Table 3. Steps for a Successful Venipuncture.| Required Step | Description |
Step #1
Sanitize your hands. | Clean your hands with soap and water or gel cleanser. |
Step #2
Positively identify patient using two unique identifiers. | Ask the patient to state his/her first and last name and date of birth; if the patient is unable to give you this information, ask the patient's caregiver to confirm the patient's name. A second unique identifier must also be used. |
Step #3
Special test requirements | Determine if the test to be obtained has any special requirements. For example, should the patient be fasting? Is this a timed test?
If any requirements are not met, consult with the caregiver to determine a course of action. |
Step #4
Prepare the patient | Explain the procedure to the patient and obtain pemission. Usually the patient will extend an arm. (This is a form of implied consent.) Position the arm for venipuncture; support the arm on a firm surface; the arm should be in a downward position. |
Step #5
Site determination | The patient can make a fist, but should not pump the hand open and closed. Apply tourniquet. Palpate the vein. Release the tourniquet and assemble appropriate equipment. |
Step #6
Aseptic technique | Wear gloves that have not been altered in any way. Cleanse site with approved disinfectant. Allow the disinfectant to air-dry to avoid hemolysis of the specimen and discomfort to the patient. |
Step #7
Specimen collection | Re-apply tourniquet about 3-4 inches above puncture site, insert needle, bevel-side up, at less than a 30° angle, the lower the angle the better, and collect specimens in the correct order of draw. Remove tourniquet (after blood flow is established or during last tube collection). Remove needle and immediately activate the safety device. Mix specimens by gentle inversion 4-8 times. |
Step #8
Patient care | Apply direct pressure to stop bleeding at puncture site; do not have patient bend arm as this may cause a hematoma to form. After about 2 minutes, check the puncture site to verify that bleeding has stopped. Apply bandage if appropriate. Thank the patient for his/her cooperation. |
Step #9
Specimen labeling | Label specimen(s) in the presence of the patient including all the information that is required by your facility. Check the labeled tubes a second time against the patient's wristband to verify labeling accuracy. |
A professional phlebotomist follows the procedure in the same way for every venipuncture. This ensures that none of the vital steps are omitted. The phlebotomist who is consistent in performance and who concentrates fully to obtain a quality specimen is an indispensable part of the healthcare team.
