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Check Your
Competency -
Using Personal Protective Equipment
Gloves
. Wash your hands before putting on gloves.
. Remove gloves by using your dominant hand to grasp the palm of the glove of your
nondominant hand.
. Gently pull the glove off the nondominant hand, turning it inside out and holding it
in your dominant hand.
. Encase the removed glove completely in the dominant hand to prevent the spread
of contaminants.
. Place the thumb or two fingers of the ungloved hand under the cuff of the remain-
ing glove, being careful not to touch the contaminated outside of the glove with
your bare hand.
. Pull the glove over your hand, turning it inside out over the other glove, leaving
none of the outside surface exposed.
. Throw the gloves away in the appropriate waste container.
. Wash your hands.
Gown
. Put on a gown with the opening in the back.
. Secure at the neck and waist.
. Remove the gown by unfastening the ties.
. Peel the gown away from the neck and shoulder and do not touch the outside.
. Turn the contaminated gown outside toward the inside.
. Fold or roll the gown into a bundle.
. Discard the contaminated gown.
Mask
. To put on the mask, place it over the nose, mouth, and chin.
. Fit the flexible nose piece over the nose bridge.
. Secure the mask on the head with ties or elastic.
. Adjust the mask to fit.
. To remove the mask, untie the bottom, then top tie.
. Remove the mask from the face without touching the outside.
. Discard the mask.
Eye Protection
. To remove goggles or face shield, grasp the ear or headpieces with ungloved
hands.
. Lift them away from the face without touching the outside.
. Place in designated receptacle for reprocessing or disposal.
Chapter Infection Control
what PPE to wear, consult a licensed practitioner caring for the patient, such
as a nurse.
Never take a tray of phlebotomy equipment into an isolation room. Take only
the equipment needed for the particular draw. If you need additional equipment, you must remove all PPE before leaving the room, collect the needed
supplies, and then don new PPE before reentering the room. Similarly, you
Copyright © 2019 by McGraw-Hill Education
must leave all unused equipment or supplies in the room. For these reasons,
it is very important to review the order and take only the necessary supplies
into the room.
A special procedure called double-bagging is used to dispose of contaminated waste and equipment from an isolation room. Two biohazard-labeled
bags are used for this procedure. One person, wearing appropriate PPE, is in
the room and places all items for disposal into the first bag. A second person
remains at the doorway, with a second biohazard bag held wide open. The first
person carefully places the closed bag into the second bag, making sure not to
contaminate the outside of the second bag. The second bag is secured by the
person outside the isolation room and can now be safely transported to the
disposal area.
You should follow standard precautions with every patient when performing
phlebotomy. Isolation precautions are used less often and only with patients
who have or are suspected of having specific infections. When isolation precautions are mandated for a patient receiving phlebotomy, you will be required
to follow the specific guidelines for the type of precautions implemented (see
the appendix Transmission-Based Precautions).
1. You have been asked to perform phlebotomy on a patient with an
unknown respiratory disease. The patient has not been placed on
isolation precautions, but as you approach the room, you can hear the
patient coughing. What PPE would you use while drawing blood from
this patient?
2. Briefly explain the differences between universal precautions, standard
precautions, and isolation precautions.
Chapter Summary
Learning Outcome Key Concepts/Examples
. Identify the elements in
the chain of infection and
the ways in which disease
can be transmitted.
. Demonstrate
knowledge of infection
control practices and
guidelines related to
phlebotomy.
The chain of infection consists of the infectious agent, reservoir, portal
of exit, mode of transmission, portal of entry, and susceptible host.
Infection can occur if any of these links become compromised. Modes of
transmission include contact, droplet, airborne, vehicle-borne, and vectorborne transmission.
Infection control practices include using appropriate hand hygiene,
following respiratory hygiene and cough etiquette, wearing personal
protective equipment (PPE), following standard precautions, and following
appropriate isolation precautions when indicated.
Checkpoint
Questions .
Related
NAACLS
Competency
2.2
2.00, 2.1, 2.2,
2.3, 2.4
Copyright © 2019 by McGraw-Hill Education
Chapter Infection Control
Chapter Review
A: Labeling
A
Label each of these links in the chain of infection.
[LO 3.1]
1. infectious agent
2. mode of transmission
3. portal of entry
4. portal of exit
5. reservoir
6. susceptible host
B: Matching
Match each link in the chain of infection with its
description.
