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Fall 2018
Angela M. Norwood BS, PBT(ASCP)
Phlebotomy Department Chairperson
College of Lake County-Lakeshore
847-543-2148
PBT Student Handbook_v12_Fa 2018
College of Lake County Phlebotomy Program Handbook
1
Program Information Disclaimer
The material in this packet is published annually for informational purposes; and is not to be
regarded as an irrevocable contract between the student and the program. The information is
subject to change.
2
GETTING STARTED
BE AT LEAST 18 YEARS OLD
HAVE A HIGH SCHOOL DIPLOMA OR EQUIVALENT
OBTAIN A CLC STUDENT ID# By applying to CLC in person or on-line at www.clcillinois.edu/apply. If you do not have
CLC student ID# at time of info session, please submit it with the date of attendance to:
Lori Deron at [email protected].
SEE ACADEMIC ADVISOR To determine College Reading & Writing Readiness and Basic Algebra Readiness ATTEND INFO SESSION
COMPLETE HEALTH CAREER PASSPORT (Immunization Screening) with CLC Health Center – Grayslake Campus 847/543-2064
COMPLETE IDPH BACKGROUND CHECK
COMPLETE DRUG SCREENING
REGISTER FOR PBT 110 & 115
PROOF OF MEDICAL INSURANCE Provide to Phlebotomy program director at CLC-Lakeshore Campus room S307 HEALTHCARE PROVIDER CPR Provide to Phlebotomy program director at CLC-Lakeshore Campus room S307
3
TABLE OF CONTENTS
Program Overview 6
Course Descriptions 12
National Certification Exam 14
Program Objectives 16
Program Code of Ethics 20
Phlebotomy Entrance Requirements 22
Health Requirements 28
Program Policies 33
Student Rights & Responsibilities 39
CLC Policies and Information 42
Phlebotomy Program Documents 47
4
Program Overview
5
PHLEBOTOMY PROGRAM OVERVIEW
Program Vison
Contribute to the general well-being of the community by providing exemplary healthcare
professionals.
Program Mission
Produce quality phlebotomist who will maintain standards of excellence and advance as
healthcare professionals.
Program Goal
Provide future healthcare professionals with a rigorous foundation in the theory and art of
phlebotomy, as well as, enhance their critical thinking and their interpersonal skills.
Prepare students as entry level phlebotomists in hospitals, clinics, blood donor centers, and other
health care settings.
Develop students with skills in performing phlebotomy procedures, specimen collection and
processing in various health care settings. The CLC Phlebotomy Program is approved by the
National Accrediting Agency for Clinical Laboratory Science:
NAACLS
5600 N. River Road Suite 720
Rosemont, IL 60018-5119
http://www.naacls.org
Phone: 847-939-3597 or 773-714-8880
E-mail: [email protected]
CLC’s Phlebotomy Certificate Program has been supplying the Lake County area with quality
graduates since 1989. The demand for entry into the Phlebotomy program is so high that there
are three sections offered in the Fall and Spring semesters and the one section offered in the
Summer. The program is designed to assist students to enhance critical thinking abilities and
their interpersonal skills. The courses and activities include:
96 hours of theory and laboratory practical at the College’s well-equipped lab on campus, with
practice arms, on-line activities and CD tutorials.
Didactic instructions that uses computer aided technology. In addition, the College has a variety
of computers available for use in the learning resource center, computer laboratory in the Bio-
Health science division and other computer labs.
Clinical practicum which allow students to work in real clinical settings as full-time student-
trainees under the supervision of professional Medical Technologists and/or Phlebotomists. The
students spend eight (8) hours a day, five (5) days per week for three weeks at clinical sites for
practical, hands-on experience with a variety of patient types (in-patient, out-patient, geriatric,
adults and pediatric). Students are required to complete a minimum of 100 hours and 100
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successful unaided sticks. The clinical practicum is only offered during week days. Evening or
weekend practicums are not available.
The Phlebotomy Certificate Program daytime intensive cohort can be completed in 11 weeks.
The didactic portion meets Monday through Thursday for 3 hours per day. The evening cohort,
meets 2 evenings per week for 3 hours each evening, allows students complete the program in 19
weeks. Students may be awarded a Phlebotomy Certificate of completion once all program
requirements are met. Granting of the Phlebotomy Certificate is not contingent upon the student
passing an external certification or licensure exam.
Phlebotomy Certificate Course Credit Hours and total hours
COURSE Credit Hrs Lect.
Hours
per week
Lab. Hours
per week
Contact
Hrs.
# Weeks Total
Hours
PBT 110 2 4 8 6 4 48
PBT 115 2 4 8 6 4 48
PBT 116 2 0 40 2 3 120
TOTAL 6 224 Graduates of this program are eligible for certification by nationally recognized certifying agencies.
PBT Program Graduation Rates:
Fiscal Year 2015-2016 2016-2017 2017-2018
% 96 97 82
PBT Program Attrition Rates:
Fiscal Year 2015-2016 2016-2017 2017-2018
% 2 4 3
PBT Program Placement Rates:
Fiscal Year 2014-2015 2015-2016 2016-2017
% 84 95 75
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The Phlebotomy Program at CLC provides learning experiences through classroom lecture, lab,
class discussion, critical thinking/case studies and other activities that enable students to achieve
the following NAACLS Entry Level Competencies:
1.00 Demonstrate knowledge of the health care delivery system and medical terminology.
1.1 Identify the health care providers in hospitals and clinics and the phlebotomist's role as a
member of this health care team.
1.2 Describe the various hospital departments and their major functions in which the
phlebotomist may interact in his/her role.
1.3 Describe the organizational structure of the clinical laboratory department.
1.4 Discuss the roles of the clinical laboratory personnel and their qualifications for these
professional positions.
1.5 List the types of laboratory procedures performed in the various disciplines of the clinical
laboratory department.
1.6 Describe how laboratory testing is used to assess body functions and disease.
1.7 Use common medical terminology.
2.00 Demonstrate knowledge of infection control and safety.
2.1 Identify policies and procedures for maintaining laboratory safety.
2.2 Demonstrate accepted practices for infection control, isolation techniques, aseptic techniques
and methods for disease prevention.
2.2.1 Identify and discuss the modes of transmission of infection and methods for prevention.
2.2.2 Identify and properly label biohazardous specimens.
2.2.3 Discuss in detail and perform proper infection control techniques, such as hand hygiene,
gowning, gloving, masking, and double-bagging.
2.2.4 Define and discuss the term “healthcare-acquired infection”.
2.3 Comply with federal, state and locally mandated regulations regarding safety practices.
2.3.1 Observe the OSHA Blood borne Pathogens Standard and Needle Safety Precaution Act.
2.3.2 Use prescribed procedures to handle electrical, radiation, biological and fire hazards.
2.3.3 Use appropriate practices, as outlined in the OSHA Hazard Communications Standard,
including the correct use of the Material Safety Data Sheet as directed.
2.4 Describe measures used to insure patient safety in various patient settings, i.e., inpatient,
outpatient, pediatrics, etc.
3.00 Demonstrate basic understanding of the anatomy and physiology of body systems and
anatomic terminology in order to relate major areas of the clinical laboratory to general
pathologic conditions associated with the body systems.
3.1 Describe the basic functions of each of the main body systems, and demonstrate basic
knowledge of the circulatory, urinary, and other body systems necessary to perform assigned
specimen collection tasks.
3.2 Identify the veins of the arms and hands on which phlebotomy is performed.
3.3 Explain the functions of the major constituents of blood, and differentiate between whole
blood, serum and plasma.
3.4 Define hemostasis.
3.5 Describe the stages of coagulation.
3.6 Discuss the properties of arterial blood, venous blood, and capillary blood.
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4.00 Demonstrate understanding of the importance of specimen collection and specimen integrity
in the delivery of patient care.
4.1 Describe the legal and ethical importance of proper patient/sample identification.
4.2 Describe the types of patient specimens that are analyzed in the clinical laboratory.
4.3 Define the phlebotomist's role in collecting and/or transporting these specimens to the
laboratory.
4.4 List the general criteria for suitability of a specimen for analysis, and reasons for specimen
rejection or recollection.
4.5 Explain the importance of timed, fasting and stat specimens, as related to specimen integrity
and patient care.
5.00 Demonstrate knowledge of collection equipment, various types of additives used, special
precautions necessary and substances that can interfere in clinical analysis of blood constituents.
5.1 Identify the various types of additives used in blood collection, and explain the reasons for
their use.
5.2 Identify the evacuated tube color codes associated with the additives.
5.3 Describe the proper order of draw for specimen collections.
5.4 Describe substances that can interfere in clinical analysis of blood constituents and ways in
which the phlebotomist can help to avoid these occurrences.
