STEPS TO FOLLOW IN PERFORMING A VENIPUNCTURE
1. Assemble Supplies
a. Make sure all the necessary equipment is on phlebotomy tray before entering the patient’s room. Item to check include:
b. Alcohol pads (70%)
c. Dry, clean gauze pads (2 inch X 2 inch)
d. Tourniquet (clean and in good condition)
e. Vacutainer holder—these are not reusable and should be discarded after use
f. Collection tubes (make sure you have correct tube for all tests ordered and confirm that the tubes are not expired.)
g. Syringe of size sufficient to draw volume of blood needed
h. Safety transfer devices for use with syringe draws.
i. Bandage tape, gauze, and/or adhesive bandages
j. Needles—stock tray with both Vacutainer collection needles and needles for syringes. The choice of needle will depend on the type of vein. The most commonly used needle is 1.5 inches in length and 21 Gauge. (This refers to needle diameter. The higher the gauge number the smaller will be the diameter or bore of the needle.) For small veins a needle 1 inch in length and 22 Gauge is preferred. The currently approved needles in use in this healthcare system are the BD Eclipse Blood Collection Needles. These needles have a safety shield which is locked in place over the needle after the venipuncture is performed.
k. Winged collection sets for difficult draws and blood cultures.
l. Sharps disposal container.
2. Knock on the patient’s door before entering. Identify yourself. Confirm the patient’s identity by checking the arm band. The armband must be on the patient. It is not acceptable for the armband to be on the bed, the table, the wall, or any where except on the patient’s body. Briefly explain venipuncture. Reassure the patient and be friendly. Ask the patient if they have a latex allergy. If the test requires a fasting state, ask the patient if they have been fasting. Guest Excellence and the Customer Satisfaction scripts should be followed at all times. Make sure the patient does not have gum, food or liquid, or other object in his/her mouth before beginning the procedure.
3. The recommended procedure is to have the patient lying down, but if this is not possible, have the patient sit in a comfortable, sturdy chair with his/her arm supported on a table or chair arm for easy access. A patient should never stand or sit on a high stool during the process of blood collection. The phlebotomist should always be prepared for the occasional patient has an adverse reaction to phlebotomy. Refer to procedure “Adverse Reaction to Phlebotomy.