Senate Bill No. 651
(By Senator Hunter)
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[Introduced February 22, 1999; referred to the Committee on
Health and Human Resources; and then to the Committee on
Finance.]
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A BILL to amend chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, by adding
thereto a new article, designated article five-q, relating
to public health; providing for a phlebotomy certification
training program; and requiring that the drawing of blood be
done only by a phlebotomist.
Be it enacted by the Legislature of West Virginia:
That chapter sixteen of the code of West Virginia, one
thousand nine hundred thirty-one, as amended, be amended by
adding thereto a new article, designated article five-q, to read
as follows:
ARTICLE 5Q. PHLEBOTOMIST SERVICES.
§16-5Q-1. Legislative findings.
The Legislature finds that although most health care
professionals are required by the state of West Virginia to
maintain standardized levels of education and training, as
regulated through licensure requirements, there is currently no
such requirement for phlebotomy technicians. Becoming a
phlebotomist in West Virginia has typically consisted of
on-the-job training in what health care professionals refer to as
"See One, Do One, Teach One," whereby the employee-trainer often
transfers his or her own poor technique and procedural errors to
the employee-trainee.
Whereas a phlebotomist is often the first health care
professional to perform an invasive procedure on the patient, an
improperly performed phlebotomy procedure reflects poorly upon
the entire health care facility and its staff. An inadequately
trained phlebotomist is a hazard to himself or herself and others
within the health care facility, increasing the risk of needle
stick and infection and can be an agent for the spread of
infection to the entire community. It is commonplace for an
inadequately trained phlebotomist to perform multiple unnecessary
phlebotomy procedures on a patient in an attempt to obtain one test specimen. Improperly performed phlebotomy procedures can
contribute to the spread of nosocomial infection, traumatize or
seriously injure the patient, produce erroneous test results,
lead to misdiagnosis and even direct the physician toward an
ineffective course of treatment. Delaying appropriate treatment
increases the cost of health care, putting an additional burden
on patients, providers of health care insurance and the medicaid
and medicare systems.
§16-5Q-2. Definitions.
"Certified Phlebotomy Technician" means an individual who
performs phlebotomy procedures and has met recognized minimum
training and certification standards.
"Indwelling Lines" means previously-existing access lines
(i.e. catheters for intravenous therapy, shunts for dialysis,
arterial lines, etc.)
"Invasive Procedure" means one in which the patient's bodily
tissues are penetrated by a sharp instrument.
"Needle Stick" typically means an accidental insertion of
the sharp point of a needle or other instrument into the body of
a health care worker or other individual potentially introducing
an infectious substance into that person.
"Nosocomial Infection" means infection contracted by a
patient while receiving care in a health care facility.
"Phlebotomist or Phlebotomy Technician" means an individual
who performs phlebotomy procedures.
"Phlebotomy or a Phlebotomy Procedure" means the clinical
procedure performed by a phlebotomist for the purpose of
withdrawing blood for clinical laboratory testing. (The word
phlebotomy comes from the Greek roots phleb, vein and -otomy, to
cut; literally, to cut into a vein.)
"Trauma" means a physical injury that has a lasting psychic
or physical effect.
"Venipuncture" means the insertion of a hollow needle into
a vein.
"Venipuncture Procedure" means a procedure, in phlebotomy,
performed for the purpose of withdrawing a sample of venous blood
for testing.
§16-5Q-3. Certification.
An unlicensed person employed for the purpose of withdrawing
human blood for test purposes upon specific authorization from a
clinical laboratory or a licensed physician and surgeon may
perform venipuncture and skin puncture procedures provided that person has successfully completed an approved phlebotomy
certification training program. An approved phlebotomy
certification training program must train and certify unlicensed
or licensed persons in the proper procedure to be employed in the
performance of venipuncture and skin puncture procedures.
§16-5Q-4. Designation.
(a) An unlicensed person entering a health care position in
West Virginia who will perform phlebotomy procedures as outlined
in this article must successfully complete an approved phlebotomy
certification training program, or must receive a waiver prior to
performing phlebotomy procedures on patients and is referred to
as a certified phlebotomy technician.