5.5 List and select the types of equipment needed to collect blood by venipuncture and capillary
(dermal) puncture.
5.6 Identify special precautions necessary during blood collections by venipuncture and capillary
(dermal) puncture.
6.00 Follow standard operating procedures to collect specimens.
6.1 Identify potential sites for venipuncture and capillary (dermal) puncture.
6.2 Differentiate between sterile and antiseptic techniques.
6.3 Describe and demonstrate the steps in the preparation of a puncture site.
6.4 List the effects of tourniquet, hand squeezing and heating pads on specimens collected by
venipuncture and capillary (dermal) puncture.
6.5 Recognize proper needle insertion and withdrawal techniques, including direction, angle,
depth and aspiration, for venipuncture.
6.6 Describe and perform correct procedure for capillary (dermal) collection methods.
6.7 Describe the limitations and precautions of alternate collection sites for venipuncture and
capillary (dermal) puncture.
6.8 Explain the causes of phlebotomy complications.
6.9 Describe signs and symptoms of physical problems that may occur during blood collection.
6.10 List the steps necessary to perform a venipuncture and a capillary (dermal) puncture in
order.
6.11 Demonstrate a successful venipuncture following standard operating procedures.
6.12 Demonstrate a successful capillary (dermal) puncture following standard operating
procedures.
7.00 Demonstrate understanding of requisitioning, specimen transport and specimen processing.
7.1 Describe the process by which a request for a laboratory test is generated.
7.2 Instruct patients in the proper collection and preservation for non-blood specimens.
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7.3 Explain methods for transporting and processing specimens for routine and special testing.
7.4 Explain methods for processing and transporting specimens for testing at reference
laboratories.
7.5 Identify and report potential pre-analytical errors that may occur during specimen collection,
labeling, transporting, and processing.
7.6 Describe and follow the criteria for collection and processing of specimens that will be used
as legal evidence, i.e. paternity testing, chain of custody, blood alcohol levels, etc.
8.00 Demonstrate understanding of quality assurance and quality control in phlebotomy.
8.1 Describe quality assurance in the collection of blood specimens.
8.2 Identify policies and procedures used in the clinical laboratory to assure quality in the
obtaining of blood specimens.
8.2.1 Perform quality control procedures.
8.2.2 Record quality control results.
8.2.3 Identify and report control results that do not meet pre-determined criteria.
9.00 Communicate (verbally and nonverbally) effectively and appropriately in the workplace.
9.1 Maintain confidentiality of privileged information on individuals, according to federal
regulations (e.g. HIPAA).
9.2 Demonstrate respect for diversity in the workplace.
9.3 Interact appropriately and professionally.
9.4 Demonstrate an understanding of the major points of the American Hospital Associations’
Patient’s Bill of Rights and the Patient’s Bill of Rights from the workplace.
9.5 Comply with the American Hospital Associations’ Patient’s Bill of Rights and the Patient’s
Bill of Rights from the workplace.
9.6 Model professional appearance and appropriate behavior.
9.7 Follow written and verbal instructions.
9.8 Define and use medico legal terms and discuss policies and protocol designed to avoid
medico legal problems.
9.9 List the causes of stress in the work environment and discuss the coping skills used to deal
with stress in the work environment.
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Course Descriptions
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REQUIRED COURSEWORK Course Credit Hours
PBT 110 Introduction to Medical Lab
Technology
2
PBT 115 Phlebotomy Techniques 2
PBT 116 Phlebotomy Practicum+ 2
Total Hours for Certificate 6
PBT 110 Introduction to Medical Lab Technology (1-2) 2 Hours
This course introduces students interested in phlebotomy to the roles of the medical laboratory
personnel in the health care system. Topics include professionalism, communication, basic
laboratory math, medical ethics, CLIA-waived testing, and legal implications of laboratory
testing, and educational preparation and certification of laboratory personnel.
Prerequisites: High School Diploma, GED or equivalent, Reading and Writing Proficiency,
Basic Algebra Readiness, GPA of 2.0 or above (for any credit classes completed at CLC),
attendance of Phlebotomy Information Session (within 2 years), Background Check, Drug
Screening, Program Immunizations and Proof of Medical Insurance.
PBT 115 Phlebotomy Techniques (1-2) 2 Hours
This course focuses on the development of skills in performing phlebotomy procedures. Topics
include proper use of equipment, current safety standards, medical and legal policies and
regulations, interpersonal and communication skills, and correct specimen collection, transport,
and preparation for laboratory testing.
Prerequisite: PBT 110 (C or better), High School Diploma, GED or equivalent, Reading and
Writing Proficiency, Basic Algebra Readiness, GPA of 2.0 or above (for any credit classes
completed at CLC), attendance of Phlebotomy Information Session (within 2 years), Background
Check, Drug Screening, Program Immunizations and Proof of Medical Insurance.
PBT 116 Clinical Phlebotomy (0-7) 2 Hours
This course provides the student with supervised clinical practice of current phlebotomy
techniques. Students will develop skill in performing phlebotomy procedures in various health
care settings. Includes proper use of equipment, current safety standards, medical and legal
policies and regulations, interpersonal skills, and correct transport, collection, and preparation for
laboratory testing. Students will complete on-line skills assessment, prepare a resume, and take
an exit exam. Students must pass the exit exam with an 80% or better to be eligible for the ASCP
Certification exam. It is recommended that PBT 116 is taken within 6 months of completion of
PBT 115.
Prerequisite: PBT 110, PBT 115 (both with C or better), High School Diploma, GED or
equivalent, Reading and Writing Proficiency, Basic Algebra Readiness, GPA of 2.0 or above (for
any credit classes completed at CLC), attendance of Phlebotomy Information Session (within 2
years), Background Check, Drug Screening, Program Immunizations and Proof of Medical
Insurance.
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National Certification Exam
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NATIONAL CERTIFICATION EXAMINATION
Students are required to take an exit exam in PBT 115. The exit exam is a simulated
certification exam. Students must pass the exit exam with a minimum of 80% to be eligible
to take the national certification exams such as the PBT-ASCP. Granting of the Phlebotomy
Certificate is not contingent upon the student passing an external certification or licensure
exam.
Industry certification exams are required by most medical laboratory employers, and allows a
graduate to work in most states that do not have a licensure requirement. The ASCP Phlebotomy
certification is highly recommended.
It is the student's responsibility to contact the national certification offices to obtain application
forms and to submit the forms with the required fees.
If the application form is submitted without the fee, the form will be returned. Transcripts also
must be sent; this should not be done only after it has been noted on your transcript that you have
completed the program. Examination Fees: $135.00
ASCP BOC CERTIFICATION PASS RATES
(for students who sat for the exam within the first year of graduation)
Year 2015-2016 2016-2017 2017-2018
CLC 100% 100% 100%
ASCP BOC CERTIFICATION PASS RATES
(for first time examinees)
Calendar Year 2015 2016 2017
CLC 100% 100% 100%
National 88% 87% 91%
AMERICAN SOCIETY FOR CLINICAL PATHOLOGY
Board of Registry
3335 Eagle Way
Chicago, IL 60678-1033
312-541-4999
www.ascp.org
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Program Objectives
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PROGRAM OBJECTIVES The program's direction and methods are guided by community needs and CLC's
resources. Consistent with this philosophy, the following objectives have been
established for the Phlebotomy Certificate Program.
The program is open to all whom:
Are academically and technically capable of profiting from the curriculum.
Meet the essential requirements developed in compliance with American with Disabilities Act (pL101-336), and the National Accrediting Agency for Clinical laboratory Sciences (NAACLS).
Demonstrate professional behaviors, cognitive and technical abilities in the field.
Meet the expectations of area employers.
Program Objectives:
Provide the community with entry level phlebotomists by:
Maintaining State, Federal and professional accreditation status by meeting or exceeding specified requirements.
Providing a framework of education that reflects the mission and goals of CLC.
Providing a well-rounded curriculum by continually recognizing the current needs of the community in the design of the curriculum.
Offering educational activities by using all possible educational resources and expertise.
Keeping instruction in phlebotomy up-to-date by continually participating in continuing
education and by continually incorporating the latest educational and technological innovations.
Assist students in developing professional attitudes and ethics (which are expected of phlebotomists) by helping students to:
Develop positive attitudes, assurance and confidence in performing laboratory tasks.
Recognize their role in the health care system and function as effective team members.
Enhance their interpersonal skills to:
Act responsibly and professionally by respecting others.
Develop rapport and cooperation by communicating and interacting with others.
Recognize and accept responsibility as productive members of our society.
3. Prepare students for professional mobility consistent with recognized standards of medical and professional ethics by:
Assisting students to develop strategies to enhance their critical thinking abilities, to take charge of their own learning and to learn the merits of continuing professional development.
