Phlebotomy licensure

Phlebotomy licensure is the process by which various regulatory bodies regulate the practice of phlebotomy within its jurisdiction through licensure. In many countries a license is not required, or is obtained through other broader qualifications (such as a medical license), while in others, professional phlebotomists are separately licensed.

In most countries, there is not a dedicated a profession to phlebotomy, but it falls under the responsibility of other allied health professions such as nursing. ^{[1] [2] [3]}

Asia

China

In China, there are no national phlebotomy regulations, and phlebotomy is primarily performed by nurses, though Chinese nursing education offers limited training in phlebotomy quality control. ^[4]

Europe

United Kingdom

Phlebotomists need not by licensed in the UK, but training can be provided on-the-job, sometimes with the support of the National Association of Phlebotomists. ^[5] The skills required may also be monitored through broader monitoring requirements, such as the licence to practice of the General Medical Council.

North America

United States

Main article: Phlebotomy licensure in the United States

In the United States there are no federal phlebotomy training or certification requirements, though several states have imposed their own requirements. In 2024, four states require licensure for phlebotomy: California, Louisiana, Nevada, and Washington.

In 2001, California enacted phlebotomy licensure after an on-the-job trained phlebotomist was found to be re-using needles. Following California, several states including Massachusetts and Missouri attempted to introduce either licensure or training/educational requirements, but the bills died. ^{[6] [7] [8]}

Phlebotomy licensure advocates claim that the licensure would enhance the quality of personnel, while the laboratory industry opposes phlebotomy licensure as an unnecessary cost. ^{[9] [10] [11]}

Phlebotomy is not without risk, and more challenging patients increase the chance of complications. ^[12] However, without licensure, it can be difficult to hold bad actors accountable.

Increasingly, a number of healthcare facilities are rolling phlebotomy duties into their patient care technician roles or other allied health roles. ^{[13] [14]}

A number of FDA 510k cleared devices, such as the BD Minidraw have been introduced to enable the drawing of blood without a phlebotomist. ^[15] Additionally, there are devices to help aid non-phlebotomists more readily find veins. ^[16]

Certifications

There are several national phlebotomy certifications in the US. ^{[17] [18] [19]}

List of Phlebotomy Certifications in the United States

Abbr	Phlebotomy Certifying Agency	Certification	Designation	Notes
AAH	American Allied Health	Certified Phlebotomy Technician	CPT (AAH)
ACA	American Certification Agency for Healthcare Professionals	Certified Phlebotomy Technician	CPT(ACA)
AMCA	American Medical Certification Association		PTC (AMCA)
AMT	American Medical Technologists	Register Phlebotomy Technician	RPT(AMT)
ASCP	American Society for Clinical Pathology	Phlebotomy Technician	PBT(ASCP)
ASPT	American Society of Phlebotomy Technicians	Certified Phlebotomy Technician	CPT(ASPT)
IAPA
NCA	National Credentialing Agency for Laboratory Personnel		CLPlb(NCA)
NCCT/MMCI	National Center for Competency Testing	National Certified Phlebotomy Technician	NCPT(NCCT)
NHA	National Healthcareer Association	Certified Phlebotomy Technician	CPT(NHA)
NAHP	National Association for Health Professionals	National Registered Certified Phlebotomy Technician	NRCPT(NAHP)
NPA	National Phlebotomy Association	Certified Phlebotomy Technician	CPT(NPA)

Further reading

• Huber, Brad R.; Sandstrom, Alan R. (1 January 2010). Mesoamerican Healers. University of Texas Press. pp. 35–37. ISBN   978-0-292-77964-8 . Retrieved 19 August 2024.

References

1. Mbah, Henry A. (4 April 2014). "Phlebotomy and quality in the African laboratory". African Journal of Laboratory Medicine. 3 (1): 132. doi:10.4102/ajlm.v3i1.132. PMC   5637764 . PMID   29043181.
2. Simundic, Ana-Maria; Cornes, Michael; Grankvist, Kjell; Lippi, Giuseppe; Nybo, Mads; Kovalevskaya, Svjetlana; Sprongl, Ludek; Sumarac, Zorica; Church, Stephen (1 August 2013). "Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA)". Clinical Chemistry and Laboratory Medicine. 51 (8): 1585–1593. doi:10.1515/cclm-2013-0283. PMID   23729577.
3. Simundic, Ana-Maria (14 August 2015). "2.9 Who is Doing Phlebotomy in Europe?". Pre-Examination Procedures in Laboratory Diagnostics. pp. 90–94. doi:10.1515/9783110334043-015. ISBN   978-3-11-033165-3.
4. Cai, Qian; Zhou, Yunxian; Yang, Dangan (15 February 2018). "Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey". Biochemia Medica. 28 (1): 010703. doi:10.11613/BM.2018.010703. PMC   5701774 . PMID   29187796.
5. "National Association of Phlebotomists" . Retrieved 5 March 2024.
6. Ernst, Dennis (October 2009). "Phlebotomy certification legislation: update on three of our 50 states". Medical Laboratory Observer. 41 (10): 42. PMID   19891151. Gale   A210847808 . Retrieved 17 February 2024.
7. Ernst, DJ (July 2008). "States fail to follow California's lead in certifying phlebotomists". Medical Laboratory Observer. 40 (7): 40, 42. PMID   18717500. Gale   A182040780.
8. Kwan, H (October 2008). "Rooster guarding hen house?". Medical Laboratory Observer. 40 (10): 6, 8. PMID   18990788.
9. Mishori, Ranit (May 31, 2004). "Drawing Without a License". Washington Post . Retrieved 17 February 2024.
10. "Should non-phlebotomists be allowed to draw blood?". Clinical Leadership & Management Review. 15 (6): 426–8. November 2001. PMID   11822275.
11. Becan-McBride, Kathleen (1 October 2009). "Phlebotomy Errors Point to Need for Mandatory Licensure of Pre-analytical Laboratory Staff" . Critical Values. 2 (4): 18–19. doi:10.1093/criticalvalues/2.4.18.
12. Harty-Golder, Barbara (January 2003). "When should a phlebotomist ask for help with a difficult draw?". MLO: Medical Laboratory Observer. 35 (1): 48. PMID   12561745. Gale   A96892952.
13. Ernst, DJ (October 1997). "Is the phlebotomist obsolete?". MLO: Medical Laboratory Observer. 29 (10): 30–4. PMID   10173584. Gale   A20076530.
14. "Should non-phlebotomists be allowed to draw blood?". Clinical Leadership & Management Review. 15 (6): 426–8. November 2001. PMID   11822275.
15. Dharma, RanjithKumar (8 December 2023). "BD receives clearance for new blood collection device". Medical Device Network. Retrieved 30 April 2024.
16. "Vein attempts? Making needles easier to bear". Orange County Register. Orange County. 14 September 2007. Retrieved 30 April 2024.
17. McCall, Ruth E.; Tankersley, Cathee M. (2008). Phlebotomy Exam Review. Lippincott Williams & Wilkins. ISBN   978-0-7817-7855-8.
18. Strasinger, Susan King; Lorenzo, Marjorie Schaub Di (25 February 2019). The Phlebotomy Textbook. F.A. Davis. pp. 11–12. ISBN   978-0-8036-9012-7.
19. Niedzwiecki, Brigitte (21 October 2021). Kinn's Medical Assisting Fundamentals - E-Book: Kinn's Medical Assisting Fundamentals - E-Book. Elsevier Health Sciences. p. 1124. ISBN   978-0-323-82454-5.