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