Proposed law would beef up phlebotomy training

Training can’t prevent irresponsibility

As a result of the court-documented admission of reuse of needles by a lab phlebotomist in Palo Alto, CA, Assemblywoman Carole Migden (D-San Francisco) is proposing a new state law that would require more rigorous infection control training for health care workers who draw blood.

Migden successfully spearheaded passage of a landmark law last year requiring medical facilities in California to purchase needle safety devices to protect health care workers from acquiring bloodborne infections from patients.

"The actions of the woman in Palo Alto appear to be very irresponsible, and no amount of training will prevent irresponsibility," Migden tells Hospital Infection Control. "But what my bill will do is to allow the state to prevent such people from doing it again. By requiring all phlebotomists be certified by the state, the state can prohibit irresponsible people from working in this field. This case has undoubtedly raised the priority of a policy that has long been neglected."

Nonetheless, a lack of training does not necessarily explain the Palo Alto case, because even the minimal current requirements that Migden is trying to upgrade would cover such a basic breach as reusing needles. State law currently requires a minimum of 10 hours of training and a demonstration of three blood draws for phlebotomy certification.

"Based on that training, [the phlebotomist] should have known that reusing needles or any other lab equipment is a serious breach of standard medical practice," says Ken August, spokesman for the state Department of Health Services in Sacramento.

If approved as drafted, beginning Jan. 1, 2001, phlebotomists must hold a valid, current certification issued by a national accreditation agency approved by state officials. The state will establish guidelines for approving certification training programs and national accreditation agencies to administer examinations and tests. In addition, phlebotomists will have to complete education, training, and experience requirements that include:

    • 40 hours of didactic instruction;
    • 40 hours of practical instruction;
    • at least 100 venipunctures;
    • three hours per year or six hours every two years of continuing education or training.