Verify orders and prepare requisition according to your facility’s policy
Collect required equipment: Appropriate collection tubes, tight fitting gloves, tourniquet, needles, skin disinfectant, gauze pad and tape, sharp container, plastic bag or container to transport blood, requisition
Identify and prepare the patient
- Greet the patient warmly and confidently in order to build confidence and trust. Introduce yourself.
- Ask the patient’s name. Identify the patient with full name and date of birth (according to the facility’s protocol).
- Tell the patient you are going to collect blood specimen. Answer questions.
- Check history of allergies including latex allergy.
Perform hand hygiene, wear personal protective equipment (PPE) including gloves. Note: Depending on the patient’s isolation status, you need to wear PPE before entering the room.
Position the patient in a comfortable position, either sitting on a chair or lying down with arm fully extended and supported.
Position yourself in a comfortable position facing the patient. Bring the bed level high to avoid bending and stooping or sit on a chair
Prepare equipment and keep it within reach. Attach needle to the vacutainer holder (if required). Open skin disinfectant package and gauze pad. Choose collection tubes. Put well-fitting gloves
Place tourniquet on the upper arm, above the cubital area. Do not apply tourniquets over open sores. A cloth or sleeve can be placed under the tourniquet to protect fragile and sensitive skin. Do not leave tourniquets tied for more than 2 minutes. If required, release it for 1 minute and then reapply.
Methods to distend veins: Ask the patient to open and close the fist. Lightly tap over the vein. If needed, apply heat for 2-3 minutes.
Palpate (feel) the vein and choose a large, spongy, bouncing veins for phlebotomy. Normal veins feel soft, spongy and bouncing. Sclerosed or damaged veins feel hard to touch and it does not bounce. Use your dominant hand to palpate. Place the palmar pad of the index finger (not the tip) and depress lightly (not hard) and feel the rebound of the blood in the vein.
Disinfect the venipuncture site: Applying firm but gentle pressure, scrub the intended insertion site and 3 co area for 30 seconds with an alcohol or chlorhexidine (according to your facility’s policy) pad. Allow the antiseptic solution to dry.
DO NOT touch the cleaned site. If the site is touched, repeat the disinfection.
Perform venipuncture and draw blood: Pick up the needle and carefully remove the needle shield and hold the needle with the bevel up in your dominant hand. Place the thumb of your non‐ dominant hand below the venipuncture site, apply skin traction, stretch and stabilize the vein.
Insert the needle directly on top of the vein with less than 30 degrees angle. Slowly and steadily puncture the vein. Use 20 – 30 degrees angle for thick larger and deep veins. Use less angle for superficial fragile veins.
If you are using a winged needle set (butterfly), Hold the wings together, insert the needle with the bevel up.
<insert pictures of blood draws>
Once the needle is properly positioned in the vein, anchor and secure the needle by grasping the holder with thumb on top and other fingers under the holder, resting the fingers on the patient’s arm
Push appropriate vacutainer tube into the holder with gentle pressure in order to puncture the cap. The tube will automatically fill with blood. Watch the blood as it flows into the vacutainer tube until collection is complete.
As soon as the last tube of blood is drawn, release the tourniquet and remove the tube from the holder. Place a gauze pad over the puncture site, remove the needle and activate the needle-stick prevention feature. Apply digital pressure and apply dressings.
Instruct the patient to leave gauze and tape in place for at least two hours.
<insert pictures of blood draws>
