Check out our favorite free online CEU courses. 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 … You'll want to do it right to ensure safety and comfort to your patient. Well, if you want to draw someone's blood (also known as phlebotomy) this video will show you how to do it. Use a comfort position when possible. Has 25 years experience. Let’s have a deeper look at one of them. Deliver blood specimens without delay to prevent hemolysis that can skew the lab results. gloves). I want to draw your blood! As the last amount of blood is drawn, remove the tourniquet. 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. equally, but do you know which nurses are making the most money in 2020? Some patient-friendly advice for getting blood drawn include the following: Drink plenty of water an hour before the draw. Hold the device over the surface of the skin making sure the vein display light is centered directly above the vein’s centerline. Sarstedt manufactures a blood-drawing system (S-Monovette) that uses this principle. Remove the needle and then press down on the venipuncture site with a gauze. 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. 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. 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. Alternate arms if you’ve given blood recently. Quality control of laboratory sampling is vital in the integrity of laboratory results. In fact, the majority of intensive care units require their nurses to possess these skills. Appropriate blood draw supplies and protective equipment, Prevention for contamination of phlebotomy equipment. Reasons for concern would include numbness, tingling, change of color to blue or white, and extreme pain. Planning must be done at the start of a phlebotomy session to ensure success and the comfort of a patient. Support wikiHow by Identify the patient correctly and explain the procedure. It’s important to speak to your supervisor to learn the steps in order to become certified in your hospital. 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. Phlebotomy is a technique in which a needle is temporarily inserted into a vein to provide venous access for venous blood sampling. As nurses enter the clinical setting, they will have to know how to draw blood as part of their clinical skills experiences. Specializes in Clinical Research, Outpt Women's Health. This process is not as simple or as straightforward as it seems. 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. 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. Blood draw must be carried out in an appropriate location whether outpatient or inpatient. Label tubes at the bedside and place in transport bins or bags. WHO Library Cataloguing-in-Publication Data WHO guidelines on drawing blood: best practices in phlebotomy. Prepare the patient for a blood draw. Position the patient and hyperextend the patient’s arm. If properly inserted blood should flash into the catheter. Be sure to bring extras in case a second attempt for venipuncture is required. 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. 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. Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. The World Health Organization has established the best practices in phlebotomy. While not commonly taught in nursing school, programs recommend nursing students take extra courses to hone this skill. Dispose of contaminated materials and needles in the designated hospital approved containers. Tips for Drawing Blood: This video discusses tips on how to draw blood successfully. Phlebotomy is essential for a variety of medical diagnoses, procedures, and tests. Take note of signs behind the patient's bed or on the patient's chart. Gather the appropriate supplies for blood draw. A nurse well-versed in phlebotomy contributes to better patient care. 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. Proper collection and transportation are critical. It also helps reduce patient discomfort, prevent misdiagnosis, avoid complications, and prevent cross-contamination of additives. In doing so, this will enable students to learn basics prior to graduation. An important tip - take extra supplies into the patient’s room in case you need to attempt a second venipuncture. Insert the needle at a 15 to 30-degree angle into the vessel. Look for a visible, … While medical technicians and nurses are allowed to draw blood, this procedure should only be done by a trained phlebotomist. If you’re a medical professional, we’ll provide a few tips for enhancing blood drawing techniques. 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. 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. 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.” The best location is an area that is quiet, clean, and well-lit. Breathe. Tools. Furthermore, it has a low risk of damaging surrounding nerves, arteries, and tendons versus other veins in the hands. If the blood is not delivered in a timely manner it can cause hemolysis and skew the lab results. After identifying the site for the blood draw, gather the appropriate supplies needed. True allergies should be identified on an allergy ID band but sensitivities may not be reported at the time of patient admission. unlocking this expert answer. There are two different techniques commonly used to obtain blood from this vessel. Apply a tourniquet approximately 3-4 inches above the selected site. Perform good hand hygiene and don appropriate PPE. Identify the patient using two patient identifiers as mandated by JCAHO. Grab the patient’s lower arm (below site of puncture) firmly to draw the skin taut and anchor the vein from rolling. It is important for the phlebotomist to follow a step-by-step procedure to ensure consistency and to make the patient comfortable. https://www.ephlebotomytraining.com/blood-draw-procedure-and-techniques You know all nursing jobs aren’t created (or paid!) Some institutions have kits with all of the needed supplies while others will require the nurses to gather them individually. Deliver blood specimens to the laboratory promptly. Unlike children, most adults can … Confirm the ordered tests and fill out the appropriate forms and labels. Observe any patient precautions. How to Draw Blood: Drawing Blood Clinical Nursing Skills for RNs. If you seriously have HORRIBLE veins and it really never works, see if the nurse would be willing/able … It also provides the phlebotomist with a good "cue" for inserting the needle. The phlebotomy butterfly technique is the process of drawing blood by means of a ‘winged’ apparatus. Learning the anatomy of the main veins and arteries in the body is essential to becoming competent in phlebotomy. Most facilities expect you to have already learned these things in nursing school, and often have vague, unhelpful policies regarding drawing blood. While it is important to know the best veins to access it’s also important to know which areas to avoid. Then, air dry for another 30 seconds. With the patient's arm extended, inspect the antecubital fossa. Relax, listen to music, talk to other donors or read while you donate. Blood Draw Best Practices, Order of Draw, and Proper Procedure. Wear appropriate PPE and perform good hand hygiene. After assembling the appropriate equipment, follow the next steps to perform a proper venipuncture. Insert the needle at an angle of 15 to 30 degrees. Position them properly and hyperextend their arm. Ask the patient if he knows of any spot on his arm has a vein that’s easy to draw blood from. Some people hold their breath in anticipation … Ask the patient to make a fist but not to pump the hand. Get them to put a warm compress on the arm 10 minutes before the blood test. By following the order of collection tubes, the time it takes to perform phlebotomy is decreased. The vein will feel like a "trampoline" … Sophisticated instruments also meant modern techniques. Perform pre-venipuncture safety procedures. 