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. The following charts give the locations, hours of service, and. Position the patient with arm extended to form a straightline from shoulder to wrist. Informed consent applies to all medical and nursing procedures. Procedures cover core functions and are outlined with stepby. Procedures can cause distress for parents and children. A typical one unit phlebotomy of blood is approximately 500 grams. Describe collection procedures when using a butterfly or syringe and the proper way to safely dispense blood into tubes following a syringe collection. Master practical phlebotomy skills with phlebotomy.
Select a suitable site for venipuncture, by placing the tourniquet 3 to 4 inches above the selected puncture site on the patient. Fundamentals and practice course manual 2021 2022 4 credits the purpose of this manual is to give you information you will need throughout the phlebotomy course. Baccalaureate nursing students may perform venipuncture when the following conditions. 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. In a study by kagel and rayan, the most common sites for developing complications in order of frequency are forearms, hand, wrist and antecubital fossa.
Students should study venipuncture in books and watch licensed nurses in clinical settings perform this task. Year 1 venipuncture and peripheral iv page 1 of march 2012 venipuncture and peripheral iv. When using a syringe, make sure that you pull the plunger in and out to. Who library cataloguinginpublication data who guidelines on drawing blood. Educate family and or sitter regarding fall prevention. General safety manuals as well as to the biosafety guidelines detailed here and 2. Please ensure you have the most uptodate copy at all times.
Venipuncture can also happen when patients have intravenous iv lines started. A transfer pack holds approximately 600 ml when full. Prepare the equipment, the patient and the puncture site. This video shows the venipuncture procedure blood draw on a practice phlebotomy arm. Venipuncture procedures in this chapter conform to. Phlebotomy, therapeutic separate procedure other cpt codes related to the cpb.
Venipuncture procedure and requirements explained e. Medical history of patient 44 surgical safety checklist 49. The procedure manual with original signatures of the above on the title page is considered as master copy, and the photocopies of the master copy for the distribution are considered as controlled copy. The program director must document continuing education hours 2. Observe the patient for adverse reactions during and immediately following the procedure. Download and print our pdf version to use as a handy study guide or hang it in your work space as a quick reference. The problem confronting you as a technician is to vary these basic principles to fit the needs of the individual patients, there is, for example, a basic method of making a hospital bed, but. Following the techniques below will prevent hemolysis which can interfere with many tests. Sep 05, 20 it is important for the phlebotomist to follow a stepbystep procedure to ensure consistency and to make the patient comfortable.
Worktext and procedures manual, 5th edition multiple choice the hospital laboratory falls under which of the following categories of administrative 1. Performed by a healthcare professional or social worker to include home safety and adequacy for members care. Nursing procedures vary according to the particular line in terms. This type of venipuncture procedure is a little different, and sometimes can be a little more involved. Introduction nursing is a series of basic prin ciples that do not vary, although theremay be a wide range of varia tionof the procedures involving these principles. Procedure for venepuncture adults st helens and knowsley. Add support under the arm with a pillow if necessary. 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. Pdn manual emedny private duty nursing provider policy provider policy private duty nursing manual 10 december 2019 information required new cases every 6 months every 12 months home evaluation.
A venipuncture can cause discomfort for a few seconds, but there should be no discomforts while the solution is flowing. Agency procedures to ensure registered nursing coverage. This training manual includes information about blood collecting you must. Procedures are outlined in a detailed storyboard format, pairing steps with fullcolor photos to help you understand the. 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. Te purpose of this manual is to help the student navigate through the clinical and skills courses taught in the generic, bridge transitional, and accelerated options of the adn nursing program. Venipuncture procedure 24 order formrequisition form 25 labeling the sample 27 equipment 27 order of draw 28 venipuncture site selection 31 performance of a venipuncture 31. Fundamental of nursing procedure manual 4 tableofcontents i. Traditional instruction versus virtual reality simulation.