Promoting satisfactory completion of transferable general education and science courses. Providing a climate conducive to stimulating interest in PBT education and participating in professional organizations. and encouraging awareness in changing trends in medical laboratory technology
Promoting successful participation in national professional certification processes and examinations. Exploring and developing articulation with other institutions.
Successful completion of the program requires developing the following skills:
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Communication Skills sufficient to:
Effectively and productively interact independently with peers, instructors, supervisors,
patients, other members of the health care system, and the community.
Recognize and respect the responsibilities of other laboratory and health care personnel when
interacting.
Effectively elicit patient information, describe changes in mood, activity, posture, and assess
non-verbal communication.
Effectively transmit information to patient, peers, faculty and staff in addition to all members of
the health care team.
Knowledge of basic science concepts applicable to medical laboratory procedures sufficient to:
Collect and process laboratory specimens efficiently and appropriately.
Recognize the importance of specimen collection in the overall patient care system.
List and explain the effects of various factors affecting test results and identify ways to
minimize or avoid them.
Relate the anatomy and physiology of body systems and anatomic terminology to the major areas
of the clinical laboratory, and to general pathologic conditions associated with body systems.
Identify and select appropriate equipment used in blood and specimen collection.
Explain the significance of quality control and practice basic quality control methods in
routine laboratory procedures.
Practice and adhere to established safety protocol arid policies.
Critical thinking and psychomotor skills sufficient to perform phlebotomy techniques and
procedures such as specimen collecting, processing, handling and transporting procedures
efficiently and accurately with minimum supervision in order to:
Organize and prioritize work accordingly.
Utilize the scientific method and own academic background in making judgments at the
appropriate level of competence.
Apply basic principles in learning new techniques and procedures.
Develop critical judgment in evaluation of own work.
Knowledge of basic phlebotomy equipment and computer applications sufficient to:
Utilize the keyboard to interact with computerized instruments and Laboratory Information
Systems.
Follow instructions associated with basic laboratory information system.
Demonstrate proper care and use of phlebotomy equipment.
Recognize, identify and respond to instrument malfunctions or specimen acceptability.
Operate and maintain commonly used phlebotomy equipment and their associated test
methods.
Keep equipment and working area clean and in good order.
Ask instructor for assistance when repairs and/or maintenance are needed.
Awareness of potential laboratory hazards and safety concerns sufficient to:
Maintain a clean, safe and organized work area.
Adhere to all safety guidelines in the collection, processing, testing, and disposal of all bio-
hazardous materials.
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Practice Standard Universal Precautions.
6. Professional attitude and demeanor sufficient to:
Maintain acceptable attitude toward instruction and the instructors.
Demonstrate readiness for class activities by following directions and completing tasks assigned
within allotted time frames.
Develop confidence in abilities to perform commensurate with experience.
Demonstrate integrity by recognizing and repeating questionable tests.
Identify the roles and functions of various laboratory personnel in health care system.
Show respect for others.
Comply with institutional rules and regulations.
Practice punctuality and regular attendance.
Develop responsibility and accountability for work and action.
Adhere to recognized standards of medical and professional ethics
Present a personal appearance, which is appropriate for a professional who has patient contact.
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Program Code of Ethics
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CODE OF ETHICS
The public and health care professions rely on the knowledge, skills, honesty, and integrity of
trained competent professionals. The Medical Laboratory Profession demands careful attention
to detail, accuracy and precision.
Medical Laboratory professionals must assume responsibility for the quality of laboratory
test results and employers rely on educators to produce ethical health care graduates. Therefore, professional ethics and attitudes are emphasized throughout the Phlebotomy
program.
Unethical behavior can result in legal action and/or loss of life. Any form of dishonest, unsafe or unethical behavior will not be tolerated in the classroom or clinical laboratory and is grounds for dismissal from the program. This includes any deliberate act of omission or commission regardless of actual injury such as plagiarism, falsification of lab results, destruction of misuse of equipment, or failure to adhere to safety policies. The College of Lake County’s Phlebotomy Certificate Program adheres to The Code of Ethics
of the American Society for Clinical Pathologist (ASCP) that sets forth the principles and
standards by which clinical laboratory professionals practice their profession.
Recognizing that my integrity and that of my profession must be pledged to the best possible
care of patients based on the responsibility of my work, I will:
Treat patients and colleagues with respect, care and thoughtfulness;
Perform my duties in an accurate, precise, timely and responsible manner;
Prudently use laboratory resources;
Advocate the delivery of quality laboratory services in a cost-effective manner;
Work within the boundaries of laws and regulations and strive to disclose illegal or improper
behavior to the appropriate authorities;
Continue to study, apply and advance medical laboratory knowledge and skills and share this
knowledge with my colleagues, other members of the health community and the public.
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Program Entrance Requirements
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ENTRANCE REQUIREMENTS College of Lake County
These policies pertain to all students in all programs. Policies for particular programs
within CLC are more specific. Please pay attention to the differences.
Anyone who can benefit from the courses and programs of study offered by
the college is welcome.
Admission to the college does not ensure entrance into a particular course or program of study.
The college reserves the right to: Limit enrollment because of space or budget restrictions.
Establish selective admission requirements.
Give preference to residents of Community College District 532.
Students must provide admissions and records office with required records/credentials:
Official high school transcript(s) must be sent directly to CLC from the High School attended, or
a copy of the applicant's High School equivalency (GED) test report must be submitted.
Official transcripts from any previous college(s) must be sent directly to CLC by the college(s).
Foreign transcript must be evaluated by an external educational agency and sent directly to
CLC's admission office.
Language proficiency
Phlebotomy Academic Program Entrance Requirements
Be at least 18 years old
Have a high school diploma, GED or equivalent
Demonstrate College Reading & Writing Readiness; and Basic Algebra Readiness prior to
enrolling in PBT 110
2.0 CLC GPA or higher
Attend an information session
Phlebotomy Non-academic Program Entrance Requirements:
Background Check
Drug Screening
Immunizations
Essential Skills and Functional Abilities
Because of the inherent requirements of the profession, candidates for the phlebotomy program
must have certain essential skills and functional abilities. If a candidate believes that he or she
does not possess one or more of these skills or abilities without accommodations, the
phlebotomy program must determine, on an individual basis, whether a reasonable
accommodation can be made. The following minimum abilities, i.e. essential functions, are
expected of the student:
Visual acuity (normal, compensated, or corrected vision) sufficient for:
Safe and successful practice of Phlebotomy.
Observation and assessment necessary in the operation of equipment and care of patients.
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Active participation in all demonstrations, laboratory exercises, classroom activities and
clinical experiences in the various program.
Independent performance of microscopic work; read charts, graphs, manuals, and instruments;
and, make color comparisons and interpretations.
Auditory abilities (normal, compensated, or corrected hearing) sufficient to:
Monitor and assess patient needs.
Independently communicate with patients, colleagues, and other health care practitioners.
Psychomotor skills (hand-eye coordination and manual dexterity) sufficient to:
Independently and safely perform phlebotomy techniques.
Perform repetitive tasks and the ability to walk, stoop, bend, twist, reach, and occasionally kneel and squat with full range of motion of joints.
Use fine motor abilities to use electronic keyboards to input and transmit data.
Physical stamina to:
Lift and move up to 50 pounds of weight daily.
Work long periods of time (4-8 hours).
Perform tasks that demand bending, stooping, standing, and sitting.
Move freely and safely about the laboratory and the clinical setting.
Perform moderately taxing continuous physical activity.
Reach laboratory counters, shelves, patients lying in hospital beds or patients seated in blood collection furniture.
Communication skills to:
Effectively communicate with patients, their families, and other members of the healthcare team to gather information appropriately; explain medical information in a patient-centered manner; listen effectively; recognize, acknowledge, and respond to emotions; and exhibit sensitivity to social and cultural differences.
Interact in English with accuracy, clarity, and efficiency with others in verbal and written form.
Sufficiently interact cooperatively with supervisors, other students, and all other healthcare team members, and they must be able to accurately identify patients.
Intellectual abilities to:
Comprehend and learn factual knowledge from readings and didactic presentations.
Gather information independently, analyze and synthesize learned material, and apply information to clinical situations.
Develop sound clinical judgment and exhibit well-integrated knowledge about the phlebotomy process of care, to include: assessment, planning, implementation, and evaluation of phlebotomy services.
Be comfortable with uncertainty and ambiguity in clinical situations, and seek the advice of others when appropriate.
Interpersonal, behavioral, social and professional abilities to:
Demonstrate the emotional maturity and stability to function effectively under the types of stress that are inherent in healthcare professions.
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Adapt to circumstances that are unpredictable or that change rapidly.
Interact productively, cooperatively, and in a collegial manner with individuals of differing personalities and backgrounds, and be an active contributor to the process of providing health care by demonstrating the ability to engage in teamwork and team building.