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. Locate The Vein. Phlebotomy is the name of the procedure for drawing blood from the vein through an incision or puncture. Try light exercise beforehand. Remove the needle from the patient’s arm and press down on the vessel with gauze. For adult patients, the most common and first choice is the median cubital vein in the antecubital fossa. The first on the list is the most common and often the first choice, especially for novice phlebotomists. Need to renew your license soon? 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. Venipuncture is a skill that takes time and practice to master. These techniques include a lateral and ventral approach. 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. Puncture is via a needle attached to a syringe or vacutainer. This method can be preferred on the elderly, those with cancer, severe burns, obesity, or … We’ve looked at programs nationwide and determined these are our top nursing schools. Observe isolation restrictions, and make sure that, if the blood test requires fasting, that the patient fasted for the appropriate amount of time. Ask the patient to make a fist and not pump the hand. Stay with Your Child — Parents are usually encouraged to stay and help their child during a blood draw. Check for any allergies or sensitivities with the patient regarding antiseptics, adhesives, or latex. Clean the venipuncture site with an alcohol pad for 30 seconds. Attach the needed tubes or syringes to remove the proper volume of blood. Posted Oct 15, 2009. The colored top of blood collection tubes helps identify the order of blood draw. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. 2.Phlebotomy – standards. 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. If this does not happen then the needle has either not punctured the vein or the needle went through the vessel. There should be provisions to ensure quality care for patients and health workers. Check for the Veins. This eases the process of locating the vein. Don't hold your breath while blood is drawn. Blood draw order is not only important to phlebotomists is but also to patients. Press the purple button on the side of the AccuVein to turn on the vein display light. The parent can be face-to-face with the child, while the child is laying down, providing physical comfort, distraction, and assistance. Hard stick patients should keep their veins warm. Without proper specimens, unhelpful or even harmful medical treatment could happen. Some health care settings may insert blood drawing peripheral intravenous catheters into this vessel for frequent blood draws. Bio-hazard leak-proof transportation bags, Evacuated Collection Tubes (tubes specific to labs ordered), Personal Protective Equipment (i.e. For young children, sitting on a caregiver’s lap in a safely … Prev; 1; 2; Next; Ok, so I took my class last february, got some tips … 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. Additionally, these steps only apply to the adult and pediatric population and not neonates. 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. 1. Read about the top student loan forgiveness programs for nurses and find out if you qualify. Incision is a surgical procedure that involves a cut section of the vein. For example, a CBC (complete blood count) will go into a lavender tube while a PT/INR will be collected into a blue tube. Do not wave, fan, or blow on the area as this contaminates the area and leads to increased risk for infection. Remove the tourniquet as the last amount of blood is drawn. Some health care workers prefer to use a syringe -needle technique for venipuncture. This includes sticking the vein correctly and using the proper tubes. Don’t be discouraged if at first, you don’t access the vein. When a lab test is ordered immediately, they should be able to draw blood even when phlebotomists are not around. Let us know if you have a preferred arm or particular vein that has been used successfully in the past to draw blood. If the antecub has already been accessed there are great options for venipuncture. This is a very common thing, especially if you're working as a nurse, nurse's aid, a doctor or even a vet. It is a proficiency that nurses should learn, and phlebotomists should excel at. If you want to know how to draw blood, you can’t learn just by reading about it or watching demonstrations. Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill. Explain the procedure and reason for the blood draw to the patient. This is a common misconception - pumping the hand does not increase venous circulation. Drawing blood/phlebotomy tips and tricks. 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. Apply a tourniquet approximately 3 to 4 inches above the intended puncture site. Count to 3 and Blow the Feeling Away — Blowing the feeling away is a useful technique. Label appropriate tubes at the bedside and place into transport bags. Speaking of the quality of laboratory sampling, phlebotomy must follow a certain order when collecting samples. There are blood draw techniques and order that nurses and phlebotomists must follow. As the person drawing blood, it is important you know how to draw blood correctly. Always remember to ask for help from seasoned nurses and seize opportunities to practice your skills. Each healthcare system has their own requirements prior to nurses performing blood draws. Check for the veins in the pressurized arm. CrunchRN, ADN, RN. 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. Use two patient identifiers identify the patient. Patients are usually nervous if they’ve never had it done before, or sometimes they have a phobia of needles or doctor’s offices. 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. Learn some tips when drawing blood as a nurse, nursing student, or as a part of clinical skills. Drawing a blood sample from a patient is the main job for a phlebotomy technician. In general, it is much more difficult to draw blood from children than from adults, due to the relative size of their veins. Closely monitor the arm to ensure that is is not applied to tight or for more than 2 minutes. Nursing schools do not teach this skill due to legality issues. Blood should flash into the catheter if done properly. Dispose of contaminated needles and materials in appropriate containers. 1.Bloodletting – standards. https://nurse.org/articles/how-nurses-professionally-draw-blood Don’t look at that arm. The practice of drawing blood from a vein or phlebotomy is essential for a variety of medical procedures and tests to diagnose a patient. This is an extremely large vessel and if stuck properly can yield excellent blood results. Before the draw. Use a syringe to practice your blood draw technique. Nurses Nursing. Prep the venipuncture site by cleansing the area with an alcohol prep pad for 30 seconds and allow to air dry for 30 seconds. 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