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.{{cite journal |last1=Mbah |first1=Henry A. |title=Phlebotomy and quality in the African laboratory |journal=African Journal of Laboratory Medicine |date=4 April 2014 |volume=3 |issue=1 |page=132 |doi=10.4102/ajlm.v3i1.132|pmid=29043181 |pmc=5637764 }}{{cite journal |last1=Simundic |first1=Ana-Maria |last2=Cornes |first2=Michael |last3=Grankvist |first3=Kjell |last4=Lippi |first4=Giuseppe |last5=Nybo |first5=Mads |last6=Kovalevskaya |first6=Svjetlana |last7=Sprongl |first7=Ludek |last8=Sumarac |first8=Zorica |last9=Church |first9=Stephen |title=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) |journal=Clinical Chemistry and Laboratory Medicine |date=1 August 2013 |volume=51 |issue=8 |pages=1585–1593 |doi=10.1515/cclm-2013-0283|pmid=23729577}}{{cite book |last1=Simundic |first1=Ana-Maria | chapter=2.9 Who is Doing Phlebotomy in Europe? |title=Pre-Examination Procedures in Laboratory Diagnostics |date=14 August 2015 |pages=90–94 |doi=10.1515/9783110334043-015|isbn=978-3-11-033165-3 }}

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.{{cite journal |last1=Cai |first1=Qian |last2=Zhou |first2=Yunxian |last3=Yang |first3=Dangan |title=Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey |journal=Biochemia Medica |date=15 February 2018 |volume=28 |issue=1 |page=010703 |doi=10.11613/BM.2018.010703|pmid=29187796 |pmc=5701774 }}

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.{{cite web |title=National Association of Phlebotomists |url=https://www.phlebotomy.co.uk/home |access-date=5 March 2024}} 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 =

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.{{cite journal |last1=Ernst |first1=Dennis |title=Phlebotomy certification legislation: update on three of our 50 states. |journal=Medical Laboratory Observer |date=October 2009 |volume=41 |issue=10 |pages=42 |pmid=19891151 |url=https://www.mlo-online.com/home/article/13003418/phlebotomy-certification-legislation-update-on-three-of-our-50 |access-date=17 February 2024|id={{Gale|A210847808}} }}{{cite journal |last1=Ernst |first1=DJ |title=States fail to follow California's lead in certifying phlebotomists. |journal=Medical Laboratory Observer |date=July 2008 |volume=40 |issue=7 |pages=40, 42 |pmid=18717500|id={{Gale|A182040780}} }}{{cite journal |last1=Kwan |first1=H |title=Rooster guarding hen house? |journal=Medical Laboratory Observer |date=October 2008 |volume=40 |issue=10 |pages=6, 8 |pmid=18990788}}

Phlebotomy licensure advocates claim that the licensure would enhance the quality of personnel, while the laboratory industry opposes phlebotomy licensure as an unnecessary cost.{{cite news |last1=Mishori |first1=Ranit |title=Drawing Without a License |url=https://www.washingtonpost.com/archive/lifestyle/wellness/2004/06/01/drawing-without-a-license/6171f338-24d6-49d1-b4e3-989cf6f3e5b4/ |access-date=17 February 2024 |newspaper=Washington Post |date=May 31, 2004}}{{cite journal |title=Should non-phlebotomists be allowed to draw blood? |journal=Clinical Leadership & Management Review |date=November 2001 |volume=15 |issue=6 |pages=426–8 |pmid=11822275}}{{cite journal |last1=Becan-McBride |first1=Kathleen |title=Phlebotomy Errors Point to Need for Mandatory Licensure of Pre-analytical Laboratory Staff |journal=Critical Values |date=1 October 2009 |volume=2 |issue=4 |pages=18–19 |doi=10.1093/criticalvalues/2.4.18 |url=https://academic.oup.com/criticalvalues/article/2/4/18/2949721|url-access=subscription }}

Phlebotomy is not without risk, and more challenging patients increase the chance of complications.{{cite journal |last1=Harty-Golder |first1=Barbara |title=When should a phlebotomist ask for help with a difficult draw? |journal=MLO: Medical Laboratory Observer |date=January 2003 |volume=35 |issue=1 |pages=48 |pmid=12561745 |id={{Gale|A96892952}} }} 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.{{cite journal |last1=Ernst |first1=DJ |title=Is the phlebotomist obsolete? |journal=MLO: Medical Laboratory Observer |date=October 1997 |volume=29 |issue=10 |pages=30–4 |pmid=10173584| id={{Gale|A20076530}} }}{{cite journal |title=Should non-phlebotomists be allowed to draw blood? |journal=Clinical Leadership & Management Review |date=November 2001 |volume=15 |issue=6 |pages=426–8 |pmid=11822275}}

A number of FDA 510k cleared devices, such as the BD Minidraw have been introduced to enable the drawing of blood without a phlebotomist.{{cite news |last1=Dharma |first1=RanjithKumar |title=BD receives clearance for new blood collection device |url=https://www.medicaldevice-network.com/news/bd-clearance-blood-collection-device/ |access-date=30 April 2024 |work=Medical Device Network |date=8 December 2023}} Additionally, there are devices to help aid non-phlebotomists more readily find veins.{{cite news | location=Orange County |title=Vein attempts? Making needles easier to bear |url=https://www.ocregister.com/2007/09/14/vein-attempts-making-needles-easier-to-bear/ |access-date=30 April 2024 |work=Orange County Register |date=14 September 2007}}

== Certifications ==

There are several national phlebotomy certifications in the US.{{cite book |last1=McCall |first1=Ruth E. |last2=Tankersley |first2=Cathee M. |title=Phlebotomy Exam Review |date=2008 |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-7855-8 |url=https://books.google.com/books?id=Ly5NPgAACAAJ |language=en}}{{cite book |last1=Strasinger |first1=Susan King |last2=Lorenzo |first2=Marjorie Schaub Di |title=The Phlebotomy Textbook |date=25 February 2019 |publisher=F.A. Davis |isbn=978-0-8036-9012-7 |pages=11–12 |url=https://books.google.com/books?id=eJWNDwAAQBAJ |language=en}}{{cite book |last1=Niedzwiecki |first1=Brigitte |title=Kinn's Medical Assisting Fundamentals - E-Book: Kinn's Medical Assisting Fundamentals - E-Book |date=21 October 2021 |publisher=Elsevier Health Sciences |isbn=978-0-323-82454-5 |page=1124 |url=https://books.google.com/books?id=Mo9JEAAAQBAJ&pg=PA1124 |language=en}}

class="wikitable sortable" \|+ 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)

References

Category:Occupational licensing