Identify and set priorities in patient management and in all aspects of their professional work.
Be punctual and to perform work under strict time frames.
Be capable of empathetic response to individuals in many circumstances and be sensitive to social and cultural differences.
Exhibit an ethic of professionalism, including the ability to place others’ needs ahead of their own.
Exhibit compassion, empathy, altruism, integrity, responsibility, and tolerance, as well as demonstrate the ability to exercise the requisite judgment required in the practice of phlebotomy.
Mental, psychological, and emotional health sufficient to:
Independently perform with speed and accuracy in potentially and occasionally stressful situations.
Demonstrate rational and appropriate behavior.
Tolerate taxing workloads, function effectively under stress, adapt to changing environments, display flexibility and learn to function in the face of uncertainties inherent to the clinical problems of many patients.
Recognize own stress level and communicate need for assistance appropriately.
Perform multiple tasks and establish priorities.
Calmly react to urgent situations. exercise good judgment in addition to the development of mature and sensitive relationships with patients. Demonstrate compassion, integrity, concern for others, interest and motivation.
The aforementioned are personal qualities which each applicant should possess. Individuals should give careful consideration to the mental and physical demands of the program prior to making application. Phlebotomy students are expected to complete an "essential functions self-assessment." When necessary, consultation from a qualified expert may be necessary in the assessment of a student's possible inability to meet the following essential functions.
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Instructions for students who want to enroll in PBT 110
Drug Screening Pay $45 for the cost of the drug screening to the CLC cashier (located on the Grayslake
campus at the Welcome and One Stop Center). You can also pay in Room N211 at Lakeshore
campus, (please note that the Lakeshore campus can accept payment by check, money order,
credit card, or cash in the exact amount. Return your receipt from the cashier to Kathy
Bianchi in D208a at the Grayslake Campus.
Complete the attached Acknowledgement of Understanding form for the drug testing and return
it to Kathy Bianchi in D208a at the Grayslake Campus.
Once I receive your receipt and Acknowledgement & Understanding form, I will email you (to
your CLC student email address) the form and instructions to have the drug screening done at
an Advocate location.
You can send your receipt and signed consent form to me in any of the following
ways:
Drop it off in D208 of the Grayslake campus (you can drop it in the lockbox on the
wall across from the room if the office is unattended).
Scan and email your receipt to [email protected].
Fax it to the confidential fax number 847-543-3043.
Ask your department chair (Angela M. Norwood) to send a hard copy via inter-
office mail to Kathy Bianchi, D208a.
Fingerprinting Background Check Complete both sides of a Disclosure and Authorization Form and return it to me. The forms
are available on the Phlebotomy Program web page. A hard copy of the form is also available in
the Nursing Education office at Grayslake and the Student Services office at the Lakeshore
campus. A valid social security number is required for this form.
The Livescan form, which you will need to take with you to the fingerprinting vendor, will be
sent to your CLC student email address. Please allow 2 business days to process the
Authorization and Disclosure Form. A fingerprinting schedule can be found here
(http://dept.clcillinois.edu/nur/FingerprintingSchedule.pdf).
Student will pay the $28 fee (debit, credit or money order – no cash accepted) to fingerprint
vendor if using Accurate Biometrics. They are located at their office in Libertyville on a walk-in
basis every Monday and Thursday 9 am – 12:30 pm and 1:30 pm – 5:00 pm, and every Friday
9:00 am – 2:00 pm. If using Morpho Trust to fingerprint, they are at the CLC Grayslake campus
by appointment only on every other Tuesday. You need to contact them at
http://www.identogo.com or at 800-377-2080 to set-up an appointment. Their fee is $30.50, and
you pay the vendor directly either online or in person.
After fingerprinting, return your “completion receipt” from the vendor to Kathy Bianchi
in D208a at the Grayslake Campus.
In order to be eligible to take the course, the background check needs to be clear of any
disqualifying convictions. Please check www.idph.state.il.us/nar/home.htm for a list of
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disqualifying convictions. If the conviction allows a waiver, the waiver must be approved by the
Illinois Department of Public Health (IDPH) prior to enrolling in the course.
You can send your fingerprinting receipt to me in any of the following ways:
Drop it off in D208 of the Grayslake campus (you can drop it in the lockbox on the
wall across from the room if the office is unattended).
Scan and email your receipt to [email protected].
Fax it to the confidential fax number 847-543-3043.
Ask your department chair (Angela Norwood) to send a hard copy via inter-office
mail to Kathy Bianchi, D208a.
If you have any questions, please feel free to contact me.
Kathy Bianchi, 847-543-2325
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Health Screening (Immunization) Requirements
27
Memorandum
Date: June 1, 2017
To: Phlebotomy Students
From: Director, Health Services
Subj.: Health Requirements
Congratulations on your acceptance into the Phlebotomy Certificate program! Now that you’re
in the program, your first assignment concerns your health and you have a number of activities
to finish as soon as possible. In order to comply with Illinois State and local health regulations,
you must complete certain health requirements BEFORE starting your clinical experience. It
is up to you to keep in touch with the Health Center and complete your requirements in time.
Your instructor will receive a message from the Health Center after you are cleared to go to the
clinical area. The health requirements are explained below.
Tuberculosis (TB) – Once considered to be a disease of the past, tuberculosis is making an
unwelcome comeback. This communicable and potential deadly respiratory disease has no
acceptable vaccine to date. However, we are able to test your immune system to see if you have
been exposed to the disease in the past. Many people are exposed to the disease without
knowing it; for example, being in a theater or restaurant near someone who is infected and
coughing or sneezing. Current research shows that initial testing may not reveal a subacute case
or carrier of the disease. So, we do a “two step skin test” to see if you have been exposed to the
disease and don’t know it. If the initial skin test result is negative, we will repeat the test one-
week later to see if your immune system has been triggered or sensitized. Thirty percent of the
tests are falsely negative, hence with the first round of testing, we have a need to make sure your
immune system isn’t hiding something. If the second test is negative, then you will be tested
annually using the one-step method by the health care institution for which you work.
If either test is positive, you will be sent to the Lake County Tuberculosis Clinic in Waukegan
and have a chest x-ray and be checked for the presence of active disease. If necessary, they will
give you medication, for you to take up to 6 months on a daily basis. When you finish that
course of treatment, you should be protected against the disease becoming active. Since your
immune system will always show a positive result, follow-up tests will consist of periodic annual
x-rays and/or a screening questionnaire done on an annual basis or as needed. Contact the T B
Clinic for prices and hours at 847-377-8700.
Please note many physicians do not understand the two-step system but it is a legal requirement.
So, PLEASE have your two-step skin test done at the Health Center, unless you already have had
one done at a health care institution. If so, bring us a copy of that test. The two-step skin test is
$14 done here. You can have the test done at the Lake County Tuberculosis Clinic (contact clinic
for price and hours). But if you do not get the 2-step done in time, you may not attend clinical
sessions.
We will also accept lab results for either a T-Spot blood test or Quantiferon Gold blood test
that tests for TB. CLC Health Center offers a T-Spot blood test for $51.
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Measles (Rubeola) – You must show evidence of immunity to Rubeola by having a blood test
showing the immunity. This blood test costs $33. There is a cost of $74 for the vaccinations
done here at CLC, if you need a booster dose to achieve immunity. If you need the 2
recommended doses, the immunizations are spaced one month apart. If your physician does the
lab test, bring a copy of those results to the Health Center for your record.
Mumps – You are required to show evidence of immunity to mumps by having the titre drawn.
If so, it can be drawn at the same time as other blood tests. The cost is $48. If you need a
booster dose, it can be given at the Health Center for a cost of $74.
Rubella (German Measles) – You must show evidence of immunity to rubella with a positive
blood titre. The cost of the blood test is $15. Many women had the test done if they were
pregnant and can get a copy of the results from their obstetrician. There is a charge of $74 for
the immunization if a booster dose is done at CLC.
Hepatitis B – You must have evidence of a series of 3 vaccinations against Hepatitis B or
quantitative surface antibody titre showing immunity. If you need to have the Hepatitis B
series, you will need a titre drawn 1-2 months after the 3rd vaccination. If the titre comes back
showing no immune system response, the series will be repeated and the titre redrawn. Hepatitis
B vaccinations cost are $44 each. The cost of the titre is $33 at CLC.
Hepatitis A – You must have a Hepatitis A Ab IgM blood titre. The cost is $20 if done at CLC.
You are not required to have the 2 shot Hepatitis A series.
Hepatitis C – You must have a Hepatitis C antibody blood titre. Hepatitis C is a major cause of
this infection and currently there is no vaccine available. This will document your status upon
entering the program. If done at CLC the cost of the lab test is $20.
