “F”.

1. Final Clinical Evaluation -45%

1. The Final Clinical Evaluation is the graded portion of your performance and is worth 45% of the clinical grade.
2. The student must achieve 70% or better in 13 of the 15 areas and an overall average score of 70% for the clinical grade.
3. If the date for withdrawal has passed a grade of “D” will be awarded for the course on the transcript.  If the student has earned less than a “D,” then the grade of record on the transcript will be an “F”.

1. Phlebotomy Clinical Success Rate- 10%
   1. Students will log in all misses/successes on draws while in clinical.
   2. At the point of paperwork submission, the success rate will be determined by the instructor.
   3. The student must have a minimum of 80% success to complete the course.
   4. The student success rate is worth 10% of the clinical grade.

1. Discussion Board in Blackboard -20% - http://acconline.austincc.edu

1. There will be a total of four (4) discussion board posts in the PLAB 1166 Blackboard course. For each forum, follow the instructions in the discussion board section, under each forum.
2. The faculty recommends creating your post in a word processing program (Word) and save it. Each program has a method of doing a word count; make sure it is 150 words. Copy/Paste the post into Blackboard. If for some reason your post is unsuccessful you will have your saved copy as a back-up.
3. The due dates for all postings will be posted in the Announcements section in Blackboard.
4. Late assignments will not be accepted. Failure to post by the due date will result in a grade of zero for any missed assignment.
5. Discussion board posts are averaged and are worth 20% of your course grade.
6. At times, instructors may change the required topic for Discussion Board postings and the required due date. Students would be notified of these changes by email at least 1 week in advance of the new due date.

1. Medtraining (MTS) Modules – 20% - http://acconline.austincc.edu

1. The instructor will assign and list the specific MTS modules in the Announcements section of Blackboard. After reviewing the module, take the module test.
2. Students are allowed to repeat each module test for a higher score until the due date. The highest score for each module will be recorded following the module due date.
3. Scores obtained from the module tests are averaged and account for 20% of the course

grade. THIS IS NOT AN OPTIONAL ASSIGNMENT.

 The due dates for the Medtraining assignments will be posted in the Announcements section in Blackboard. No late assignments will be accepted.

1. Log-In: Students may access Medtraining by clicking on the appropriate button in the course Blackboard OR directly enter the site through www.medtraining.org . Your user name AND password are the same as you used for Medtraining in the PLAB 1323 course. Your username is your ACC ID without the first letter.

 EXAMPLE: ACCeID s023456 would be “023456”.

Problems with logging in to Medtraining or accessing Medtraining assignments should be brought to the course instructor’s attention ASAP.

1. Clinical Paperwork Packet and Site Survey- 5%
   1. Site Evaluation Survey
      1. After completion of the clinical rotation, every student must complete a site evaluation. This is completed electronically, and a link will be provided in the Announcement section of Blackboard. The information gathered from this form is utilized to make decision as to the quality of training at the site. Be as open and objective as possible. All student responses are combined into one document and any persons named are de-identified before results are shared with the clinical sites. Students must complete the site evaluation prior to submitting clinical paperwork.
      2. If the student fails to complete the survey prior to the paperwork appointment date and time, the student will receive a zero for the completion of the survey grade and will be expected to complete the evaluation during the clinical paperwork appointment.

1. 1. Documentation and Submission of Clinical Paperwork

During the clinical rotation, your ACC Instructor will come to your clinical site to check on your progress. During this visit, the ACC Instructor will review your clinical paperwork. It is the student’s responsibility to maintain proper documentation of their clinical experience. This includes:

•  Properly document their specimen collections daily on their log sheets.
•  Initials of clinical mentors on daily log sheets.
•  Clinical mentor signature and dates on clinical orientation sheet, check off sheets, competency forms, weekly progress reports, and final clinical evaluation.
•  This syllabus serves as the verbal warning for student to keep their log sheets up to date daily. Students who do not have the log sheets filled in will be placed on corrective actions at the conference level.

