UPHB 180 - Phlebotomy for Law Enforcement

Theory and practice of the recommended performance standards for Arizona Law Enforcement Phlebotomy trained phlebotomists for the purpose of maintaining a uniform approach in the execution of blood draws. Includes phlebotomy, anatomy, terminology, consent, Clinical and Laboratory Standards (CLSI), venipuncture guidelines to include needles, evacuated tube system, law enforcement blood draw purposes, rights, responsibilities, documentation, reporting procedures, legal, and ethical practices.

Course Learning Outcomes:

Describe importance of proper specimen collection and overall client/patient care including HIPAA regulations.
Describe and apply quality assurance standards for phlebotomy, including OSHA regulations and lab safety
Explain the use of medical terms and codes related to phlebotomy and law enforcement
Identify the anatomy and physiology of the hand, arm, and vascular system.
Demonstrate appropriate use of venipuncture equipment for obtaining blood specimens
Demonstrate required scope of practice through communication, documentation, and behavior.

Outline:

Phlebotomy Instruction
- Introduction to law enforcement phlebotomy
  - Classroom expectations
    - Attendance and participation
    - Handwashing
    - Gloves, PPE
    - Sanitizing workstation
  - Lab safety
    - OSHA guidelines
    - Standard precautions
    - BBP, infection control
    - Sharps and biohazard disposal
- Basics of the phlebotomy process
  - Anatomy, and Physiology
    - Arm
    - Hand
    - Vascular System
  - Medical Terminology – Common abbreviations / acronyms
  - Basic venipuncture equipment - demonstration
    - Tourniquet
    - Cleaning agents
    - Evacuated tube system (ETS)
      - Needle and Holder
      - Vacutainer Tubes
    - Winged infusion system (butterfly)
    - Syringe and transfer devices
- Collection of blood sample
  - Identification of subject – Details will be discussed in legal section
  - Identifying puncture site
    - Application of tourniquet
    - Acceptable areas for performing puncture
    - Palpation of vein
    - Positioning of subject for blood draw
  - Cleansing puncture area
    - Acceptable cleaning agents
    - 2017 CLSA standards for cleansing area
      - Circular target (concentric) cleansing
      - Back and forth friction cleansing
    - Allow site to air dry
  - Collection equipment – Hands on practice
    - Evacuated tube system (ETS)
      - Vacutainer (straight) needle and holder
      - Required tubes – Na fluoride + K oxalate
      - Verification of lot #s and expiration dates
    - Winged infusion set (butterfly)
    - Syringe adapters / blood transfer devices
- Post collection processes
  - Subject evaluation and care
  - Sharps disposal
  - Labeling specimens
  - Documentation and dept specific reports
  - Storage and transport of sample
  - Chain of custody
- Complications during the collection process
  - Restricted vascular access and problem sites
  - Contamination
  - Special needs subjects
  - Subject behaviors
- Patient/Client Care
  - Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  - Medical history collection
  - Positioning of subject
  - Subject assessment
  - Complications during the procedure
  - After-procedure care
  - Post procedure evaluation
- Professionalism
  - Communication
  - Documentation
Legal Instruction
- Forensic specific draw considerations
  - Standards and indicators for law enforcement blood draws
  - Subject identification and pre-draw authorization and consent
  - Equipment examination for lot number and expiration dates
  - Required identifiers on the sample and report
  - Role of law enforcement compared to other settings
- Blood Evidence Submission
  - Regulatory Agencies
    - Federal
    - State
    - Local
  - Blood draw report - Agency-specific forms
  - Required storage for samples
  - Chain of custody - required documentation
- Courtroom Testimony
  - GOHS and Pima County Attorney’s office
  - Purpose of both tube additives (Na+ Fluoride and K+ Oxalate)
  - Examination of tubes, purpose of glass vs. plastic tubes
  - Relevant Case Law
  - Statutory Guidelines
- Miscellaneous Situations and Concerns
  - Failure to obtain specimen
  - Special needs subjects
    - Refused consent
    - Role of admin per se
    - Requesting a search warrant
    - Procedure for forcible blood draws and combative arrestees
  - Restricted vascular access and problem sites
  - Legal rights of the subject
- Proficiency and continuing education
  - Required number of successful blood draws
  - Phlebotomy skills refresher requirements