7. [LO 3.1] infectious agent
8. [LO 3.1] reservoir
9. [LO 3.1] portal of exit
10. [LO 3.1] mode of transmission
a. break in skin, nose, mouth, and so on
b. disease-producing microorganism
c. droplet, airborne, or direct contact
d. oozing skin, cough, urine specimen
e. person at risk for developing infection
f. site or person in which the pathogen grows
B
F
E
D
C
11. [LO 3.1] portal of entry
12. [LO 3.1] susceptible host
C: Fill in the Blank
Write in the word(s) to complete the statement.
13. [LO 3.2] One of the most critical steps in preventing HAIs is correct .
14. [LO 3.2] When entering a room that has airborne precautions, you should wear a(n)
.
15. [LO 3.2] Three actions of the phlebotomist that can prevent the spread of infection include:
.
Copyright © 2019 by McGraw-Hill Education
Chapter Infection Control
D: Sequencing
Place the items when donning PPE in the correct order (from 1 to 3).
16. [LO 3.2] gloves
17. [LO 3.2] goggles
18. [LO 3.2] gown
Place the items when removing PPE in the correct order (from 1 to 3).
19. [LO 3.2] gloves
20. [LO 3.2] goggles
21. [LO 3.2] gown
E: Case Studies/Critical Thinking
22. [LO 3.1] A patient in an isolation room asks the phlebotomist to take a magazine the patient has just
finished reading and return it to the visitor’s lounge, where the patient’s friend originally found it. How
should the phlebotomist handle this request?
23. [LO 3.2] You are asked to give an infection control talk to children at a community outreach event. How
should you instruct them to contain a cough or sneeze when a tissue is not available?
F: Exam Prep
Choose the best answer for each question.
24. [LO 3.1] A phlebotomist enters a room to draw
blood on a patient undergoing care for an
infected wound. The site of the wound and its
bandages are considered which link in the chain
of infection?
a. Infectious agent
b. Mode of transmission
c. Portal of exit
d. Susceptible host
25. [LO 3.1] A fomite is a(n)
a. alcohol-based foam hand sanitizer.
b. contaminated object.
c. sterile container.
d. type of pathogenic bacterium.
26. [LO 3.1] Which of the following is an example of
a healthcare-associated infection (HAI)?
a. A patient enters the emergency department
with suspected food poisoning after eating at
a local restaurant.
b. A patient admitted for a bleeding problem is
found to have acute leukemia two days after
admission.
c. A phlebotomist develops high blood pressure
after having been working at a hospital for
three months.
d. A phlebotomist who has a staph infection
does a point-of-care blood draw from a
hospital patient, who later develops a staph
infection.
Copyright © 2019 by McGraw-Hill Education
Chapter Infection Control
27. [LO 3.2] A patient in which type of isolation
is the least likely to transmit disease to the
phlebotomist?
a. Airborne
b. Contact
c. Droplet
d. Protective
28. [LO 3.1] For which of the following diseases
or conditions might a hospital routinely test
patients being admitted to the hospital?
a. Cancer
b. MRSA
c. Ulcer
d. Arthritis
29. [LO 3.2] A common allergen found in blood
collection equipment is
a. latex.
b. nitrile.
c. vitrine.
d. vinyl.
30. [LO 3.2] Double-bagging is
a. using a bag inside a bag to transport
specimens.
b. placing normal waste into two separate bags.
c. placing biohazardous material into a bag and
then that bag into another bag.
d. wearing two pairs of gloves while working
with biohazardous materials.
32. [LO 3.2] A patient enters an outpatient
laboratory for testing. The phlebotomist notices
that, after applying alcohol to the patient’s
skin prior to the blood collection procedure,
the skin turned red. What question should the
phlebotomist ask the patient?
a. “Are you allergic to any medications?”
b. “Do you have any allergies to alcohol or
antiseptics?”
c. “Are you feeling all right?”
d. No questions are needed. Developing a red
color is normal when alcohol touches the skin.
33. [LO 3.1] A woman who has a cold wipes her
hands on a dinner napkin and leaves the napkin
on the table when she leaves the restaurant.
The server who clears the table touches the
napkin and later develops a cold. What type of
transmission has occurred?
a. Airborne transmission
b. Vector-borne transmission
c. Vehicle-borne transmission
d. Droplet transmission
34. [LO 3.1] Nosocomial is a term that was used to
describe infections from
a. nasal passages.
b. a communal setting such as a school.
c. a healthcare facility.
d. any of these.