Influenza – You must show evidence of having a vaccination to the current influenza virus
during the fall semester because many of the clinical rotation sites require it. Contrary to most
rumors, the vaccination is made of noninfectious viral protein particles and can NO longer give
you the “flu”. CLC offers the flu shot at a very low cost (usually almost half the price offered at
public locations). It is a real bargain and a SMART investment for the flu season for any year!
Tetanus/Diphtheria/Acellular Pertussis (TDaP) – You must have evidence of an immunization
to TdaP within the past 10 years. Please bring a copy of the record to attach to your CLC health
record. There is a cost of $40 for this vaccine at CLC.
Varicella titre – This is a blood test to show immunity to varicella (chicken pox). If you are not
immune, then you should consider the vaccination only between semesters and out of the patient
care/clinical arena. For adults, it is a 2 shot series. The second vaccination is given 4 – 8 weeks
after the first. If you consider the vaccination, you should plan the dates so it is completed in
time to attend clinical. Remember, you CANNOT go to your clinical experience if you
develop a rash after either vaccination! The vaccination can result in infection in people with
compromised immune systems. A written report that you had the disease does NOT excuse you
29
from getting the blood test. If done here at the CLC Health Center, the cost is $40. After
payment for the test, if necessary we can print a letter for your insurance company so that you
can obtain reimbursement.
We will keep a copy of your health record here. If you ever need a copy of your immunizations
or lab work, you can get one by completing, sending or faxing a signed written request to us. We
need to know it is YOU making that request because ALL records, visits, or information are
considered confidential. Because you may go to several different institutions for your clinical
experience, we would like you to sign a “Universal Request for Copies” form at this time. This
will allow us to copy the parts of your health record for those institutions in which you have
clinical experience that will verify your TB skin testing, your immunizations and associated
titres. If you need copies for other reasons, then you will be asked to fill out that separate
request.
Costs of tests can be added to your student bill or you can pre-pay and bring the receipt from the
cashiers’ window with you to the Health Center
Please remember that the Health Center is here to serve you, whether the need is for
immunizations, minor cures for headaches, heartaches or head colds, or information about a
condition for a class presentation or assignment. We have a lot of brochures, pamphlets and
teaching aids that may be of assistance for your classroom needs.
We will be happy to answer any questions you may have. The Health Center is open from 8am
until 4:30pm Monday, Thursday and Friday and from 8am until 7pm Tuesday and Wednesday
during the semesters. The telephone numbers are (847) 543-2064/2274. The fax number is
(847) 543-3064 and we look forward to seeing you in the Health Center! Have a great
semester!!!
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31
Program Policies
32
APPEARANCE, ATTITUDE, AND DEMEANOR At the clinical sites, the PBT student trainee is a member of a health care team, and is responsible
for staying physically and mentally alert, healthy, and productive.
Appearance:
Appropriate personal hygiene and grooming is required.
Natural colored hair
Long hair pulled up
Clipped nails with clear polish only Tattoos and piercings covered
Adhere to dress code. Students are required to wear:
Pewter colored scrubs
Leather or vinyl closed toe shoes
Attitude:
Respect for the people you serve and work with is required. Candid and professional discussion
of concerns, uncertainties and/or questions with the phlebotomy instructor, supervisor, or
coordinator is expected. Adherence to institutional guidelines concerning confidentiality
regarding student and/or patient and laboratory information is required.
Demeanor:
Poise and self-confidence are expected (poise comes from being prepared for the work). Competence is expected; perform all procedures to the best of your ability (being competent
includes knowing when to ask for help).
Integrity is required (patients, doctor, and co-workers depend on it).
CELL PHONE / PAGER POLICY Cell phone/pager must be set to vibrate mode (inaudible) so as not to disturb the learning
environment.
ATTENDANCE AND PUNCTUALITY Attendance and punctuality is required to successfully complete the program. Class activities,
laboratory exercises, clinical experience and training are arranged sequentially to build up the
necessary skills and competence. Perfect attendance and punctuality is expected. Class
activities at the college and clinical sites start promptly. Missing class activities undermines skill
development, and missing lectures leads to confusion, thereby undermining the learning process.
Attendance and punctuality affect overall performance and, therefore, will affect overall grade.
RELIGIOUS OBSERVATION
Any student who is unable, because of his or her religious beliefs, to attend classes or to
participate in any examination, study, or work requirement on a particular day shall be excused
from any such examination, study, or work requirement and shall be provided with an
opportunity to make up the examination, study, or work requirement that he or she may have
missed because of such absence on a particular day; provided that the student notifies the faculty
member or instructor well in advance of any anticipated absence or a pending conflict between a
scheduled class and the religious observance and provided that the make-up examination, study,
or work does not create an unreasonable burden upon the institution. No fees of any kind shall be
charged by the institution for making available to the student such an opportunity. No adverse or
prejudicial effects shall result to any student because of his or her availing himself or herself of
the provisions of this Section.
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CLASSROOM ATTENDANCE
Students are expected to notify the instructor prior to starting time if unable to report
or report on time so reagents and specimens are not wasted.
Students will be permitted to make up a maximum of two missed exercises during
regular lab times (specified by the instructor) if the students notify the instructor prior to missing a class.
A student who misses 3 days of classes for PBT 110 or 2 days of PBT 115 may be advised to
drop the course, and if the student wishes, to repeat the course.
PRACTICUM ATTENDANCE: Missing work and being tardy or leaving early are not easily tolerated. Students are expected to notify the clinical instructor, PBT supervisor, or coordinator at the clinical site prior to starting time if unable to report or to be on time. Absences and tardiness are documented and incorporated in the performance evaluations.
Make-up times are allowed for absences not to exceed 2 occurrences. To schedule the extra
burden involved with making up missed work, the make-up days will be specified by the clinical
site coordinator.
ILLNESS/PREGNANCY In order to ascertain that the student is not placing her/himself, another student, or the client in
physical jeopardy, the student who returns to the classroom or clinical area following:
a. illness requiring treatment by a health care provider
b. illness requiring hospitalization
c. pregnancy
d. delivery of a baby
will bring a statement from her/his health care provider, which indicates that the student may
return to participation without restriction in all assigned client care activities and responsibilities.
This statement must be presented to the instructor prior to the student’s return to the classroom or
clinical area.
If the doctor’s note includes restrictions it is the responsibility of the student to initiate requests
for accommodations. The College of Lake County’s Office for Students with Disabilities (OSD)
is responsible to coordinate accommodation plans for students who have medical restrictions.
The student will need to apply with OSD and will be asked to provide the staff of OSD with a
copy of the specific restrictions, accommodations recommended by their treating physician, and
any other documentation found necessary by OSD to determine need for accommodation(s). The
OSD will review the documentation and meet with the student to determine necessary
accommodations, if any.
Keep in mind that a student is responsible for adhering to the guidelines within a given class,
including clinical/practicum site visits, as well as any state requirements, if any. The student may
need to consider, for example, dropping a class according to the parameters of that class or seek
a Medical and Catastrophic Incident Withdrawal through the Office of the Associate Vice
President of Student Development if progress is such that it would be extraordinarily difficult to
complete the term. The student is responsible for knowing the appropriate drop dates with regard
to the effects on the grade and refund eligibility.
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Specific Risks
Students admitted to CLC health programs are at greater risk for exposure to certain materials or
incidents that may result in injury. Some of these exposures could potentially affect a pregnant
student or her unborn child. Possible exposures may include: radiation exposure, chemical
exposure, infectious agents and other illness.
Medical Conditions
The Americans with Disabilities Act (ADA) has required CLC student programs to identify
Essential Functions and, in collaboration with Office for Students with Disabilities, determine
the capability of students to perform those functions with or without “reasonable
accommodations.” When a student returns to class or clinical/field placement following an
accident, extended illness, significant psychological problems, pregnancy, or potentially serious
medical conditions, he/she must submit documentation from a physician or healthcare provider
giving clearance to continue with the program.
CLC does not discriminate against students on the basis of sex or pregnancy. CLC recognizes
that it is the right of the pregnant student to make decisions concerning the pregnancy. At the
same time, the pregnant student is expected to complete each requirement of the curriculum by a
schedule or plan that can reasonably be implemented and under which risks are deemed
acceptable by the student and her physician. The student and her physician are responsible to
determine risk levels of participation in educational activities within the Biological and Health
Sciences division, based upon the student’s health condition and any known risk factors. CLC
makes no representations as to whether risks of harm to the pregnant student and/or unborn child
are acceptable.
Disclaimer: CLC does not control decisions of affiliate hosts of clinical and practicum
placements for students to determine eligibility for placement at a site based upon safety and
health risks. While safety or health risks may be regulated by the affiliate hosts, CLC may bear
the responsibility of finding alternate placements, if reasonable and possible, in cases where a
clinical/practicum site may make those concerns known.
