1 Wear gloves you should always have on clean - unused - gloves before beginning a venipuncture. Don't forget hand sanitizer or handwashing before putting gloves on.
2 Greet patient Hi, my name is Nikki and I am going to be your phlebotomist today.
3 Identify the patient "May I verify your name & date of birth"? Does it match your records and/or patients wristband?
4 Explain procedure / Ask permission "I'm going to perform a venipuncture / blood draw today" - "Is that okay with you?" "Do you have any questions before I get started?"
5 Position the patient / Support their arm If in a lab chair, the arm rest should be across the pt. on the side of the pt. of their arm that is being used for venipuncture.
6 Selects appropriate equipment Remember to have all of your supplies within reach of the hand using to hold them.
7 Place needle in hub Make sure the multisample needle is securely fastened into the hub.
8 Place gauze and tubes within reach Remember, you don't want to be reaching across your body to grab a tube or gauze.
9 Position tourniquet Tourniquet can't be left on for longer than 1 minute
10 Asks pt to make a fist
11 Selects vein by palpating with index finger. Feel for good patency.
12 Cleanse the area with alcohol / air dry Never fan dry or use gauze to wipe the site dry - this is against CLSI standards
13 Remove needle cap - place with supplies - bevel up Do not reach across your pt. to throw away the needle cap. Always quickly check your needle for any irregularities and to be sure that your bevel is facing up.
14 Anchor vein Make sure you fix the vein below the site of entry.
15 Angle Needle CLSI standards are that needle insertion is below 30 degrees
16 Insert Needle You want to insert the needle quickly but controlled
17 Tube onto hub You should push the tube into the hub without moving the needle.
18 Obtains blood and fills tube
19 Asks pt to release fist Once a good flow is established you should ask the pt to relax / release their fist.
20 Switch tubes If multiple tubes are needed make sure that you anchor the hub securely and that the needle doesn't pull out of the pts. arm.
21 Remove the tourniquet Again - making sure that the needle doesn't pull out of the pts arm.
22 Covers the site with gauze and removes needle Be certain that you don't press down on the skin until the needle is fully out of the skin. Also be sure that you exit the needle at the same angle you entered. Safety is immediately applied.
23 Apply pressure Apply firm pressure to a straight arm. The pt. may assist in this if they are able to.
24 Tubes inverted if not already done Pay attention to how many inversions are to be done.
25 Properly dispose of needle Needle should be placed in the sharps container with safety on.
26 Label tubes For pre-labeled tubes; phlebotomist would put date; time; and their own initials. For un-labeled tubes; you would also add pts. name / dob / mr #
27 Discards waste Pick up all of your supplies and dispose of properly.
28 Checks pts arm and applies bandage Be certain that the bleeding has fully stopped. Ask pt if they would like a bandaid.