Venipuncture check the venipuncture site after 35 minutes. Healthcare professional should notify nurse or supervisor if bleeding lasts more than five 5 minutes. Ifbleeding persists fur longer than is minutes, notify nurse responsible fo. Ajn the american journal of nursing venipuncture adriani, john. In this video, pcc medical assisting faculty member stephen date explains and demonstrates a venipuncture procedure using a multineedle and evacuated tube s. Rns previously iv certified in another institution, including blood administration, must challenge the i. Specimen collection before starting the procedure, the rn will call a time out. Venipuncture procedure is the collection of blood from a vein, usually for laboratory testing, is done through venipuncture and performed by a phlebotomist. There should be a cover page signed by the district health director that references the immunization program manual as being accepted by the district to serve as either their official policies and procedures for the administration of vaccines and provision of immunization services or a. By establishing a procedure for the correct collection of blood by venipuncture many preanalytical errors and patient management complications can be avoided. The world health organization has issued practice guidelines for nurses who draw blood, which is referred to as phlebotomy. Instructions after your therapeutic phlebotomy procedure. Nursing schools do not teach this skill due to legality issues.
The procedure can be hindered by flinching and tenseness caused by either the patient or phlebotomy technician. Venipuncture procedure step 1 label the tube with the patients particulars step 2 put tourniquet on the patient about. Procedures are outlined in a detailed storyboard format, pairing steps with. Facts zchildren receive 18 million needle sticksyear ziv placement and venipuncture are some of the most frequently performed interventions by nurses, yet the most distressing for patients ziv placement is the tone setter for the childs entire hospital experience zsuccess or failure of the venous access procedure can set the tone for a lifetime of interactions with the health care.
You may feel lightheaded or dizzy after your therapeutic phlebotomy procedure. Known for its storyboard format of procedures and beautiful illustrations, this handson worktext describes all aspects of phlebotomy with focused and current coverage of lab tests, equipment, safety and collection procedures, emergency situations, special populations, and pointofcare testing. Phlebotomy venipuncture procedure postedlis principle. One unit of blood is approximately equal to 500 grams or 470 mls. Known for its storyboard format of procedures and beautiful illustrations, this handson worktext describes all aspects of phlebotomy with focused and current coverage of lab tests, equipment, safety and collection procedures, emergency. Klatt, department of pathology, school of medicine, mercer university, savannah, ga. Recognize complications associated with the phlebotomy procedure. Nursing is a unique profession that combines both an art and a science. Nursing procedure manual should be available on the patients wards. The nicc nursing programs have a long tradition of providing an exceptional nursing education for both practical nursing pn and associate degree nursing adn students and is designed to provide excellent career potential. It can be applied painlessly and reduce the need for restraint. Worktext and procedures manual, 4 th edition describes all aspects of phlebotomy, with current coverage of equipment, safety procedures, arterial blood gases, pointofcare testing, and practical phlebotomy skills. Although most professionals in the medical field can draw blood, a phlebotomy tech specializes in the process.
Without proper specimens, unhelpful or even harmful medical treatment could happen. The blood should be collected at a rate that the patient can tolerate, generally over 1015 minutes. Topical anesthesia is used to reduce the pain associated with painful procedures in children. Contact nursing supervisor or nurse manager to obtain bed. Medicare claims processing manual chapter 16 laboratory services table of contents crosswalk to old manuals 10 background 10.
With a storyboard format and fullcolor illustrations, phlebotomy. Burned areas are very sensitive and susceptible to infection whereas veins under scarred areas are difficult to palpate 4,6 and difficult to insert needle 4. Position the draw site for best visualization andor palpation. Step by step procedure for how a phlebotomist draws blood. Although most professionals in the medical field can draw blood, a phlebotomy tech specializes in. Family, friends to stay with patient, or sitter, if needed. When proper techniques for blood specimen collection are followed, the risks of preanalytic errors and injury to patients andor. F725 sufficient nursing staff f726 competent nursing staff f727 rn 8 hrs. Venipuncture able to perform able to perform with assistance unable to perform initials and date general guidelines for specimen collection. Venipuncture procedure the venipuncture procedure is complex and requires both knowledge and skill. C the laboratory is a part of a hospitals professional services.
