venipuncture procedure Flashcards
It is the process of collecting or “drawing” blood from a vein.
Venipuncture
- It is the most common way to collect blood specimens for laboratory testing and the most frequent procedure performed by a phlebotomist.
What should the patient do before specimen collection can take place
The patient must be registered with the healthcare facility or specimen collection center
- misidentification leads to invalid results
It is a routine process during which data is collected that creates a patient record for the specific individual who is being admitted to the facility or has arrived for testing at the specimen collection center.
Registration
- includes full name, DOB, sex and address
- proof of id
- patient identity number
Who request laboratory testing
Physicians
Other qualified healthcare professionals
- exceptions are certain rapid tests that can be purchased and performed at home by consumers.
The form on which test orders are entered
Test Requisition
- becomes part of a patient’s record and requires specific information to ensure that the right patient is tested.
Why are test requisition important
To meet the physician’s orders
Correct tests are performed at proper time under the required condition
Patient is billed correctly
What is required in the requires requisition information
★ Ordering a healthcare provider or another authorized person’s name
★ Full name (first name and middle name or initial if applicable)
★ Patient-specific identifier (eg inpatient medical record number)
★ Sex
★ Date of birth or age (per facility policy)
★ Room no. and bed (if inpatient)
★ Test(s) that are to be performed
★ Date test is to be performed (and time if applicable)
★ Test status (e.g. timed, fasting, priority)
★ Registration is a routine process during which data is collected that creates a patient record for the specific individual
*request form varies if they are inpatient, outpatient or emergency patient
venipuncture steps
- receive, review and accession test request
- approach, greet and identify the patient
- explain the procedure and obtain consent
- verify collection requirements and identify sensitives and potential problems
- sanitize hands and put on gloves
- position patient, apply tourniquet and ask patient to make a fist
- select a vein, release the tourniquet and ask the patient to open the fist
- clean and air-dry the site
- prepare collection equipment
- reapply the tourniquet and uncap and inspect the needle
- ask the patient to remake a fist, anchor the vein and insert the needle
- establish blood flow, release tourniquet and ask the patient to open the fist.
- fill, remove and mix tubes in order of draw or fill syringe
- withdraw needle, place gauze, activate the needle safety and apply pressure
- discard needles and transfer blood
- label and prepare tubes for handling and transport
- check the patient’s arm and apply a bandage
- dispose of used materials and reposition moved items
19 thank the patient, remove gloves and sanitize hands - transport specimens to the lab promptlty
This is the first step for the laboratory in the pre-examination or pre-analytical (before analysis) phase of the testing process.
receipt of the test request
requisition form for inpatients vs outpatients
inpatients:
print out at a special computer terminal at the phleb station
outpatients:
test orders written on them by their physicians
what do you have to do when you receive the request form/ test request
● Check to see that all required information is present and complete.
● Make certain that the request matches the labels generated.
● Resolve any problems or discrepancies by contacting the provider.
● Verify the tests to be collected and time and date of collection.
● Identify diet restrictions or other special circumstances that must be met prior to collection.
○ Must explain the factors and
consequences if they overfast.
● Determine test status and collection priority
what happens if there is an error in the requisition form
return the form to the nurse area for them to correct the information
rank the priority of the tests
- STAT, shortest turn around time (less than 1hr)
- immediately cos patient is critical
- ER stats have priority over other STATs - Med Emergency
- Timed
- collect at a specific time
2/3:
ASAP, as soon as possible
- patient is not critical
Preop, before operation
Postop, after operation
- Fasting
- no food or drink except for water - NPO
- prior to surgery or other anesthesia procedures - Routine
- establish diagnosis r monitor patient’s progress
process or recording in the order received
accession
-assigned a uniquue no used to identify the specimens and all associated processes and paperwork associated
approaching patients: outpatients vs inpatients
outpatients:
make certain they are safely situated in the phleb chair with the armrest down
inpatients:
arrange test requisition according to priority and review them to see the necessary equipment
what are the steps that needs to consider for inpatient when a approaching a patient
● Entering a Patient’s Room
● Scanning the Room
● Encountering Physicians and Clergy
○ Wait for them to finish talking to the patient
● Handling Family and Visitors
○ Sometimes the family are kulet
● Finding the Patient Unavailable
○ Ask the nurse station if there is no patient in the room or ask estimated time on when the patient will come back
● Bedside Manner
○ Tender Loving Care
when checking the patient’s identification, what happens when the patient is
sleeping:
unconscious:
neonates and other infants:
sleeping:
Tap gently to wake up. If not, come back later. Do not force the patient to wake up.
unconscious:
Ask the nurse/ relatives for the identity of the patient and give extra care to the unconscious patients.
neonates and other infants:
Check the ID band. Moreover, if they are crying, the blood collection should be quick.
the response if the patient is asking if it hurts
the pain is minimal but very tolerable
how do u address needle phobia
Explain the procedure and gain trust that you can really perform the procedure as swiftly as possible and less painful.
why is it important to comply with the diet restrictions
for the accuracy of test results as eating can alter blood composition
what do you have to verify collection requirements
diet restrictions
allergies
history of fainting, vomiting, nausea or seizures
This is one of the most common malpractices of our allied health workers.
Sanitize Hands and Put on Gloves
*Wear gloves when we are ready for venipuncture and must be sure that when you touch the skin for venipuncture, it is not infected.
positioning the patient:
inpatient -
outpatient -
emergency patient -
inpatient - recumbent, inclined
outpatient - seated
emergency patient - we should e adjusting
why should the tourniquet be tight enough
to slow venous flow w/o affecting arterial flow
what do palpating determine
their patency (state of being freely open)
size and depth
direction
what is required to do once youve established blood flow
release tourniquet
release the fist
when withdrawing the needle, why must we o it as quickly as possible
as it will cause discomfort to the patients
this will appear on all test request and specimen labels for that patient
patient-specific identifier
some patients can order some of their own blood tests
direct access testing DAT
- not widespread
- no. of tests that can be requested is limited
what are the 2 types of requisition
manual
computer-generated forms
*both contain the same required info
true or false:
verbal test is used in emergencies however the request is usually documented on standard request forms or entered in the computer by the time the phlebotomist arrives to collect the specimen
true
why is the use of manual requisition declining
increase of computer system
- they are typically used when computer system fails
what do the phlebotomist have to label after collecting the specimen when computer-generated labels are used
time of collection
their initials
type of barcode requisition
one-dimensional barcode requisition:
black and white stripes of varying widths that correspond to letters and numbers
two-way barcode requisition:
use rectangle, triangles and other geometric patterns in two dimension