(b) An unlicensed health care worker currently performing
phlebotomy procedures on patients within West Virginia must
satisfy state phlebotomy certification requirements in one of the
following ways:
(1) The unlicensed person has, during the last three years,
received documented training equal to or exceeding the standards
required in section five of this article, and is called a
certified phlebotomy technician and must utilize the training
documentation as a waiver of the training requirement in section five of this article.
(2) The unlicensed person has not received equivalent
training and is granted a grace period of twelve months, during
which time the unlicensed person must complete the minimum
training requirements and obtain a phlebotomy certification
through an approved provider in one of the following ways:
(i) The unlicensed person may complete the phlebotomy
training and certification program of an approved provider.
(ii) The unlicensed person is permitted to challenge the
written examination and the clinical training requirements of an
approved provider. The unlicensed person who satisfactorily
completes the written examination and clinical evaluation of an
approved provider is granted a phlebotomy certification and is
called a certified phlebotomy technician.
§16-5Q-5. Approved phlebotomy certification training program.
(a) The West Virginia office for laboratory services, an
office of the bureau of public health, shall administer the
provisions of this article. The office for laboratory services
must approve providers of phlebotomy certification training
programs and must require that the providers follow the training
guidelines established in this article prior to issuing a provider number. The office for laboratory services retains the
right to audit approved providers, employers and unlicensed
persons employed to perform phlebotomy procedures to ensure
compliance with standards of phlebotomy certification training
programs. To cover administrative expenses, the office for
laboratory services may charge phlebotomy certification training
program providers no more than twenty-five dollars as an initial
application fee and annually as a renewal fee.
(b) An approved provider of a phlebotomy certification
training program must satisfy all of the following requirements
and an approved provider must satisfy at least one of the
following qualifications:
(1) Possession of a graduate degree in a scientific field of
study of registered nursing or higher and have no less than three
years of experience performing phlebotomy procedures in an
inpatient hospital setting within the last ten years; or
(2) Possession of a graduate degree in a scientific field of
study of registered nursing or higher and no less than six years
of experience performing phlebotomy procedures in an inpatient
hospital setting; or
(3) Possession of a minimum of six years of phlebotomy experience and at least three years of said experience in a
supervisory capacity in an inpatient hospital setting within the
last ten years.
(c) The approved provider must personally supervise and
teach the phlebotomy certification training program or may
designate a qualified substitute instructor to supervise and
instruct the phlebotomy certification program in the absence of
the provider.
(d) The approved provider must instruct the phlebotomy
certification training program using the following guidelines:
(1) A minimum of ten clock hours of an approved phlebotomy
certification training program is acceptable and must include:
(A) Lecture and instruction with: (i) Pertinent anatomy,
physiology and histology; (ii) proper skin-puncture procedure and
technique; (iii) proper venipuncture procedure and technique;
(iv) post-puncture patient care; (v) choice of equipment; (vi)
common laboratory tests, tubes, additives; (vii) indwelling
lines; (viii) infection control and isolation procedures; (ix)
hazards and complications; (x) care of specimen; (xi) documented
performance by the unlicensed person or at least three successful
venipunctures; and (xii) documented performance by the unlicensed person of at least three successful venipunctures.
(B) Written evaluation with receipt of a passing score of at
least eighty percent on a written examination covering instructed
material and consisting of not less than twenty questions.
(e) Upon satisfactory completion of phlebotomy certification
training program requirements, the approved provider of a
phlebotomy certification training program shall issue an original
certificate to the unlicensed person and a copy of the
certificate to the office for laboratory services stating the
following: (1) The approved training programs name and provider
number; (2) the name of the unlicensed person certified; (3) the
dates of the training period; (4) the date issued; (5) that the
provisions of section eleven, article five-j of this chapter have
been satisfied; and (6) the signature of the instructor.
(f) The approved provider of a phlebotomy certification
training program must maintain all training records of certified
persons for at least five years.
§16-5Q-6. Proof of certification.
The employer must retain a copy of the phlebotomy
certification, or waiver thereof as described in section four of
this article, of an unlicensed health care worker or licensed health care worker requiring phlebotomy certification.
NOTE: The purpose of this bill is to require that the
drawing of blood by an unlicensed health care position be done
only by a phlebotomist. To that end, it provides for a
phlebotomy certification training program to be approved by the
West Virginia Office for Laboratory Services.
This article is new; therefore, strike-throughs and
underscoring have been omitted.