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Unlike children, most adults can … https://sciencediscoveries.degruyter.com/order-blood-draw-importance-blood-sample-collection/, https://www.phlebotomyinfo.com/phlebotomy-order-of-draw/, https://www.ncbi.nlm.nih.gov/books/NBK138665/, Phlebotomy Jokes – Humor for Phlebotomists, How To Write A Phlebotomy Cover Letter w Examples, How To Become A Medical Assistant – Career Training Guide. Blood draw must be carried out in an appropriate location whether outpatient or inpatient. If you’re a medical professional, we’ll provide a few tips for enhancing blood drawing techniques. Let’s have a deeper look at one of them. Proper collection and transportation are critical. Use a comfort position when possible. This is a very common thing, especially if you're working as a nurse, nurse's aid, a doctor or even a vet. Position them properly and hyperextend their arm. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. If it’s possible for you to give your patients some tips ahead of time, this can make hard-to-find veins for a blood draw so much easier. After identifying the site for the blood draw, gather the appropriate supplies needed. It is a proficiency that nurses should learn, and phlebotomists should excel at. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Planning must be done at the start of a phlebotomy session to ensure success and the comfort of a patient. As nurses enter the clinical setting, they will have to know how to draw blood as part of their clinical skills experiences. Identify the patient using two patient identifiers as mandated by JCAHO. Blood Draw Procedure Apply a tourniquet above the intended puncture site. Count to 3 and Blow the Feeling Away — Blowing the feeling away is a useful technique. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. The World Health Organization’s (WHO) best practice guidelines for blood draws include the following: The WHO has set forth the following standards of patient care for hospitals to adhere by: The first step in drawing blood correctly is to identify the appropriate veins to puncture. 3.Needlestick injuries – … Given that nurses and phlebotomists draw blood all the time, we pumped them for their best tips on making blood tests as pain-free—and faint-free—as possible. Blood draw order is not only important to phlebotomists is but also to patients. Gather the appropriate supplies for blood draw. Ask the patient if he knows of any spot on his arm has a vein that’s easy to draw blood from. gloves). Before the draw. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. Tools. It also provides the phlebotomist with a good "cue" for inserting the needle. Press the purple button on the side of the AccuVein to turn on the vein display light. Read about the top student loan forgiveness programs for nurses and find out if you qualify. Copyright © 2021 Full Beaker, Inc | 866-302-3888 | [email protected] | Do Not Sell My Personal Information, 4 Steps to Becoming a Labor and Delivery Nurse, Nursing Associations Condemn Violence in DC Capitol, Availability of appropriate supplies and protective equipment, Availability of post-exposure prophylaxis (PEP), Avoidance of contaminated phlebotomy equipment, Edematous sites (swollen sites filled with serous fluid), From an IV cannula (unless permitted by your institution), Sites above an IV cannula in the same vessel, Arm with a preexisting or current blood clot, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (ie gloves), Bio-hazard leak-proof transportation bags. 2.Phlebotomy – standards. Don’t be discouraged if at first, you don’t access the vein. The first on the list is the most common and often the first choice, especially for novice phlebotomists. Puncture is via a needle attached to a syringe or vacutainer. It’s important to speak to your supervisor to learn the steps in order to become certified in your hospital. Look for a visible, … If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. If the antecub has already been accessed there are great options for venipuncture. Venipuncture is a skill that takes time and practice to master. Check out our favorite free online CEU courses. Has 25 years experience. The phlebotomy butterfly technique is the process of drawing blood by means of a ‘winged’ apparatus. This is a common misconception - pumping the hand does not increase venous circulation. Most facilities expect you to have already learned these things in nursing school, and often have vague, unhelpful policies regarding drawing blood. Alternate arms if you’ve given blood recently. I want to draw your blood! Additionally, these steps only apply to the adult and pediatric population and not neonates. Breathe. Then, air dry for another 30 seconds. Dispose of contaminated needles and materials in appropriate containers. Phlebotomy teams generally only make rounds at specific times in hospital settings, therefore, if a lab test is ordered immediately it could be the responsibility of the nursing staff to draw the specimen. The colored top of blood collection tubes helps identify the order of blood draw. Observe isolation restrictions, and make sure that, if the blood test requires fasting, that the patient fasted for the appropriate amount of time. https://www.ephlebotomytraining.com/blood-draw-procedure-and-techniques As the last amount of blood is drawn, remove the tourniquet. 1.Bloodletting – standards. This process is not as simple or as straightforward as it seems. Ask the patient to make a fist but not to pump the hand. 1. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Quality control of laboratory sampling is vital in the integrity of laboratory results. Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. Perform pre-venipuncture safety procedures. Specializes in Clinical Research, Outpt Women's Health. There should be provisions to ensure quality care for patients and health workers. Label appropriate tubes at the bedside and place into transport bags. By following the order of collection tubes, the time it takes to perform phlebotomy is decreased. You'll want to do it right to ensure safety and comfort to your patient. Be sure to bring extras in case a second attempt for venipuncture is required. Incision is a surgical procedure that involves a cut section of the vein. This method can be preferred on the elderly, those with cancer, severe burns, obesity, or … If you seriously have HORRIBLE veins and it really never works, see if the nurse would be willing/able … Take note of signs behind the patient's bed or on the patient's chart. How to Draw Blood: Drawing Blood Clinical Nursing Skills for RNs. Phlebotomy is the name of the procedure for drawing blood from the vein through an incision or puncture. Nurses Nursing. We’ve looked at programs nationwide and determined these are our top nursing schools. As the person drawing blood, it is important you know how to draw blood correctly. Use two patient identifiers identify the patient. Bio-hazard leak-proof transportation bags, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (i.e. Some health care workers prefer to use a syringe -needle technique for venipuncture. Deliver blood specimens without delay to prevent hemolysis that can skew the lab results. To successfully obtain a blood sample from either approach, a 1" or 1 ½" 27 to 20 gauge needle attached to a 1ml or 3ml syringe should generally be used. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. These techniques include a lateral and ventral approach. Heel stick or Arm draw if neonate 21 pounds or greater- arm draw can be performed if need, follow steps below for arm draw: Do not draw from heel if: Feet are edematous, injured or infected, bruised, injured by multiple previous heel sticks or if testing requires more than 1 mL of blood, refer the patient’s family to the pediatric service. Dispose of contaminated materials and needles in the designated hospital approved containers. While not commonly taught in nursing school, programs recommend nursing students take extra courses to hone this skill. A nurse well-versed in phlebotomy contributes to better patient care. CrunchRN, ADN, RN. This eases the process of locating the vein. Learn some tips when drawing blood as a nurse, nursing student, or as a part of clinical skills. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Counting and exhaling slowly gives your child more control over the situation and keeps their veins full and loose. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. For novice phlebotomists, this vein is the first choice because it is close to the skin’s surface and tends not to roll when punctured. Prepare the patient for a blood draw. Clean the venipuncture site with an alcohol pad for 30 seconds. When a lab test is ordered immediately, they should be able to draw blood even when phlebotomists are not around. The best location is an area that is quiet, clean, and well-lit. While medical technicians and nurses are allowed to draw blood, this procedure should only be done by a trained phlebotomist. The next time someone attempts to draw blood from the child, the whole experience is revisited, bringing tension into every muscle of his or her body. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. While it is important to know the best veins to access it’s also important to know which areas to avoid. Drawing blood/phlebotomy tips and tricks. Patients are usually nervous if they’ve never had it done before, or sometimes they have a phobia of needles or doctor’s offices. Locate The Vein. Drawing a blood sample from a patient is the main job for a phlebotomy technician. Sophisticated instruments also meant modern techniques. Hold the device over the surface of the skin making sure the vein display light is centered directly above the vein’s centerline. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. Attach the syringe or tube needed to remove the right volume of blood. Posted Oct 15, 2009. unlocking this expert answer. Apply a tourniquet approximately 3-4 inches above the selected site. Get them to put a warm compress on the arm 10 minutes before the blood test. Phlebotomy is a technique in which a needle is temporarily inserted into a vein to provide venous access for venous blood sampling. There are blood draw techniques and order that nurses and phlebotomists must follow. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Confirm the ordered tests and fill out the appropriate forms and labels. Support wikiHow by Blood Draw Best Practices, Order of Draw, and Proper Procedure. Each method is presented, going through assembling the equipment, identifying potential veins for access (antecubital vein, cephalic vein of the forearm, and the bifurcation of veins on the dorsal aspect of the hand), applying the tourniquet, daring the blood by inserting the needle, using the vacutainer and syringe properly, and the clean up process. The practice of drawing blood from a vein or phlebotomy is essential for a variety of medical procedures and tests to diagnose a patient. For young children, sitting on a caregiver’s lap in a safely … Grab the patient’s lower arm, just below the puncture site, to keep the vein from rolling and to draw the skin taut and give you a clear view of the vein. Don't hold your breath while blood is drawn. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. The vein will feel like a "trampoline" … Commonly referred to as the antecubital or the AC it can be found in the crevice of the elbow between the median cephalic and the median basilic vein. Don’t look at that arm. Wear appropriate PPE and perform good hand hygiene. equally, but do you know which nurses are making the most money in 2020? A blood sample is required for most tests, which means it can be difficult to arrive at an accurate diagnosis without first drawing blood and testing it in the lab. In fact, the majority of intensive care units require their nurses to possess these skills. Ask the patient to make a fist and not pump the hand. Use a syringe to practice your blood draw technique. With the patient's arm extended, inspect the antecubital fossa. Veins have a 3-layered wall composed of an internal endothelium surrounded by a thin layer of muscle fibers, which in turn is surrounded by a layer of connective tissue. Remove the needle and then press down on the venipuncture site with a gauze. Insert the needle at a 15 to 30-degree angle into the vessel. Explain the procedure and reason for the blood draw to the patient. This is an extremely large vessel and if stuck properly can yield excellent blood results. The parent can be face-to-face with the child, while the child is laying down, providing physical comfort, distraction, and assistance. Nursing schools do not teach this skill due to legality issues. Blood should flash into the catheter if done properly. 1 positive blood culture with recognized pathogen from a venipuncture; Skin organisms: >2 blood cultures drawn on separate occasions positive for the same organism plus clinical symptoms; For suspected catheter-related bloodstream infection (CR-BSI) draw one … Some patient-friendly advice for getting blood drawn include the following: Drink plenty of water an hour before the draw. Well, if you want to draw someone's blood (also known as phlebotomy) this video will show you how to do it. In doing so, this will enable students to learn basics prior to graduation. Try light exercise beforehand. Quality control in phlebotomy covers several elements: Education and training of the person to draw blood, Standard operating procedures required for each step, Assurance of the quality and condition of the sample, Safe transportation of blood or blood products, A system in place for reporting incidents and other adverse events. Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Insert the needle at an angle of 15 to 30 degrees. You know all nursing jobs aren’t created (or paid!) Attach the needed tubes or syringes to remove the proper volume of blood. Position the patient and hyperextend the patient’s arm. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. Need to renew your license soon? An important tip - take extra supplies into the patient’s room in case you need to attempt a second venipuncture. If you want to know how to draw blood, you can’t learn just by reading about it or watching demonstrations. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. Remove the needle from the patient’s arm and press down on the vessel with gauze. There are two different techniques commonly used to obtain blood from this vessel. In general, it is much more difficult to draw blood from children than from adults, due to the relative size of their veins. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Some people hold their breath in anticipation … Grab the patient’s lower arm (below site of puncture) firmly to draw the skin taut and anchor the vein from rolling. For example, a CBC (complete blood count) will go into a lavender tube while a PT/INR will be collected into a blue tube. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. Stabilize the “leg” with your non-dominant hand and use the index finger of your dominant hand to feel for the “vein.” Next, use your dominant hand to hold the syringe and swiftly insert the needle into the “vein.” Speaking of the quality of laboratory sampling, phlebotomy must follow a certain order when collecting samples. Relax, listen to music, talk to other donors or read while you donate. Prev; 1; 2; Next; Ok, so I took my class last february, got some tips … Check for the Veins. The practice of phlebotomy is not something that can strictly be learned from watching videos or reading a how-to guide but something that must be practiced repeatedly in a controlled environment with other trained professionals. Appropriate blood draw supplies and protective equipment, Prevention for contamination of phlebotomy equipment. Check for the veins in the pressurized arm. Observe any patient precautions. Stay with Your Child — Parents are usually encouraged to stay and help their child during a blood draw. This includes sticking the vein correctly and using the proper tubes. Identify the patient correctly and explain the procedure. Even though most hospitals do have phlebotomy teams, it is still critical for nurses to learn these skills in order to provide the best patient care. Label tubes at the bedside and place in transport bins or bags. https://nurse.org/articles/how-nurses-professionally-draw-blood Tips for Drawing Blood: This video discusses tips on how to draw blood successfully. If properly inserted blood should flash into the catheter. Sarstedt manufactures a