Phlebotomy has been called the most underestimated procedure in healthcare. Why else would most states require a license to curl hair but not to navigate a needle around someone's nerves and arteries in search of a vein for a blood sample?

Unskilled personnel threaten laboratory quality

Laboratories are currently giving specimen-collection responsibilities to individuals from a wide variety of healthcare disciplines--and with ruinous results. Multiple articles and studies show a significant decline in specimen quality and patient satisfaction when blood is drawn by nonlaboratory personnel. (1-6) One hospital reported error rates due to unacceptable specimens drawn by nurses to be three times that of phlebotomists. (6)

"But it is more than just rejected specimens and re-collects that plague laboratories receiving blood drawn by nonlaboratory personnel," says Dennis J. Ernst MT (ASCP), director of the Center for Phlebotomy Education and coordinator of the Coalition for Phlebotomy Personnel Standards (the Coalition). "It is the havoc that poorly collected specimens wreak on clinical laboratory instrumentation and the injuries patients sustain at the hands of the unskilled.

"I have seen patients permanently disabled, even paralyzed, when personnel of every healthcare discipline are not taught the standard of care for collecting blood specimens," he says. "Then there are the transfusion-related deaths we often hear about that are traced back to patient- or specimen-identification errors."

Ernst cites his own firsthand experience to underscore lack of training. He recalls a medical assistant who recently came to his office to draw his blood for a life insurance application. "She would have used a contaminated needle if I had not stopped her," he says. "After uncapping the needle, she sat it point up on a table and proceeded to palpate for a vein. The needle fell over, and the beveled tip touched the surface of the table. She then picked up the now-contaminated needle and was about to insert it into my arm when I stopped her and insisted she change the needle."

That was not all. He explains that she also did not wear gloves, that she had removed the needle from the tube holder, and had left the sharps container in her car. "She left my office with a real education on...