Presentation on theme: "Age Specific Care And Phlebotomy"— Presentation transcript:
1Age Specific Care And Phlebotomy Prepared by Terry Kotrla, MS, MT(ASCP) BBIntended for the Phlebotomy Technician students of Austin Community CollegeRevised February 24, 2014i
2What’s Up with this “Age Specific Care?” The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) requires that all healthcare staff annually meet competency expectations in performing Age Specific Care.An interpretation of the standards and their intent relates to all staff members who assess, treat, and manage, or who work in areas that have direct impact on, patients in age-specific populations.Managers are being challenged to make sure their phlebotomists are not only proficient at phlebotomy, but proficient with all age groups.
3Phlebotomy Applications Basic knowledge of human growth and developmentAge specific interpersonal skillsPsychological needsSocial needsAppropriate tone of voice, eye contact and active listening skillsTechnical expertise – physical skills
4Age Specific Groups Neonate/Infant 0-1 Toddlers 1-3 Pre-School 4-5 yearsSchool Age 5-12 yearsAdolescent 13-18Young Adult 19-35Adulthood 36-65Late Adult 65+
5Neonate/Infant Psycho-Social Needs 0-1 years Total dependence on parents/adultsOlder infant has fear of strangers and separation from parentParent may hold child and provide comfortPacify with bottle/pacifier or distract with toysPrimary interaction will be with parentIntroduce yourselfGentle, comforting tone of voiceCompassionate expression and body languageClearly explain the procedureOlder infants - talk slowly and make eye contactMake sure all materials are kept out of infant’s reach
6Neonate/Infant – Fears/Safety Try not to separate from parent unless absolutely necessaryDo not perform venipunctures on infants less than 6 months of age unless absolutely necessaryFor heelsticks follow recommended procedures to the letter.Collect minimum amount of blood necessaryMicro-collection of samples is most common
7Toddlers 1-3 Years Psycho-Social Needs Try not to separate from parent unless absolutely necessary.Parent may assist by holding, explaining to and comforting the childFriendly, cheerful and empathetic manner.Speak before you touch, use child’s nameExplain procedure in soothing tone using age appropriate terms, children this age fear painEmphasize cooperationPraise child during procedureEncourage parent to praise child after procedure
8Toddlers 1-3 Years – Fears/Safety Childproof area, no supplies in reachBe prepared, have all supplies needed to avoid delayNEVER say “This will not hurt”, rather use age appropriate terms and it’s ok for them to say “ouch”Distract with a toy or other objectIf appropriate, keep child informed on how much longer it will beBandaids may not be appropriate, child may swallow and choke.
9Pre-School 4-5 years Psycho-Social Needs Parent may be present to provide emotional support and to assist in obtaining child's cooperation.Approach in friendly, cheerful & empathetic manner, use child’s name.Explain procedure in soothing tone using age appropriate terms, children this age fear painNEVER say “This will not hurt”, rather use age appropriate terms and it’s ok for them to say “ouch”Keep child informed on how much longer it will be.Praise for bravery, say “Thank you”
10Pre-School 4-5 – Fears/Safety Child proof collection areaFear of painAvoid delays, have all equipmentAssemble equipment out of child’s eye sight.Use your best judgment whether to encourage child to look away.Involve child in after careby allowing selection of bandaidand sticker.
11School Age 6-12 Psycho-Social Needs Increased language skills and self-control.Move from security seeking behavior towards independence.Try not to embarrass the child.Must communicate with them as an individual using age appropriate words and appropriate eye contact.May want parent to hold hand.Explain the procedure and why blood is needed.Be prepared to answer questions.
12School Age 6-12 - Fears/Safety Younger ages fear of pain, older ages may “act” brave.Younger ages may need distraction such as a toy or other object.Explain use of equipment if appropriate.Reassure the patient during the procedure.Let them know how much longer.Explain the importance of maintaining pressure after completion of procedure.
13Adolescent 13-18 Psycho-Social Needs Maintain privacy.Concerned with the present more than the future.Conscious of appearance.Actively involved in anything concerning the body.Engage in behaviors to establish they are an adult.May be hypersensitive or non-interactiveMay act hostile to hide fear.Important to assess the patient and use appropriate interpersonal skills.Take extra time for explanations and or preparation.
14Adolescent 13-18 - Fears/Safety Embarrassed to show fear.Adolescent male has greater potential for fainting.Periodically check for pre-syncope signs.Be aware of sudden silence in a previously talkative patient or extremely talkative after previously silent.Keep up a running conversation to distract the patient.Stress importance of post-phlebotomy care.
15Young Adult 19-35 Psycho-Social Needs Reflect on interests, goals and aspirations for the future.Focused on preservation and maintenance of health.May work and play too hard and sacrifice sleep, nutrition and exercise.May experience anxiety, stress and depression related to work, marriage, parenting and social expectations.
16Young Adult 19-35 Psycho-Social Needs (Continued) More involved with healthcare decisions, may ask questions which put you “on the spot”.Communicate in a professional manner.Explain why you cannot answer certain questionsDo not patronize or talk down to the patient – treat respectfullyClearly and honestly explain the procedureAvoid negative body languageEye contact critical, promotes sense of trust but be aware of cultural differences.
17Young Adult 19-35 - Fears/Safety Can possess same fears as pediatric patient.Confidence and professionalism are essential to set patient at ease.Be aware of signs of syncope, especially in fasting or GTT patients.Stress importance of post-phlebotomy care.
18Adulthood 36-65 Psycho-Social Needs Generatively vs stagnationPrepares for empty nestAdapts to aging process.Older, wiser and more likely to be at peace with society and self.Respectful treatment critical to maintaining trustHealth problems may require prescription drugs.Interpersonal skills the same as the young adult.Hair thins, skin wrinkles and sags, weight gain, changes in sight, hearing, memory or judgement, longer recovery time
19Adulthood 36-65 - Fears/Safety Rarely fearful of the procedure.Stress post-phlebotomy site care ESPECIALLY for patients on anti-coagulant therapy.Phlebotomy site should always be checked before patient leaves.
20Late Adult 65+ Psycho-Social Needs Patients’ aging process creates challenges for the phlebotomist:Reduced attention span and memory.Limited mobility, failing eyesight and hearingChanges in skin and tissue textureExperiences anxiety over loss, isolation and changes.Reflect on their lives and come to accept death.Due to loneliness may take more of your time.
21Late Adult 65+ - Fears/Safety “Normal” older adults not a problemPatients with physical or neurological problems can present very challenging problems.Ask for assistance if limbs must be manipulated or held still.Take GREAT care to select your equipment.Provide exceptional after care to prevent bruising.Bandaids MAY NOT be appropriate for elderly patients with “paper thin” skin.
22ReferencesKirven, Donna R., Age-Specific Techniques in Phlebotomy Competency “Advance For Laboratory Professionals” (3/10/2003)UTMB Clinical Pathology Services,The Not-So-Simple Art of the Blood Test 9/9/2007Kotrla, Terry, Unit Notes: Pediatric Procedures. Austin Community College (2013).Kotrla, Terry, Unit Notes: Geriatric Patients and Point of Care Collection and Testing. Austin Community College (2013).