31. [LO 3.2] Personal protective equipment includes
all of the following except
a. eyewash.
b. face shields.
c. gloves.
d. gown.
Chapter Infection Control
Enhance your learning by completing these exercises and more
at connect.mheducation.com.
Copyright © 2019 by McGraw-Hill Education
References
Davis, D. (2009). Laboratory safety: A self-assessment workbook. Chicago, IL: American Society for Clinical Pathology.
Dudeck, Margaret A., & The Association for Professionals in Infection Control and Epidemiology, Inc. (2009). National Healthcare
Safety Network (NHSN) report: Data summary for 2010, device-associated module. Retrieved June 13, 2013, from www.cdc.gov/
nhsn/PDFs/dataStat/NHSNReport_DataSummaryfor2010.pdf
Loo, V. G., Poirier, L., Miller, M. A., Oughton, M., Libman, M. D., Michaud, S., . . . Dascal, A. (2005). A predominantly
clonal multi-institutional outbreak of Clostridium difficile–associated diarrhea with high morbidity and mortality. New
England Journal of Medicine, 353(23), 2442–2449. Retrieved February 26, 2011, from www.nejm.org/doi/full/10.1056/
NEJMoa051639#t=article
Mirza, A., & Steele, R. (2011). Hospital-acquired infections. Medscape: Drugs, Diseases, and Procedures. Retrieved July 26, 2011,
from http://emedicine.medscape.com/article/967022-overview
Moore, N., & Flaws, M. (2011). Antimicrobial resistance mechanisms in Pseudomonas aeruginosa. Clinical Laboratory Science, 1,
47–51.
National Accrediting Agency for Clinical Laboratory Sciences. (2016). NAACLS entry-level phlebotomist competencies. Retrieved
February 2, 2017, from www.naacls.org/getattachment/d5a69a7a-7323-439e-9db8-1f0ea000b718/2012-Standards-Edited.aspxf
Siegel, J. D., Rhinehart, E., Jackson, M., Chiarello, L., & Healthcare Infection Control Practices Advisory Committee. (2007).
Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. Retrieved June 19, 2013,
from Centers for Disease Control and Prevention website: www.cdc.gov/hicpac/pdf/isolation/isolation2007.pdf
Copyright © 2019 by McGraw-Hill Education
Chapter Infection Control
NAME: __________________________________________________ DATE: ___________________________________________________
COMPETENCY CHECKLIST: HANDWASHING
Practice Performed
Procedure Steps Yes No Master
. Assembles equipment and removes jewelry.
. Uses paper towel to turn on the water supply.
. Adjusts the water temperature.
. Discards the paper towel.
. Dispenses an appropriate amount of soap into
the hand.
. Creates a sufficient amount of lather.
. Sufficiently removes gross contamination from
all skin surfaces.
. Cleanses the nail beds of each finger.
. Cleanses underneath the nails in an appropriate
fashion.
. Rinses off the soap.
. Appropriately positions the hands while rinsing
them.
. Dispenses soap into the palm of the hand.
. Ensures that all surfaces of the hands are
washed.
. Rinses off the soap.
. Appropriately positions the hands while rinsing.
. Dries the hands, using paper towels.
. Uses paper towel to turn off the water supply.
COMMENTS: ___________________________________________________________________________________
______________________________________________________________________________________________
SIGNED
EVALUATOR: ________________________________________________________________________________
STUDENT: _________________________________________________________________________________
Chapter Infection Control
Copyright © 2019 by McGraw-Hill Education
NAME: __________________________________________________ DATE: ___________________________________________________
COMPETENCY CHECKLIST: GOWNING, GLOVING, AND MASKING
Practice Performed
Procedure Steps Yes No Master
Donning PPE
. Removes the lab coat.
. Washes hands before putting on the protective clothing.
. Dons the gown, tying the ties at the neck and waist.
. Dons a mask.
. Positions the mask with the appropriate side facing out.
. Securely fastens the wire at the top of the mask around
the nose.
. Securely ties the ties high on the head.
. Dons gloves.
. Positions the gloves with the cuff pulled over the sleeve
of the gown.
Removing PPE
. Removes the gloves.
. Removes the gloves inside out without contaminating
the hands.