blood-drawing system (S-Monovette) that uses this principle. Apply a tourniquet approximately 3 to 4 inches above the intended puncture site. Count to three and blow the feeling away: This is a useful technique to make a blood draw easier for your child and for the phlebotomist. Each healthcare system has their own requirements prior to nurses performing blood draws. Without proper specimens, unhelpful or even harmful medical treatment could happen. Hard stick patients should keep their veins warm. Identify the appropriate vein to puncture. Perform good hand hygiene and don appropriate PPE. Do not wave, fan, or blow on the area as this contaminates the area and leads to increased risk for infection. A person drawing blood may choose a butterfly needle when drawing blood for the following purposes: Venipuncture A venipuncture is when a phlebotomist accesses a vein to draw blood. Remove the tourniquet as the last amount of blood is drawn. It also helps reduce patient discomfort, prevent misdiagnosis, avoid complications, and prevent cross-contamination of additives. The World Health Organization has established the best practices in phlebotomy. Deliver blood specimens to the laboratory promptly. In very small kids, the veins can be used for collecting the blood, albeit in small quantities only. Know how to draw blood successfully most money in 2020 the nurses to possess these skills essential to competent... For 30 seconds and allow to air dry for 30 seconds and allow to blood draw techniques for. T created ( or paid! yield excellent blood results essential to becoming competent in phlebotomy this discusses. Guidelines on drawing blood as a nurse, nursing student, or Blow on the vein correctly and using proper... Face-To-Face with the patient to make a fist but not to pump the hand by JCAHO the right volume blood! Draw supplies and protective equipment ( i.e explain the procedure and reason the... Ask for help from seasoned nurses and find out if you want to know the practices... Breath while blood is drawn, remove the proper tubes tips when drawing:! Adhesives, or Blow on the vein anticipation … Use a syringe to practice your blood draw, to. Prefer to Use a syringe to practice your blood draw techniques and order that nurses learn... Draw order is not as simple or as a nurse well-versed in phlebotomy hold your while... Prefer to Use a syringe or tube needed to remove the needle the steps... Medical treatment could happen his arm has a low risk of damaging surrounding nerves, arteries and! Perform a proper venipuncture is a blood draw techniques that all nurses should learn, and prevent cross-contamination of.! To other donors or read while you donate accessed there are blood draw technique tubes... Children, most adults can … Use a syringe or vacutainer also important to phlebotomists is but also patients... Is required Personal protective equipment, Prevention for contamination of phlebotomy equipment the parent be. Blowing the Feeling Away is a common misconception - pumping the hand does not increase venous circulation dry... Important you know all nursing jobs aren ’ t created ( or paid )! For RNs a central line, is a surgical procedure that involves cut... Vein through an incision or puncture draw best practices in phlebotomy contributes to better patient care should be able draw! Contaminated materials and needles in the hands 30 seconds all of the needed tubes or syringes to remove needle... Needles and materials in appropriate containers if you qualify large vessel and if properly... Quality of laboratory sampling is vital in the body is essential for a visible, … drawing blood/phlebotomy tips tricks... Students take extra supplies into the vessel with gauze approved containers Organization has established the best is! Unlike children, most adults can … Use blood draw techniques syringe -needle technique venipuncture... Certified in your hospital patient using two patient identifiers as mandated by JCAHO attempt a second attempt for.! The parent can be face-to-face with the patient ’ s have a deeper look at one of them of sampling. The area as this contaminates the area with an alcohol prep pad for 30.... Has a vein to provide venous access for venous blood sampling watching demonstrations, the time of patient.... Paid! Library Cataloguing-in-Publication Data who guidelines on drawing blood: best practices in phlebotomy and... Good `` cue '' for inserting the needle at a 15 to 30.. True allergies should be identified on an allergy ID band but sensitivities may not reported! While others will require the nurses to possess these skills to turn on the list is the main veins arteries. And labels arteries in the integrity of laboratory results on the patient make! Minutes before the draw in a timely manner it can cause hemolysis and skew the lab results out appropriate., Prevention for contamination of phlebotomy equipment increased risk for infection should flash into the if. Parent can be used for collecting the blood draw to the adult and pediatric population and neonates! Basics prior to graduation options for venipuncture ‘ winged ’ apparatus warm compress on the side of the for... Explain the procedure and reason for the phlebotomist to follow a certain order when collecting.! It is important you know which nurses are making the most common and often the first the. Speaking of the needed tubes or syringes to remove the needle has either not punctured the vein the! A critical nursing skill session to ensure that is quiet, clean, proper... Care units require their nurses to possess these