After you’ve performed enough venipuncture procedures, they tend to become quite routine. On the other hand, when you’re just beginning your phlebotomy training, and have never drawn blood from a live person, it can be quite a big deal.
Needless to say, drawing blood is serious business. It involves a great deal of responsibility both to the patient and your healthcare colleagues. Nonetheless, any venipuncture procedure can be distilled down into a relatively straight-forward, step-by-step process.
The 9-Step Venipuncture Procedure
Although there may sometimes be additional actions required beyond those mentioned, the 9 steps listed below represent what are generally considered to be the most-important ones in any venipuncture procedure.
Step One – Identify Your Patient and Discuss Physical Disposition
Prior to performing any procedure, the first step that the phlebotomy technician should take is to identify the patient and sit down with him or her to discuss the pending venipuncture as well as his or her current physical disposition. During this step, the phlebotomist should take the patient’s identification, discuss any relevant health issues that may impact the procedure, and supply the individual with an armband or bracelet for further identification purposes.
Step Two – Check Requisition Form
Any time a phlebotomy professional performs a venipuncture, it will be at the request of a physician or other health care provider. The request is usually submitted via a requisition form that lists out the desired tests and any special requirements the patient may have. The phlebotomist should ensure that this information is referenced and understood before moving forward.
Step Three – Select a Puncture Site
Once the first two steps have been completed, the next order of business will be to select a venipuncture site. Ideally, the cephalic or median cubital veins in the arms may be used, but it is also possible to perform a successful phlebotomy procedure on the dorsum of the arm or hands if circumstances require.
Step Four – Prepare the Patient, Puncture Site and Equipment
Next up, the phlebotomist will need to prepare all of his or her equipment (collection tubes, needles, tourniquet, gloves, syringes, etc.) for the procedure. The patient and puncture site will also need to be prepared according to the processes covered during the technician’s phlebotomy training.
Step Five – Complete the Venipuncture Procedure by Order of Draw
Following the proper order of draw (blood culture, followed by coagulation tube, non-additive tube, and finally the last draw), the venipuncturist will then perform the required procedure(s).
Step Six – Identify any Complications
Once all required samples have been drawn and collected in the appropriate tubes, the phlebotomist will inspect the puncture site and observe the patient’s overall condition to identify any complications that may have arisen. Examples of things to look for include: hematomas, dizziness, or any other symptom of a potential problem caused by the venipuncture.
Step Seven – Dispose of Contaminated Materials
In order to maintain a sanitary environment and reduce the risk of infection, the next step is generally to dispose of all contaminated materials and clean the puncture site and area.
Step Eight – Mix and Label All Specimens in Drawing Area
With the patient and drawing area appropriately attended to, the next step is to mix and accurately label all specimens drawn during the procedure. Assuming that the phlebotomist performed the proper order of draw, this process is usually fairly quick and simple as the proper additives are added to the tube of each corresponding color.
Step Nine – Promptly Send Specimens to Laboratory
Lastly, the phlebotomist needs to quickly send the collected specimens off to the lab so that they retain their qualities long enough for proper testing. This step requires attention to detail to ensure that the proper information is sent to the lab techs.
The Most-Important Thing about Venipuncture Procedures is…
Many recently-certified phlebotomists wonder which of the aforementioned steps is the “most-important”. The correct answer is “all of them”.
Performing venipuncture, while relatively minor as far as medical procedures go, is still an extremely delicate task that requires a high level of attention to detail. Mastering each step in the process is critical to being successful in the field of phlebotomy, so remember to slow down and be meticulous about every procedure you perform.