LABORATORY SAFETY Students working in a clinical laboratory are responsible for their own safety and the safety of
others. Strict adherence to basic rule of safety must be continually observed and practiced in
order to eliminate/minimize risks related to the various potential hazards in a laboratory.
Acquaint yourself with the safety guidelines, procedures, MSD's and the location of the
various safety devices and exits.
Observe and practice Standard Precaution continually, i.e. treat all specimens as
infectious.
Wear laboratory coats, gloves, and /or face shields when processing/ handling specimens
and when performing dermal punctures or venipunctures.
Change gloves after each patient contact or if the gloves develop holes.
Wash hands frequently and appropriately with antiseptic detergent after:
Removal of gloves.
Removal of lab coats.
Contact with specimens.
Wash hands appropriately with antiseptic detergent prior to leaving the
laboratory.
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Touching your face, contact lenses or eyeglasses.
Adhere to guidelines relative to spills and disposal of waste materials (i.e. sharps,
needles, bio-hazardous specimens, etc.)
No eating or drinking is allowed while performing laboratory procedures.
Notify classroom instructor immediately of accidental exposure or needle stick.
PATIENT SAFETY Safety, for the patient and student, is at the forefront of our responsibility. Students will
perform all procedures under the supervision of an instructor or site preceptor. Students will be
dismissed from their clinical externship and will not be allowed to complete if the following
occur:
Performs unsupervised procedures
Failure to report an incident or accidental exposure
Failure to disclose a condition that may affect their essential functioning, therefore putting others at risk.
Students will be required to meet with one or all of the following upon safety violation: Program Chairperson, Director of Student Life, Director of Students with Disabilities, and Director of Health Services.
SERVICE WORK AND EMPLOYMENT Program affiliation agreements specify that students will not replace the regular laboratory staff
or perform services without supervision by a qualified personnel during the clinical practicum.
Service work by students during clinical practicum and outside of academic hours is non-
compulsory. The program director will try to place the student at a practicum site other than one
where the student is not employed to prevent conflict. If this is not possible, the student
employed at the practicum site, cannot work during the designated practicum hours. Employment
should not interfere with or replace the clinical practicum. The arrangement is between the hospital and the student and is separate from the program practicum requirements.
CLINICAL PRACTICUM POLICIES The program director will place all students in a clinical practicum immediately after completing
PBT 115 with a C or better and all required clinical practicum prerequisites. In the event that
immediate placement is not possible, the program director will place the student in a clinical
setting no later than 6 months after successfully completing PBT 115 with a C or better and all
required clinical practicum prerequisites. Students are required to be complete/submit the
following prior to program enrollment and clinical phlebotomy practicum placement:
Acknowledgement Form
Student Confidentiality Agreement
Drug Screening
Proof of Healthcare Insurance
IDPH Background Check
Universal Release of Medical
Records
Emergency Medical Form
Human Subjects Informed Consent
Professional Qualities Release Form
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Documentation of meeting health requirement as evidenced by the” Health Passport”
signed by CLC’s Health Center nurse indicating all requirements are met.
Current Health Care Provider CPR or BSL certification.
Students must comply with all policies and procedures of the clinical affiliate. It is the
responsibility of the student to become familiar with the policies and procedures of the clinical
affiliate. It is the responsibility of the clinical affiliate to orient the students to all applicable
procedures and policies, including Incident Exposure Plan. During clinical rotations the
preceptor, phlebotomy supervisor, should be notified immediately of accidental exposure or
needle stick. CLC PBT Program chairperson must be notified the day of the incident.
Students are required to complete and submit the following during the course of their clinical
practicum:
Time sheets and venipuncture logs must be signed by clinical site coordinator and
submitted to CLC Phlebotomy Department Chairperson weekly. All written and on-line assignments.
TEACH OUT POLICY If there is an administrative decision to suspend or terminate the Phlebotomy Program, NAACLS
will be notified within 30 days or the official announcement. New students will not be admitted
to the program. Students enrolled, at the time of announcement, will be allowed to follow their
academic plan to complete the program requirements.
DISMISSAL POLICY Failure to comply with the policies and procedures of the program and/or facility or failure to
respect the safety, authority and responsibility of the facility and staff may result in removal of a
student from a facility and/or dismissal from the Phlebotomy Program. This will result in an
unsatisfactory grade for the course.
TRANSPORTATION The student is responsible for providing their own transportation to and from the clinical
facilities and any special clinical assignments, such as lectures at various hospitals.
DRIVER’S LICENSE AND LIABILITY INSURANCE Some clinical affiliates will not allow drivers on their premises without proof of insurance.
CLC’s PHLEBOTOMY CLINICAL SITE AFFILIATIONS Advocate Condell Medical Center- full service hospital 801 S Milwaukee Avenue
Libertyville, IL 60048
Advocate Good Shepherd Hospital- full service hospital 450 IL Route-22
Barrington, IL 60010
Cancer Treatment Centers of America at Midwestern Regional Medical Center-
predominantly a cancer treatment center
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2520 Elisha Avenue Zion, IL 60099
Capt. James A. Lovell FHCC- a military hospital; services restricted to retired, active duty
military and their dependents 3001A Sixth Street
Bldg. 200 H
Great Lakes, IL 60088
Northwestern Lake Forest Hospital- a full service hospital
660 N. Westmoreland Avenue
Lake Forest, IL 60045
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Students Rights and Responsibilities
39
STUDENT RIGHTS & RESPONSIBILITIES: Students are entitled to enjoy the rights protected by the United States and Illinois
Constitutions and laws, subject to legally recognized restraints that may be imposed
because of the college’s role and function. Students should exercise these rights reasonably and
avoid violating the rights of others.
By enrolling in the college each student agrees to conduct himself/herself in a manner
consistent with the college’s educational purpose and its policies and procedures.
If this obligation is not fulfilled by the student, the college may take appropriate disciplinary
action. The college may impose sanctions on a student whenever he or she
commits, attempts to commit, or contributes to conduct that violates this policy on
college premises, on a college extension site, at a college-sponsored activity or event,
or off-campus conduct that (1) adversely affects the health, safety, or security of any member of
the college community or (2) adversely affects the interests of the college.
See the CLC Catalog for more details or contact visit the Office of Student Life in C101 at the
Grayslake campus.
PHLEBOTOMY STUDENTS RESPONSIBILITIES:
Treat other students and CLC faculty and staff with respect.
Cooperate with peers, CLC faculty and staff.
Demonstrate a responsible attitude toward your work and others by acting in the best interest of
the college.
Abide by CLC and Phlebotomy policies and procedures.
Bring ideas and concerns to your instructor or faculty advisor.
Not to represent someone else's work as your own or use unauthorized assistance for a
proficiency test, competency test, quiz or exam.
Work independently in lab without collaboration unless given a group assignment.
Practice safety precautions at all times.
Failure to comply with the Phlebotomy Students’’ Responsibilities or failure to respect the
safety, authority and responsibility of the facility and staff may result in removal of a student
from a facility and/or dismissal from the Phlebotomy Program. This will result in an
unsatisfactory grade for the course.
FERPA:
The Family Rights and Privacy Act (FERPA) gives students certain rights with respect to their
education records. See the CLC Catalog for more details.
COUNSELING/ADVISING SERVICES:
The College of Lake County Counseling Office offers professional counseling for students who
are in crisis or are having personal problems which as a result may affect their academic and
career goals. The services of professional counselors are available on an appointment or drop-in
basis: Grayslake Campus, (847)543-2060; Lakeshore Campus in Waukegan, N211, (847)543-
2186; Southlake Campus in Vernon Hills, V130, (847)543-6501.
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FINANCIAL ASSISTANCE
The Financial Aid Office administers a variety of aid programs that help students reach their
educational goals. Financial aid is available in the form of scholarships, grants, loans and work-
study. Over 7,800 students applied for financial assistance at CLC last year. In 2010-11, the
office disbursed almost $11.7 million of federal, state and private funds to eligible students. To
learn more about financial aid opportunities or for help in applying, please contact our office by
Phone: (847) 543-2062; Fax: (847) 543-3062; or
e-mail: [email protected].
SERVICES FOR STUDENTS WITH DISABILITIES:
If you are a student with a documented disability and may need academic accommodations
including but not limited to: extended time for exams and/or an in-class note taker, please contact
the Office for Students with Disabilities in B171 at the Grayslake campus. For more information,
please call: (847) 543-2474 or e-mail [email protected].
If you have already contacted the Office for Students with Disabilities and have completed the
Instructor Notification Form, please schedule a time to meet with OSD and discuss your needs.
