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Phlebotomy

    Instruction

    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
Personal Information

Full Name

Email

Phone number

Date

Accurately Collects Blood Specimen following VUMC policy

Verifies order. Gathers all venipuncture supplies prior to entering room

Washes hands properly observing all isolation protocols. Greets patient and introduces self

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

Assess patient for an acceptable site to perform venipuncture

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

If unable to find site, applies tourniquet to select site, then removes tourniquet.

Verbalizes sites that should be avoided: Areas with extensive scar tissue

Verbalizes sites that should be avoided: Hematomas

Verbalizes sites that should be avoided: Edematous areas

Verbalizes sites that should be avoided: Extremities with dialysis shunts, PICC lines, and/or IVs

Positions patient, extending upper extremity comfortably

Verifies tubes to be collected correspond to tests requested

Applies tourniquet 3-4 inches above the selected puncture site. Does not leave tourniquet on more than 2 minutes

Asks the patient to make a fist without pumping their hand

Cleanses puncture site with alcohol in circular pattern, beginning at site, working outward. Allows to air dry

Dons gloves. Connects vacutainer to butterfly. Removes needle cap and inspects needle

Draws skin taut to anchor the vein

Inserts the needle (bevel up) at a 15-30 degree angle, avoiding trauma and excessive probing

Holds butterfly completely still while inserting tubes onto vacutainer. Fills vacutainer tubes in correct order

Blood Culture tube (yellow-black stopper)

Non Additive tube (red stopper or SST)

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

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

Heparin (dark green stopper)

EDTA (lavender stopper)

Removes the tourniquet as the last tube is filling and asks patient to open fist

Removes the vacutainer tube

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

Places the needle into the sharps container

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

Records puncture site, full name with title, date and time on the requisition

Note that tubes labeled for the blood bank must have a full signature on them

Places properly labeled specimens into biohazard bag and seals completely. Places the requisition in the front non sealable pouch of the biohazard bag

Assures that puncture site bleeding has stopped. Applies Band-Aid after checking for allergy or a piece of tape with gauze

Removes gloves and discards properly

Washes hands properly

Leaves patient settled comfortably

Sends specimens to laboratory and documents procedure

Note that if they feel the need to feel the vein after cleansing with alcohol, they may do so with sterile gloves only

Verbalize no staff member should attempt phlebotomy on the same patient more than twice

Verbalize methods to avoid hemolysis

Mix tubes with anticoagulant additives gently 5-10 times

Avoid drawing blood from a hematoma

Make sure the Venipuncture site is dry

Avoid a probing, traumatic venipuncture

Verbalizes and demonstrates proper procedure for drawing blood cultures

Peripheral venipuncture is the preferred method

When multiple blood cultures are ordered, separate venipunctures are required for each culture set

Cleanses skin thoroughly with 70% isopropyl alcohol and allows site to dry

Swabs the site concentrically with Chlora Prep

Allow solution to completely dry before attempting venipuncture. This allows disinfection of the site to take place

Once disinfected the venipuncture site should not be probed with your finger unless you are wearing a sterile glove

Verbalizes appropriate sample volumes: 20ml sample (10 ml in each bottle)

Label bottles with source and time

All venipunctures should be documented in HED as a procedure

Please read and agree to the statements below by marking the checkbox.

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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