. Deposits the gloves in the appropriate receptacle.
. Removes goggles or face shield.
. Touches only the handles or head band when removing
the mask.
. Deposits the goggles in the appropriate receptacle.
. Unties the gown at the waist if ties are at the back of the
gown.
. Unties the gown at the neck.
. Removes the gown inside out.
. Does not touch the front of the gown with either the
hands or the uniform during removal.
. Removes the mask by touching only the ties.
. Discards the mask.
. Properly washes the hands.
COMMENTS: ___________________________________________________________________________________
______________________________________________________________________________________________
SIGNED
EVAL UATOR : _________________________________________________________________________________
STUDENT: _________________________________________________________________________________
Copyright © 2019 by McGraw-Hill Education
Design Elements: Communicate & Connect icon (patient and doctor) ©Rocketclips, Inc./Shutterstock.com RF.
Chapter Infection Control
Medical Terminology
4
abdominopelvic cavity
anatomical position
anatomy
anterior
atoms
brachial
caudal
cells
combining vowel
coronal
cranial
essential terms
deep
deoxyribonucleic acid (DNA)
diaphragm
distal
dorsal
electrolytes
femoral
frontal plane
inferior
lateral
medial
and Abbreviations
midsagittal plane
molecules
organelles
organism
organs
physiology
posterior
prefix
prone
proximal
ribonucleic acid
(RNA)
sagittal plane
suffix
superficial
superior
supine
thoracic cavity
tissues
transverse plane
ventral
word root
©Nancy Louie/Getty Images RF
Learning Outcomes
. Recognize medical prefixes, word roots, and
suffixes to build commonly used medical terms.
. Define common medical abbreviations.
. Explain body position, direction, and parts
using medical terms.
Related NAACLS Competencies
. Demonstrate knowledge of the healthcare
delivery system and medical terminology.
. Use common medical terminology.
. Demonstrate basic understanding of the
anatomy and physiology of body systems and
anatomic terminology in order to relate major
areas of the clinical laboratory to general
pathologic conditions associated with the body
systems.
Introduction
This chapter presents the basics of how medical words are formed. It emphasizes
anatomical and medical terminology as well as abbreviations that phlebotomists are likely to encounter in the healthcare setting.
.
Medical Language
Medical terminology can often look like a foreign language because its
complex-looking terms, rarely used in most of our everyday dialogues, are
formed from Greek and Latin words. However, healthcare professionals
use this terminology daily when communicating with colleagues. Medical
terminology allows healthcare professionals to identify diseases and affected
areas of the body much more precisely than if they used our everyday language. To learn medical terminology, you will need to understand the basic
word parts and how to build and decode terms in order to “read” them.
Let’s start with the root of a word. All medical words have a word root that
contains their base meaning. Many words also have a suffix at the end that
alters the meaning of the word root. See Table 4-1 for some examples. Because
the meanings of the word parts stay consistent, it is easier to learn new terms
containing already known word parts—for example:
●
Appendectomy—the word root append refers to “appendix” and the
suffix -ectomy means “surgical removal.” So appendectomy means “surgical
removal of the appendix.”
●
Hysterectomy—the word root hystero means “uterus.” Given that -ectomy means
“surgical removal,” hysterectomy means “surgical removal of the uterus.”
Some words also contain a prefix, which comes at the beginning of the
word and, like a suffix, alters its meaning. In defining words, the general
rule is to start with the suffix, then add the prefix (if present), and finally
TABLE Medical Terminology Word Parts
Term Using
Word Part Description
Word root Base meaning of
the word
Suffix Ending of the word;
alters the meaning of
the word root
Prefix Beginning of the word;
alters the meaning of
the word root
Combining
vowel
Placed between the
word root and suffix
to ease pronunciation
Word Part Term Meaning
Colostomy Colo- = colon; -stomy = to cut (or create) a new opening
Colostomy = to cut a new opening for the colon
Hematology Hemat- = blood; -ology = study of
Hematology = study of the blood
Tachycardia Tachy- = rapid; cardi- = heart; -ia = condition of
Tachycardia = condition of rapid heart(beat)
Cardiologist Cardi- = heart; o- = combining vowel to ease pronunciation;
-logist = specialist in knowledge of
Cardiologist = specialist in the knowledge of the heart
Copyright © 2019 by McGraw-Hill Education
Chapter Medical Terminology and Abbreviations