41
College Policies and Information
42
COLLEGE POLICIES AND INFORMATION
TUITION Refer to Class Schedule and College Catalog
WITHDRAWAL AND REFUNDS PHLEBOTOMY STUDENTS ARE EXPECTED TO CONSULT WITH THE
PROGRAM COORDINATOR PRIOR TO DROPPING ANY CLASS.
Student who decides to drop the course must officially withdraw.
The date of the official withdrawal governs the granting of tuition fee refund and the final
grade. Refer to the catalog for details.
REFUND POLICY (Refer to catalog for details)
Students must officially drop classes before or within the refund period to not be charged for the
classes.
Students can view the drop deadline for each of their classes through Student-Self Service on the
Web.
The Full tuition fee refund is granted if official withdrawal occurs before 15% of class days
pass. No refund is granted after that day.
CLC POLICIES GOVERNING STUDENT LIFE Please refer to the College Catalog for details about general policies affecting students, in
particular:
Policies Governing Student Life
Student Rights and Responsibilities
Sanctions
Restriction
Notification of Rights under FERPA for
Postsecondary Institutions
Student Right-to-Know
Addressing Students' Academic Concerns
Discrimination/ Harassment Complaint
Procedures
Services for Students with Disabilities
Career/Job Search Assistance
CLC SAFE ZONE As a means of increasing CLC’s commitment to open access and educational opportunity, CLC
has actively participated in the national Safe Zone program since the fall of 2003 semester. The
national program represents an effort to address homophobia, heterosexism, and transphobia in
schools and is intended to provide support for LGBTQA+ students, faculty, and staff. The
LGBTQA+ Resource Center facilitated program tangibly identifies safe allies for LGBTQA+
people in an effort to increase students’ academic success and retention. I hereby declare myself
as such an ally, and this class as a Safe Zone.
STUDENTS WITH DISABILITIES Contact the Coordinator for Students with Disabilities, in the Learning Resource Center, LIB,
next to the Testing Center, Grayslake Campus, at (847)543-2474. Please refer to the College of
Lake County Catalog for details.
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ADRESSING STUDENT CONCERNS Student Academic Concerns - Students may address academic concerns as explained in the
Addressing Student’s Academic Concerns guidance in the college catalog. Students who have
been suspended for not meeting the academic grade point average requirement may appeal
their suspension as explained in the Academic Appeal Procedure.
Discrimination/Harassment Concerns - contact Vice President for Student Development and refer to CLCs College Catalog.
HEALTH SERVICES
Located in Room A149. Physical assessments of health problems and primary care for illnesses and injuries, with
appropriate referrals when necessary. Health education programs and screening services.
Required immunizations for health career and transfer students; available by
appointment.
Health insurance to all fulltime and part-time students and their dependents.
Phlebotomy students must submit their physical health record evidence of immunization to the
Health Center before they can go to their clinical affiliation site.
LEARNING RESOURCE CENTER (LRC) AND LIBRARY See catalog for more details
Has a collection of over 105,000 books and nearly 675 periodical titles. The audiovisual center provides students with access to 7,750 pieces of media. Have the Learning Assistance Center, the Testing Center, and the Community Gallery of
Art. Has computerized catalog to make searching for books and A V materials more efficient. Several indexes of periodical materials are housed on the CD-ROM system in the LRC to
facilitate retrieval of information.
The LRC conducts information sessions on writing research papers,' preparing for tests,
and other areas of interest.
Hours of operation are generally maintained during the semester while classes are in session,
except during breaks or holidays. Please refer to http://library.clcillinois.edu/ for each campus’
hours of operation.
EMERGENCY PROCEDURES
The College of Lake County works to ensure that the students, staff, and faculty are provided a safe environment for learning. To ensure this, emergency procedures have been developed.
Emergency instructions are posted in each classroom. Please acquaint yourself with them. In the
event of an emergency, please stay with the instructor or your fellow classmates. For the events
listed below, the following procedures will be used: Fire Alarm or Fire Event: Upon activation of the fire alarm, exit the room and remain together
once outside the building. Remain outside, at least 100 feet from the building, until officially
advised to re-enter.
Tornado: The College of Lake County designates safe zones in the event of a tornado. You will either be asked to remain in place or move to the designated safety zone.
Life Threatening Emergency: Based on the most current information, the college will advise
44
all campus stakeholders of the identified threat. Options to address the threat may include, exiting the building or sheltering in place. Please follow the instructions provided and move
quickly. Should the decision be made to shelter in the classroom, members of the classroom
will immediately secure the classroom door and move to an area not visible from the windows
or door. Please silence all cell phones, and remain quiet. Earthquake: Should an earthquake occur, the procedure will be to shelter in the room seeking
cover under tables or desks until the tremors stop. You will then exit the building and remain
at least 100 feet from the building.
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Phlebotomy Program Documents
46
ACKNOWLEDGMENT FORM I have a copy of the Phlebotomy Student Handbook and understand that I am responsible for knowing the
contents.
I agree to abide by the policies and Code of Ethics of the PBT/Phlebotomy program.
I certify that I understand the CLC Phlebotomy Program's Essential Functions requirements and that I meet
each one.
I am aware of the phlebotomy program completion requirements which include successful completion of PBT
110, PBT 115 and PBT 116.
I am aware of the clinical practicum placement policies and procedures; i.e.
I am required to enroll in PBT 110 and PBT 115 consecutively. It is recommended that students enroll into
PBT 116 within 6 months of completing PBT 115.
I am required to successfully complete 120 hours of supervised practical phlebotomy training in a clinical site
with 100 unaided successful blood draws.
The number of clinical spaces available in affiliated area hospitals and other clinical sites may vary, and my
placement, at particular site at a particular time is not guaranteed.
CLC will place every student at a practicum site at systematically scheduled times as soon as possible, but
delays may be unavoidable. To date, no unusual delays have occurred.
I will notify program chair if I am employed at assigned practicum site. My practicum hours must be
completed outside of my hours of employment.
I am aware of the immunization requirements, drug testing and criminal background check requirements by the
Illinois Department of Public Health (IDPH) and the Joint Commission on Accreditation of Health Care
Organization (The Joint Commission) and I agree to abide by them.
I am aware that must provide proof of healthcare insurance prior to attending the clinical practicum.
I am aware that I am responsible for reporting an incident exposure to the Clinical Site Coordinator, CLC
Phlebotomy Department Chair and the CLC Health Center. I am also aware that neither CLC nor the affiliated
clinical site will assume the cost of treatment or care for injury or any medical condition occurring during my
student laboratory classes and during my clinical practicum.
I am aware of the confidentiality requirements (patient and medical records) and will abide by them.
I am aware that I must pass the exit exam with a minimum of 80% for eligibility to take the ASCP(PBT)CM
national certification exam.
I am aware that I must take the ASCP exam within 6 months of successfully completing PBT 116 and passing
the exit exam.
I agree that while enrolled in the Phlebotomy Program I will treat my studies, labs and clinical practicum as an
employee would treat job responsibilities, recognizing that my instructor assumes the role of my supervisor. I
will attempt to learn not only the technical skills, but will also strive to develop a professional manner and
attitude.
I have had an opportunity to ask questions about this material and have had those questions answered to my
satisfaction
I understand that failure to abide by the policies will be grounds for disciplinary action and possible dismissal
from the program.
Student’s Name: _________________________________ ID Number: ___________
(Print)
Student’s Signature: _______________________________Date: _________________
47
Professional Qualities
Release of Information
I give permission to release information regarding my professional qualities,
academic achievement and technical abilities to the Phlebotomy Instructor I Program Director when responding to requests for employment
consideration.
Student’s Name: _________________________________ ID Number: ___________
(Print)
Student’s Signature: _______________________________Date: _________________
48
EMERGENCY MEDICAL INFORMATION
STUDENT INFORMATION
Student’s Name: ______________________________________________________________
Gender: _____ Date of Birth: ____________ Social Security #: XXX-XX-______
Address: _____________________________________________________________________
City/State: __________________________________________ Zip Code: ______________
Phone #: (______) ______-________
HEALTH INSURANCE INFORMATION
Insurance Carrier: ____________________________________________________________
Policy Holder’s Name: ____________________________ Relationship: _______________
Policy I.D. #: __________________________ Group #: ___________________________
EMERGENCY CONTACTS
Name: _____________________________________ Phone #: (______) ______-________
Name: _____________________________________ Phone #: (______) ______-________
List any allergies, medications or health conditions that may be pertinent for emergency
treatment.
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
Student’s Name: _________________________________ ID Number: ___________
(Print)
Student’s Signature: _______________________________Date: _________________
49
HUMAN SUBJECTS DOCUMENT
ASSUMPTION OF RISK AND CONSENT TO PROCEDURES
General Information:
During this course you will be participating in laboratory activities in which learning by students
requires the use of human subjects as part of the training. As a part of these learning activities
you will be asked to perform specific skills as well as be the subject of specific skills practiced
by students. These learning activities will be conducted under the supervision of the course
instructor.