1. A specific date is set aside at the end of the clinical rotation for each student to submit their completed clinical paperwork. Each student’s date will be noted on the clinical schedule as “ACC”. During the final week of the student's rotation, the student must contact one of the course instructors, preferably by email, to arrange a specific meeting time and location. The date is indicated on the clinical rotation schedule. If needed, program faculty may adjust a student’s “ACC” date to account for extensions in the clinical rotation length.  
2. A 5-point penalty will be deducted from the student’s Final Clinical Evaluation grade for failing to keep the scheduled "ACC" appointment date and time.
3. The student may face an additional 10-point penalty from their Final Clinical Evaluation grade for failure to submit completed paperwork within 7 working days of the completion of the clinical rotation.
4. The student’s clinical paperwork packet must be complete, appropriately initialed, signed and dated. Only completed clinical paperwork packets will be accepted. If incomplete, points will be deducted and the student will be required to return to the clinical site and arrange to have the appropriate paperwork completed. A second appointment with the course instructor must then be scheduled. If more than 7 working days from the completion of the rotation have passed, the 10-point penalty will be applied.    

Late Work Policy

1. Medtraining and discussion board posts must be completed by the posted due date in the Announcements section of Blackboard, unless otherwise directed by the instructor. No late work is accepted.
2. NO assignments will be accepted by email.

GRADING

An overall grade of 70% or better is required to be awarded a certificate of completion

            A =90-100%

            B= 80-89%

            C=70-79%

            D=60-69%

            F= 59% or below

I = Incomplete, may be awarded if the student has completed the majority of the course work with a passing grade and experiences highly unusual circumstances that prevent course completion. Withdrawing from the course may be a more appropriate action. The course work must be completed by the final withdrawal deadline of the following semester.

ESSENTIAL FUNCTIONS AND TECHNICAL STANDARDS The Phlebotomy Technician Student Handbook contains the essential functions and technical standards.

Clinical paperwork packet: ACC provides the packet to the student at the Clinical Orientation.

Lecture guide and laboratory notebooks from PLAB 1323/1023 class.

COURSE DESCRIPTION

The student will demonstrate skill development in the performance of a variety of blood collection methods using proper techniques and standard precautions.  Collection methods includes vacuum collection devices, butterfly needles, capillary skin puncture, syringes and blood culture, with specimen collection on adults, children, and infants. Emphasis is placed on infection control and prevention, proper patient identification, labeling of specimens, quality assurance, specimen handling, processing, and accessioning.

Emphasis is placed on practical work experience for which the student has already acquired the necessary theoretical knowledge and basic skills. Direct supervision is provided by the clinical professional, generally a clinical preceptor. The goal of the rotation is that the student accurately and competently performs basic phlebotomy with minimum supervision. The practicum is an unpaid learning experience.

Students must perform a minimum of 100 successful venipunctures and a minimum of 5 successful capillary punctures. Students will be scheduled for a minimum of 100 hours of clinical experiences up to a maximum of 120 hours of clinical, Monday through Friday during the day shift.  Students are expected to complete their clinical hours based on the provided schedule. Students who successfully complete PLAB 1323/1023 and PLAB 1166/1066 will be awarded a certificate of completion and be eligible to take a national certification exam.

Successful completion of the PLAB 1166 course requires that the student will be able to do the following:

1. Perform phlebotomy procedures and tasks in an accurate, timely and professional manner.
2. Accurately and legibly record patient and laboratory information, results, and records.
3. Demonstrate interpersonal and interdisciplinary communication skills necessary for working in the health care setting.
4. Demonstrate safe and skillful use of phlebotomy equipment.
5. Apply safety and governmental regulations and standards as applied to Phlebotomy.
6. Demonstrate basic understanding of quality assurance.
7. Demonstrate critical thinking skills and ability to solve problems.
8. Demonstrate professionalism, including initiative, teamwork, respect and caring.

ESSENTIAL FUNCTIONS AND TECHNICAL STANDARDS

The Phlebotomy Technician Student Handbook contains the essential functions and technical standards.

