[checklist name= "Phlebotomy" mailto="credentialing@teemagroup.com" templatedoc="1P5DMEUct6Huv_rr4pMq3PLSQCVxPHij16YA8kIFNES0" templatedrive="1LG9WAg21_L3L-ZkZEChBzrYRhBOjpmcc" savedrive="15FFQjDXxe9nC9FkAAcuxbswGy1hq4sWm" sheetid="1xJkggLvktsyYL6zuIhdO-OURJhJTkWdDKunR11agspw"] [checklistHeading title="Phlebotomy"] Please rate your experience / frequency (within the last year) using the scale (check the appropriate boxes below) 0 = No theory and/or experience 1 = Limited experience/need supervision and/or support 2 = Experienced/minimal support needed to perform) 3 = Proficient/can perform independently 4 = Expert/very experienced in the field [/checklistHeading] [checklistInputGroup name="Recruiter Information"] [checklistInput type="text"]Recruiter TEEMA email[/checklistInput] [/checklistInputGroup] [checklistInputGroup name="Personal Information"] [checklistInput type="text"]Full Name[/checklistInput] [checklistInput type="email"]Your Email[/checklistInput] [checklistInput type="text"]Your phone number[/checklistInput] [checklistInput type="text"]Last 4 of Social Security Number[/checklistInput] [/checklistInputGroup] [checklistInputGroup name="Accurately Collects Blood Specimen following VUMC policy"] [checklistInput type="scale"]Verifies order. Gathers all venipuncture supplies prior to entering room[/checklistInput] [checklistInput type="scale"]Washes hands properly observing all isolation protocols. Greets patient and introduces self[/checklistInput] [checklistInput type="scale"]Verifies patient identity using any two of the following identifiers: Patient name, date of birth, medical record number, last four digits of SS#, driver’s license, Polaroid photograph (Vanderbilt Psychiatric Hospital). Verify that the lab requisition and label information matches correctly[/checklistInput] [checklistInput type="scale"]Assess patient for an acceptable site to perform venipuncture[/checklistInput] [checklistInput type="scale"]Median cubital and cephalic veins are the optimal choices and provide the least risk of nerve damage; if unacceptable the wrist or hand veins may be used[/checklistInput] [checklistInput type="scale"]If unable to find site, applies tourniquet to select site, then removes tourniquet.[/checklistInput] [checklistInput type="scale"]Verbalizes sites that should be avoided: Areas with extensive scar tissue[/checklistInput] [checklistInput type="scale"]Verbalizes sites that should be avoided: Hematomas[/checklistInput] [checklistInput type="scale"]Verbalizes sites that should be avoided: Edematous areas[/checklistInput] [checklistInput type="scale"]Verbalizes sites that should be avoided: Extremities with dialysis shunts, PICC lines, and/or IVs[/checklistInput] [checklistInput type="scale"]Positions patient, extending upper extremity comfortably[/checklistInput] [checklistInput type="scale"]Verifies tubes to be collected correspond to tests requested[/checklistInput] [checklistInput type="scale"]Applies tourniquet 3-4 inches above the selected puncture site. Does not leave tourniquet on more than 2 minutes[/checklistInput] [checklistInput type="scale"]Asks the patient to make a fist without pumping their hand[/checklistInput] [checklistInput type="scale"]Cleanses puncture site with alcohol in circular pattern, beginning at site, working outward. Allows to air dry[/checklistInput] [checklistInput type="scale"]Dons gloves. Connects vacutainer to butterfly. Removes needle cap and inspects needle[/checklistInput] [checklistInput type="scale"]Draws skin taut to anchor the vein[/checklistInput] [checklistInput type="scale"]Inserts the needle (bevel up) at a 15-30 degree angle, avoiding trauma and excessive probing[/checklistInput] [checklistInput type="scale"]Holds butterfly completely still while inserting tubes onto vacutainer. Fills vacutainer tubes in correct order[/checklistInput] [checklistInput type="scale"]Blood Culture tube (yellow-black stopper)[/checklistInput] [checklistInput type="scale"]Non Additive tube (red stopper or SST)[/checklistInput] [checklistInput type="scale"]Coagulation tube (light blue stopper). A light blue stopper (sodium citrate) tube is NEVER the first tube drawn. If a coagulation assay is the only test ordered, draw a non-additive (discard) tube (red stopper or SST) first, and then draw the light blue stopper tube[/checklistInput] [checklistInput type="scale"]Last draw - additive tubes in this order; note tubes with additives must be thoroughly mixed. Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive[/checklistInput] [checklistInput type="scale"]Heparin (dark green stopper)[/checklistInput] [checklistInput type="scale"]EDTA (lavender stopper)[/checklistInput] [checklistInput type="scale"]Removes the tourniquet as the last tube is filling and asks patient to open fist[/checklistInput] [checklistInput type="scale"]Removes the vacutainer tube[/checklistInput] [checklistInput type="scale"]Removes the needle from the patient’s arm using a swift backward motion. While withdrawing the needle from the patient’s skin, engages the safety mechanism. Presses down on the gauze over the puncture site with adequate pressure to avoid hematoma formation or asks competent patient to apply direct pressure over site keeping arm straight[/checklistInput] [checklistInput type="scale"]Places the needle into the sharps container[/checklistInput] [checklistInput type="scale"]Gently inverts the tubes 5-10 times and correctly labels all tubes while at the bedside. Records own initials, date and time of venipuncture on each tube label[/checklistInput] [checklistInput type="scale"]Records puncture site, full name with title, date and time on the requisition[/checklistInput] [checklistInput type="scale"]Note that tubes labeled for the blood bank must have a full signature on them[/checklistInput] [checklistInput type="scale"]Places properly labeled specimens into biohazard bag and seals completely. Places the requisition in the front non sealable pouch of the biohazard bag[/checklistInput] [checklistInput type="scale"]Assures that puncture site bleeding has stopped. Applies Band-Aid after checking for allergy or a piece of tape with gauze[/checklistInput] [checklistInput type="scale"]Removes gloves and discards properly[/checklistInput] [checklistInput type="scale"]Washes hands properly[/checklistInput] [checklistInput type="scale"]Leaves patient settled comfortably[/checklistInput] [checklistInput type="scale"]Sends specimens to laboratory and documents procedure[/checklistInput] [checklistInput type="scale"]Note that if they feel the need to feel the vein after cleansing with alcohol, they may do so with sterile gloves only[/checklistInput] [checklistInput type="scale"]Verbalize no staff member should attempt phlebotomy on the same patient more than twice[/checklistInput] [checklistInput type="scale"]Verbalize methods to avoid hemolysis[/checklistInput] [checklistInput type="scale"]Mix tubes with anticoagulant additives gently 5-10 times[/checklistInput] [checklistInput type="scale"]Avoid drawing blood from a hematoma[/checklistInput] [checklistInput type="scale"]Make sure the Venipuncture site is dry[/checklistInput] [checklistInput type="scale"]Avoid a probing, traumatic venipuncture[/checklistInput] [checklistInput type="scale"]Verbalizes and demonstrates proper procedure for drawing blood cultures[/checklistInput] [checklistInput type="scale"]Peripheral venipuncture is the preferred method[/checklistInput] [checklistInput type="scale"]When multiple blood cultures are ordered, separate venipunctures are required for each culture set[/checklistInput] [checklistInput type="scale"]Cleanses skin thoroughly with 70% isopropyl alcohol and allows site to dry[/checklistInput] [checklistInput type="scale"]Swabs the site concentrically with Chlora Prep[/checklistInput] [checklistInput type="scale"]Allow solution to completely dry before attempting venipuncture. This allows disinfection of the site to take place[/checklistInput] [checklistInput type="scale"]Once disinfected the venipuncture site should not be probed with your finger unless you are wearing a sterile glove[/checklistInput] [checklistInput type="scale"]Verbalizes appropriate sample volumes: 20ml sample (10 ml in each bottle)[/checklistInput] [checklistInput type="scale"]Label bottles with source and time[/checklistInput] [checklistInput type="scale"]All venipunctures should be documented in HED as a procedure[/checklistInput] [/checklistInputGroup] [checklistFooter] [/checklistFooter] [/checklist]