Nursing services nursing services general policy a. Select the proper size needle and attach it to the syringe or vacutainer. Pdf best practices nursing guideline in phlebotomy for patient. Outpatient phlebotomy services the use of outpatient phlebotomy services for the procurement of outpatient specimens is strongly encouraged in order to provide efficient laboratory services to patients. Specimen collection procedure performing a venipuncture. Have the patient sit in the phlebotomy chair and raise or lower the chair arm accordingly. Therapeutic phlebotomy medical clinical policy bulletins. Objective at the end of the class student will be able to define venipuncture explain the purpose of venipuncture enlist the indication of venipuncture what should be observed during the procedure enlist the equipment used explain the procedure of venipuncture discuss the complication of venipuncture explain the nursing. Phlebotomy venipuncture procedure phlebotomy career training. Venipuncture is the process of collecting or draw ing blood. This policy establishes criteria for the correct collection of blood specimens by venipuncture. Known for its storyboard format of procedures and beautiful illustrations, this handson worktext describes all aspects of phlebotomy.
Venepuncture childrens health ireland chi at crumlin. Nursing is a series of basic principles that do not vary, although theremay be a wide range of variationof the procedures involving these principles. Authorization is also extended to ecg technicians and phlebotomist at kgh under the dca 1201, march 2011. Considerations when undertaking the venepuncture procedure. This guide follows the steps as outlined in the world health organizations guidelines on drawing blood. Monitor lying and sitting bps as condition warrants. Designation 1 chairman 2 rmo 3 nursing superintendent. Policy procedure based on the immunization program manual. Venipuncture is carried out to withdraw a specimen of blood for diagnostic testing.
All tubes should be gently inverted, labeled, and sent to the lab imm. This procedure provides instruction for collecting patient blood samples by. With an illustrated, storyboard format for procedures, phlebotomy. The problem confronting you as a technician is to vary these basic principles to fit the needs of the individual pa tients, there is, for example, a basic method of making a hospital bed, but this method may be varied. Worktext and procedures manual describes all aspects of phlebotomy, with complete coverage of equipment, safety procedures, arterial blood gases, pointofcare testing, and practical phlebotomy skills. If swelling is noticed during venipuncture, immediately release tourniquet, remove needle and apply pressure using gauze pad. When drawing a blood specimen, the trained phlebotomist must. Avoid activities that may strain the arm used during your procedure such as exercise and heavy lifting for at least 1 day after your procedure. Handbook of nursing procedures for medical and surgical. Therapy certification program exam and a supervised clinical venipuncture experience involving 3 venipunctures and 3 blood component administrations. Phlebotomy procedure student health center manuals.
A lab coat or gown must be worn during blood collection procedures. Neither team member will perform any other activity until the type and screen sample is labeled and collected. The patient will be identified by two 2 identifiers, neither of which is the patients room number. It is intended as a supplement to the college catalogue and the student handbook and supplements, but does not negate the information they contain. Regular supervision of the nurses being responsible for intravenous. Leave the pressure bandage on your needle site for 3 to 6 hours after your procedure. This module is designed to teach the necessary skills needed to perform proper peripheral intravenous iv catheter insertion and venipuncture techniques on an adult patient. To carry out this delicate procedure with the least trauma and the greatest efficiency requires precise skill and an understanding of the anatomy and physiology of the blood vessels involved. How to draw blood a stepbystep guide to performing venipuncture important. Fundamental of nursing procedure manual for pcl course. Check the accuracy of participants name and birthdate per identification policy before starting the procedure. Assess the need for sample recollection andor rejection. Let the patient know that venipuncture procedure may be a little painful, but of short duration. Who intends these guidelines to help improve outcomes for health care providers and their patients, to share information about the risks associated with drawing blood, to increase safe practices, and to reduce bloodborne virus exposure and transmission.
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