COURSE OBJECTIVES

Psychomotor and Cognitive Objectives

1. With 100% accuracy, properly identify patients prior to performing any procedure.
2. Properly identify themselves to the patient as an ACC student and by stating their first name.
3. Properly inform the patient of any procedures and get verbal consent to proceed.
4. Select the appropriate equipment needed to perform a venipuncture or capillary puncture for all patient populations.
5. Select the appropriate blood collection equipment considering the tests requested, minimum sample requirements and the needs of the patient.
6. Identify and select a suitable venipuncture or capillary site for all patient populations.
7. Properly prepare a venipuncture or capillary site.
8. Apply a tourniquet correctly.
9. Perform a venipuncture or capillary puncture correctly using appropriate technique and order of draw, following the recommended safety precautions.
10. Perform the necessary follow-up care on patients following a venipuncture or capillary procedure.
11. Collect a suitable blood specimen following capillary or venipuncture.
12. Observe appropriate precautions and procedures when collecting specimens under isolation conditions.
13. When appropriate, notify appropriate clinical personnel and ACC professor of specimen collection irregularities or potential problems.
14. Observe appropriate specimen perseveration and handling procedures.
15. Identify situations where special precautions may be necessary including Nursery, Pediatrics, ICU/CCU, Emergency Room, surgery and other special areas of the hospital and take appropriate action as necessary.
16. Accurately label all specimens in the presence of the patient.
17. Dispose of all used equipment in the appropriate waste receptacle.
18. Maintain a clean and orderly work area.
19. Document a minimum of 100 successful, unaided blood collections by venipuncture on assigned patients using acceptable techniques.
20. Follow appropriate safety procedures 100% of the time.
21. Document an 80% overall success rate on venipuncture procedures.

Affective Objectives

1. Perform assigned tasks with interest and positive attitude.
2. Demonstrate dependability by always being on time or early and following published clinical rotation schedules.
3. Notify ACC professor and clinical supervisor of tardiness and/or absences in advance.
4. Accept constructive criticism as a learning process.
5. Demonstrate inquisitiveness by asking necessary questions concerning practical performance or theoretical application of laboratory procedures.
6. Demonstrate progression and independence in the performance of laboratory procedures.
7. Follow oral or written directions.
8. Demonstrate appropriate interpersonal skills by interacting with patients, peers, and other healthcare workers in an ethical and professional manner.
9. Maintain confidentiality of patient information by adhering to HIPAA protocol.
10. Follow all safety and facility policies.

Upon completion of the Certificate in Phlebotomy, the student will:

1. Identify components of the health care delivery system and the services each provides;
2. Identify each department within the laboratory, list tests, and corresponding pathologic conditions associated with each department;
3. Apply knowledge of infection control and safety in the workplace;
4. Demonstrate basic understanding of the anatomy and physiology of body systems and anatomic terminology;
5. Utilize computers, information systems and other technology as related to job duties and responsibilities;
6. Demonstrate basic understanding of age specific or psycho‐social considerations involved in the performance of phlebotomy procedures on various age groups of patients;
7. Demonstrate understanding of the importance of specimen collection and specimen integrity in the delivery of patient care;
8. Identify and report potential pre-analytical errors that may occur during specimen collection, labeling, transporting and processing.
9. Demonstrate knowledge of phlebotomy collection equipment, various types of additives used, special precautions necessary and substances that can interfere in clinical analysis of blood constituents;
10. Perform standard operating procedures to collect specimens via venipuncture and capillary (dermal) puncture;
11.  Explain the collection of non-blood specimens, such as urine, stool, sputum, throat or others in order to instruct patients, process and handle non-blood specimens.
12. Perform specimen requisitioning and processing;
13. Transport specimens following safety regulations, predetermined criteria, and standard protocol;
14. Explain quality assurance and quality control in phlebotomy;
15. Communicate professionally (verbally and nonverbally) in the workplace;
16. Perform waived and POCT procedures as established using standard protocol and predetermined criteria for testing and quality assurance.
17. Promote diversity and cultural sensitivity among students and faculty in preparation for clinical practice.