Benefits:
The activities listed have been selected because they are skills essential to the learning process
and the faculty believe that realistic practice is essential for optimum learning.
Bloodborne Pathogen Exposure
It is important that you be aware that blood and other body fluids have been implicated in the
transmission of certain pathogens, particularly Hepatitis B Virus (HBV) and Human
Immunodeficiency Virus (HIV), the virus responsible for Acquired Immune Deficiency
Syndrome (AIDS). In order to minimize risk of exposure to bloodborne pathogens, the student
must agree to follow Standard Precautions guidelines as well as comply with regulations outlined
in the OSHA Bloodborne Pathogen Standard.
Risks/Discomforts
Participation may create some anxiety or embarrassment for you. Some procedures may create
minor physical or psychological discomfort. Specific risks are listed below.
Your Rights
You have the right to withhold consent and to withdraw consent after it has been given. You
may ask questions and expect explanation of any point that is unclear.
Learning Activity
Specific Benefit
Risks/Discomfort
Venipuncture using both evacuated tube
system (ETS)
and syringe system
Student gains experience needed prior to
performing procedures on actual patients
Possibility of hematoma or bruising; slight, temporary
pain with procedure; slight risk of temporary nerve
inflammation
Skin puncture of the finger tip
Same as above
Slight, temporary pain upon puncture; minimal
possibility of infection (provided area is kept clean)
I have read the above Human Subjects Document. I acknowledge my understanding of the risks and benefits described. My questions have
been answered.
I agree to participate as a subject in the learning activities listed above.
____________________________________________________________ _________________
Signature of student Date
50
CLINICAL PRACTICUM
STUDENT CONFIDENTIALITY AGREEMENT
The discussions, uses, and disclosures addressed by this agreement apply to any written, verbal,
or electronic communications.
I understand that I am never to discuss or review any information regarding a patient at a clinical
site unless the discussion or review is part of my assignment to the site. I understand that I am
obligated to know and adhere to the privacy policies and procedures of the clinical site to which I
am assigned. I acknowledge that medical records, accounting information, patient information,
and conversations between or among healthcare professionals about patients are confidential
under law and this agreement.
I understand that, while in the clinical setting, I may not disclose any information about a patient
during the clinical portion of my clinical assignment to anyone other than the medical and
nursing staff of the clinical site.
I understand that I may not remove any record from the clinical site without the written
authorization of the site. Additionally, I understand that, before I use or disclose patient
information in a learning experience, classroom, case presentation, class assignment, or research,
I must attempt to exclude as much of the following information as possible:
• Names
• Geographical subdivisions smaller than a state
• Dates of birth, admission, discharge, and death
• Telephone numbers
• Fax numbers
• E-mail addresses
• Social security numbers
• Medical record numbers
• Health plan beneficiary numbers
• Account numbers
• Certificate/license numbers
• Vehicle identifiers
• Device identifiers
• Web locators (URLs)
• Internet protocol addresses
• Biometric identifiers
• Full face photographs
• Any other unique identifying number,
characteristic, or code
• All ages over 89 years
Additionally, I acknowledge that any patient information, whether or not it excludes some or all
of those identifiers, may only be used or disclosed for health care training and educational
purposes, and must otherwise remain confidential.
I understand that I must promptly report any violation of the clinical site’s privacy policies and
procedures, applicable law, or this confidentiality agreement, by me, or a student or faculty
member to the appropriate clinical coordinator or program director.
Finally, I understand that, if I violate the privacy policies and procedures of the clinical site,
applicable law, or this agreement, I will be subject to disciplinary action.
By signing this agreement, I certify that I have read and understand its terms, and will comply with them.
Signature: __________________________________________________ Date: ____________________
Printed Name: ____________________________________________ CLC ID#: ________________
51
Universal Release of Copies of Medical Records
For Health Career Students
Name_________________________________________________________________ Please print
Date of Birth __________________________ CLC ID # __________________________
Address________________________________________________________________
________________________________________ ______ _____________ City State Zip Code
Telephone (________) _________________________ Area Code
I hereby give permission to the College of Lake County Health Center staff to copy my health
records as appropriate and when necessary so that the documentation can be given to the health
care institutions where I have my clinical experience.
I understand that once the information is disclosed, it may be re-disclosed by the recipient and
the information may not be protected by federal privacy laws and regulations.
THIS MAY INCLUDE COPIES OF THE:
*PHYSICAL EXAMINATION
*TB SKIN TEST RESULTS; CHEST X-RAY RESULTS
*LABORATORY REPORTS OF SERUM TITRES SHOWING IMMUNITY; CBC, URINALYSIS
*IMMUNIZATION VERIFICATION AGAINST DISEASES (SUCH AS RUBEOLA, RUBELLA,
HEPATITIS B, TETANUS/DIPHTHERIA, VARICELLA)
DENTAL HYGIENE STUDENTS: I UNDERSTAND THAT THE INFORMATION MAY INCLUDE
HUMAN IMMUNODEFICIENCY VIRUS (HIV) BLOOD TEST RESULTS.
Permission expires upon completion of my health career program. I understand that I may revoke
this authorization at any time by notifying the providing organization in writing. I also
understand that if I do, my clinical privileges at participating clinical sites may be revoked. This
may result in my being dropped from the health career program.
_______________________________ ____________________
Signature Date
52
URINE DRUG SCREENING PROCEDURE
(Non-Nursing Health Programs)
Purpose: To adhere to the policies of clinical agencies and assure clinical agencies that the College of
Lake County students who participate in clinical experiences will not present an unreasonable
risk to the safety of their clients, urine drug screens will be required of all students upon
entering health programs at the College.
General Information:
All students who have been accepted into and/or are enrolled in health programs at the College
of Lake County must successfully pass a urine drug screen as a condition of
admission/participation in the program. Authorization for the drug screen shall be furnished
by the student, and the student shall be responsible for the required fees. Drug screens
conducted prior to this request will not be accepted and must be repeated. If a prospective
student refuses to complete the drug screen, the student will be terminated from the program.
Following the initial drug screen students may be subject to random drug screening for reasonable
suspicion.
If an initial drug screen is positive without documentation of medical necessity or a prospective
student refuses to complete the drug screen, the student will not be allowed to enter into the
health program. If the initial drug screen is positive, the student will be provided the
opportunity to refute the positive or at the student’s expense, complete a more extensive
drug test. Additionally, if a random drug screen is positive without documentation of medical
necessity, or a student refuses to complete a random drug screen, the student will not be
allowed to continue in the program. Any student who fails a urine drug screen or refuses to
complete a urine drug screen will be referred to counseling for follow-up.
Procedure:
The initial drug screen will be conducted prior to any clinical participation.
Drug screening will be conducted on a yearly basis for students continuing in any health
programs for longer than 12 months.
Students will pay the fee for the drug screen and obtain a receipt for payment. Each
CLC campus has a designated office for accepting student payments and issuing
receipts.
The students will sign the drug screen Acknowledgement of Understanding.
Once receipt for payment and signed Acknowledgement are turned in to the
designated College employee, students will receive an Advocate consent
form and instructions for completing the urine drug screening.
A valid photo i.d. will be required at the location of the urine drug screening.
The results will be reported to the College department responsible for the student’s health
program.
If the initial drug screen is positive, the student will be provided the
opportunity to refute the positive or at the student’s expense, complete a more
extensive drug test.
53
A student who is asked by a faculty member or clinical agency personnel to submit to a random
drug/alcohol test for reasonable suspicion may be asked to have the test completed at the clinical
agency at the student’s expense or will have 24 hours to complete the test at a designated
Advocate Medical Center testing site. Attendance at the clinical agency may be suspended
pending the results of the random test. A drug test will be required if a student’s behavior is
inappropriate, questionable, indicative or suggestive of alcohol or drugs, if the student
demonstrates physical symptoms or manifestations of drugs or alcohol use (including but not
limited to slurred speech, staggered gait, flushed face, dilated/pinpoint pupils, wide mood swings,
deterioration of performance), or if the student is convicted by a court or otherwise found guilty
of a misdemeanor or criminal violations relating to possession or use of a drug, alcohol or other
controlled substance.
54
ACKNOWLEDGEMENT OF UNDERSTANDING
I have read the College of Lake County’s Urine Drug Screening Procedure applicable to
phlebotomy students. I understand the contents and I will comply with the procedure. I understand
that if I have any questions about the contents of the Urine Drug Screening Procedure, I have been
advised to contact my phlebotomy faculty advisor for clarification.
Print Student’s Name:
Student’s Signature:
Date:
55
56
57
58
NOTES