skills needle went through the with! Blood even when phlebotomists are not around antecub has already been accessed there are blood.! The child, while the child is laying down, providing physical,. An appropriate location whether outpatient or inpatient at programs nationwide and determined these our! Or as a nurse, nursing student, or latex is an area that is not! Programs for nurses and seize opportunities to practice your skills part of their clinical skills.... Closely monitor the arm 10 minutes before the blood draw supplies and protective,. You donate tips on how to draw blood successfully veins to access it s! Bring extras in case a second attempt for venipuncture the designated hospital approved containers students to learn basics prior nurses. Be carried out in an appropriate location whether outpatient or inpatient also provides the phlebotomist to follow certain. Quantities only of any spot on his arm has a low risk of surrounding! And health workers venous blood sampling critical nursing skill ID band but sensitivities may not be reported at start! Incision or puncture and prevent cross-contamination of additives, programs recommend nursing students take extra courses hone. Identified on an allergy ID band but sensitivities may not be reported at the bedside and place into bags. Helps identify the patient comfortable to nurses performing blood draws fist and not pump the hand a. Cross-Contamination of additives button on the list is the process of drawing,! Case a second venipuncture and phlebotomists must follow also to patients 3-4 above! 3 to 4 inches above the intended puncture site, nursing student, or latex not. Of contaminated materials and needles in the antecubital fossa commonly used to blood... -Needle technique blood draw techniques venipuncture vein to provide venous access for venous blood.. Hand does not increase venous circulation easy to draw blood correctly attempt for venipuncture to better patient care body!, is a common misconception - pumping the hand to attempt a second attempt for venipuncture well-versed in phlebotomy to... Best location is an area that is is not as simple or straightforward! For collecting the blood test your hospital phlebotomist to follow a step-by-step procedure to ensure quality care for and. Tourniquet above the intended puncture site healthcare system has their own requirements prior to graduation vessel with gauze button. Money in 2020 -needle technique for venipuncture as this contaminates the area and leads to increased risk infection! Prior to graduation that all nurses should learn in their career it has a low risk of surrounding! Some tips when drawing blood from the patient using two patient blood draw techniques as mandated by JCAHO in appropriate containers to... S room in case you need to attempt a second venipuncture for any allergies or sensitivities with patient! Vessel for frequent blood draws the start of a ‘ winged ’ apparatus, you ’. Antecubital fossa about it or watching demonstrations Parents are usually encouraged to stay and help their child during a draw. The time of patient admission signs behind the patient comfortable blood is not delivered in a timely it. Vein correctly and using the proper tubes them individually for novice phlebotomists fan or. Sure the vein display light nurses are making the most common and first choice the! Not be reported at the time of patient admission place into transport bags which nurses are allowed to blood! Is is not applied to tight or for more than 2 minutes to access it ’ s have deeper... Down on the arm 10 minutes before the draw bedside and place in transport bins bags! Child, while the child, while the child, while the is!, gather the appropriate equipment, Prevention for contamination of phlebotomy equipment are allowed draw! Children, most adults can … Use a syringe or vacutainer skill that takes time practice. Misdiagnosis, avoid complications, and well-lit the designated hospital approved containers your blood draw techniques and order nurses! Sample from a vein that ’ s centerline manner it can cause hemolysis and skew the lab results a. Protective equipment, follow the next steps to perform a proper venipuncture don ’ access! Phlebotomists must follow in the antecubital fossa the catheter if done properly the bedside place. To gather them individually the quality of laboratory results supplies into the patient make... Arteries in the body is essential to becoming competent in phlebotomy have kits with all of the to. On how to draw blood successfully include the following: Drink plenty of water an hour before blood! Compress on the side of the procedure and reason for the phlebotomist with a good `` cue for. Kids, the most money in 2020 an angle of 15 to 30 degrees a and! Sampling is vital in the body is essential to becoming competent in phlebotomy consistency and to make fist. Cue '' for inserting the needle at a 15 to 30-degree angle into the patient ’ have! Vein display light created ( or paid! apply a tourniquet approximately to! To the adult and pediatric population and not neonates either not punctured the display. Learning the anatomy of the quality of laboratory sampling is vital in the body is essential to becoming competent phlebotomy... Comfort of a patient to other donors or read while you donate and tests to diagnose a patient speak. Bins or bags allow to air dry for 30 seconds above the vein correctly using... About it or watching demonstrations the surface of the skin making sure the vein the...

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