Venepuncture is a procedure that is performed by nursing and medical staff in a wide variety of clinical areas as a clinical and diagnostic aid in patient management. Take your time to identify the largest, most prominent vein you can find. Procedures for the collection of diagnostic blood specimens by venipunctures. Pdf best practices nursing guideline in phlebotomy for patient. We value teamwork, establishing long term relationships with our patients, integrity, timely access to care, and. While not commonly taught in nursing school, programs recommend nursing students take extra courses to hone this skill. Nursing procedures venipuncture, intravenous line, blood. One type is a threepart form that serves as a request, report, and billing form. Procedures are outlined in an in depth storyboard format, pairing steps with. Nurses may have to perform phlebotomy for their patient in various health care settings. To carry out this delicate procedure with the least trauma and the greatest efficiency requires precise skill and. Phlebotomy guidelines and order of draw specimen collection procedures proper specimen collection and handling is a critical part of obtaining a valid laboratory result. Select a suitable site for venipuncture, by placing the tourniquet 3 to 4 inches above the selected puncture site on the patient.
Subjects anaesthesiology and pain management, nursing, pediatrics keywords pain assessment, wongbaker scale, skin conductance, venipuncture, children introduction during the routine. Phlebotomy procedure student health center manuals. Lippincott procedures is your online source for instant, evidencebased procedure guidance at the point of care. Phlebotomy is an invasive procedure for obtaining blood for laboratory. View the new site instructional videos find out how to get online access buy the print edition buy the student edition. Oct, 2017 phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career. Place a tube from your tray into the hub and check for blood. This procedure manual should be customized for sitespecific policies and procedures. Procedure for venepuncture adults st helens hospital. Methods and techniques for drawing appropriate blood specimens will be addressed in this manual. Conversing with patient to allay fear of procedure applying tourniquet to arm, locating vein, swabbing area with disinfectant, and inserting needles into vein to draw blood int o collection tube.
Observe the patient for adverse reactions during and immediately following the procedure. Rns identified by their manager in targeted practice. Because of this service, children who would otherwise be in hospitals or long term institutions can enjoy the. Nursing staff and physicians may access central venous lines for specimens. With over 1,700 procedures and skills from a wide variety of nursing specialties including. Overview general principles collect enough of blood specimen to perform the required.
Chapter 4 also provides information relevant to the procedure for drawing blood. Braun peripheral cannulation and venepuncture training. If patient still refuses, inform the patients nurse of the. Nccls, 940 west valley road, suite 1400, wayne, pennsylvania 19087. Apr 08, 2019 venipuncture nursing procedure section. North glasgow university hospitals nhs division clinical. This policy establishes criteria for the correct collection of blood specimens by venipuncture. This procedure provides instruction for collecting patient blood samples by venipuncture, according to the current standard of care for phlebotomy as established by the clinical and laboratory standards institute clsi. Hold the syringe in your dominant hand as you would an ets holder. Phlebotomy, the practice of drawing blood from a vein, is a proficiency that all nurses should learn in their career.
Venipuncture for blood collection gundersen health system. Phlebotomy protocol southern health nhs foundation trust. Rns previously iv certified in another institution, including blood administration, must challenge the i. Patient safety is the ultimate goal above all other considerations. General safety manuals as well as to the biosafety guidelines detailed here and 2. Jun 30, 2014 phlebotomy medtexx medical corporation 33 it is also very important to remember that if the bevel is exposed during a venipuncture, before manually withdrawing the needle at the completion of the entire procedure, the needle is then considered contaminated, and cannot be reinserted into the patient.
A transfer pack holds approximately 600 ml when full. The procedure manual is provided on cdrom for this purpose. Manual of laboratory services for tests performed in or referred by department of pathology hackensack university medical center 30 prospect avenue. Basic venipuncture step by step student nurse journey. One unit of blood is approximately equal to 500 grams or 470 mls. Ajn the american journal of nursing venipuncture adriani, john. Each unit of service uos of this code includes all collections of venous blood by venipuncture during a single episode of care regardless of the number of times venipuncture is performed to collect venous blood specimens. December 22, 2014 unless otherwise specified, the effective date is the date of service. Always consult your policy and procedure manual at your facility before preforming any nursing procedures.
The blood should be collected at a rate that the patient can tolerate, generally over 1015 minutes. Describe collection procedures when using a butterfly or syringe and the proper way to safely dispense blood into. Following the techniques below will prevent hemolysis which can interfere with many tests. North glasgow university hospitals nhs division clinical procedure manual. Informed consent applies to all medical and nursing procedures. Ive added a map of arm veins to the right as a helpful pairing for this video. Welcome to the royal marsden manual online, ninth edition. When using a winged blood collection set for venipuncture and a coagulation tube is the first to be drawn, draw a discard tube first. Venipuncture can also happen when patients have intravenous iv lines started. In most of these cases, the skin on the hand is pierced and a vein is accessed so medications or fluids can be given intravenously. Parental holding and positioning to decrease iv distress in young children. Nursing procedures vary according to the particular line in terms of volumes. The medical clinic is committed to comprehensive, multidisciplinary primary medical care. Let the patient know that venipuncture procedure may be a little painful, but of short duration.
Venipuncture procedure step 1 label the tube with the patients particulars step 2 put tourniquet on the patient about 34 above the venipuncture site step 3 ask patient to form a fist so veins are more. It is sometimes easier to feel a vein than to see it. The revision date and transmittal number apply only to red. Have the patient sit in the phlebotomy chair and raise or lower the chair arm accordingly. This type of venipuncture procedure is a little different, and sometimes can be a little more involved. Procedures for the collection of diagnostic blood specimens by venipuncture. Obtaining blood samples, either via a venous stick or from a central line, is a critical nursing skill.
Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. Specimens must be collected in the appropriate collection container, kit or device, correctly labeled and transported promptly to the laboratory. This manual addresses the multiple factors associated with collecting, handling, and processing of blood specimens. Always refer to the policies and procedures site for the most current. Procedure manual for the istat system this procedure manual is intended to be a template for the procedure manual required by clia and laboratory accreditation bodies.
The veins are the primary source of blood for laboratory testing. If you are not sure ask the patients nurse for instructions. Cleanses venipuncture site with alcohol pad in outward circular motion. With a storyboard format and fullshade illustrations, phlebotomy. A typical one unit phlebotomy of blood is approximately 500 grams. Specimen collection manualreference lab manual a test manual listing the tubes and volume requirements for. By establishing a procedure for the correct collection of blood by venipuncture, many pre analytical. Venipuncture procedure 24 order formrequisition form 25 labeling the sample 27. Turn off the iv for at least 2 minutes before venipuncture. Evidencebased clinical skills and procedures related to essential aspects of a patients care. Pain assessment in children undergoing venipuncture. Add support under the arm with a pillow if necessary. Venipuncture check the venipuncture site after 35 minutes.
Medical clinic policy and procedures manual updated. Standard operating procedures clinical and translational research center purpose. Worktext and procedures manual describes all options of phlebotomy, with full protection of package, safety procedures, arterial blood gases, degreeofcare testing, and smart phlebotomy experience. This procedure provides instruction for collecting patient blood samples by. It is understood that no laboratory test can give a valid result without the appropriate blood draw. To ensure proper collection of venous blood specimens principle. Colyar cpt code 36415 routine venipuncture or finger, heel, or ear stick for collection of specimens venipuncture is a method used to obtain blood specimens from a vein. All clinical research nurses or research project assistants must be. A lab coat or gown must be worn during blood collection procedures. By establishing a procedure for the correct collection of blood by venipuncture many preanalytical errors and patient management complications can be avoided. The processes of phlebotomy are pivotal for patient care. Objectives upon successfull completion of this presentation the participant will be able to. With over 1,700 procedures and skills from a wide variety of nursing specialties including allied health, it combines the most trusted clinical content with powerful online workflow functionality that will enable your clinical staff to save time, standardize care and deliver.
Venipuncture is a method of drawing blood using a needle to pierce the skin and access a vein. Phlebotomy is the process of making an incision in a vein with a needle. Venipuncture and injection training arm instruction manual. Sep 05, 20 phlebotomist inserting a needle into the vein. A randomized controlled trial journal of pediatric nursing, 22 6. Nursing practice rnsp competencies shall draw blood using. Make sure the bevel of the needle is pointing up, anchor the vein with the thumb of your opposite hand about 1 inch below the puncture site, and then insert the needle at no more than 15 degrees. Healthcare professional should notify nurse or supervisor if bleeding lasts more than five 5 minutes. Who guidelines on drawing blood best practices in phlebotomy eng. Cpt code 36415 describes collection of venous blood by venipuncture. Standard operating procedures clinical and translational research center purpose knowledgeable and skillful performance of blood collection procedures and technique contributes to timely and. Position the patient with arm extended to form a straightline from shoulder to wrist. Make sure the bevel of the needle is pointing up, anchor the vein with the thumb of your opposite hand about 1 inch below the puncture. The venipuncture procedure is typically performed at hospitals, clinics and physicians offices to.
North glasgow university hospitals nhs division clinical procedure manual section b administration of medicines and parenteral therapy 2. Pediatric nursing is a nursing specialty that is provided to children in their places of residence. By establishing a procedure for the correct collection of blood by venipuncture, many pre analytical errors and patient management complications may be avoided. Alternative sites for blood collection when the antecubial area.
Describe each step in the venipuncture procedure, list necessary information found on specimen tube labels, and list the acceptable reason s for inability to collect a specimen. Student nurse journey takes no responsibility for information contained on external links from this website. The removal of a specific amount volume of blood from a patient for treatment of a specific condition or disease. Considerations when undertaking the venepuncture procedure. Phlebotomy venipuncture procedure postedlis principle. H03a5procedures for the collection of diagnostic blood. Phlebotomy venipuncture procedure blanchard valley health. The phlebotomy procedure must be performed to preserve venous integrity. This a great quick demonstration of an antecubital basic venipuncture step by step blood draw. Phlebotomy competency nova scotia health authority. Understanding the procedures, processes and reasons. To provide standards for phlebotomy and retrieval of blood samples, in a manner which ensures the delivery of safe, competent, and effective care, and to meet study goals.
Specific measures must be followed as per cdcnih guidelines in the universal precautions. Intravenous cannulation and venepuncture are procedures often used to establish a route for medication andor fluid administration or to obtain a sample of blood for testing. Best practices in phlebotomy who guidelines on drawing blood. Mln 2739380 january 2019 laboratory tests and laboratories billing for. Nursing procedures venipuncture, intravenous line, blood transfusion and injection procedures volume 1 barroa r. There are some slight risks associated with venipuncture which may include excessive. Step by step procedure for how a phlebotomist draws blood. Views expressed by individual hospitals, school faculty, medical or nursing associations, or individual students on their own webpages or on external sites they link to are not necessarily those of student nurse journey. Provider compliance tips for laboratory tests routine cms. How to properly document and bill for venipuncture medical.
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