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    Procedure Checklist Chapter 34, Skill 34-02: Performing Venipuncture

    Uploaded by

    NursyNurse

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 3

    PROCEDURE CHECKLIST

    Chapter 34, Skill 34-02: Performing Venipuncture

    Check () Yes or No

    PROCEDURE STEPS Yes No COMMENTS


    1. Reviews the physician’s order to determine the patient
    and type of test for which blood is to be drawn.
    2. Obtains the requisition and compares it to the
    physician’s order.
    3. Determines whether special conditions, such as fasting
    or specific times, are required and have been met.
    4. Assesses the patient’s veins to determine which type
    of phlebotomy equipment will be best to use: evacuated
    tube system or needle and syringe.
    5. Screws the needle or winged infusion set onto the
    plastic tube holder or syringe.
    6. If more than one test is ordered, determines the order
    in which the tubes should be drawn.
    7. Follows the “Initial Implementation Steps.”
    8. Washes hands to prevent cross-contamination. This is
    particularly important due to the invasive nature of this
    skill.
    9. Verifies patient identity by checking the patient’s
    identification band and using a second method.
    10. Arranges supplies within arm’s reach, positioned so
    you do not have to turn around or lean to pick up the tubes
    once the needle is positioned in the vein.
    11. Dons gloves.
    12. Applies the tourniquet 3 to 4 inches above the intended
    puncture site, with the tails of the tourniquet extending
    from the top side
    13. Palpates the intended vein.
    14. With left hand, grasps the tourniquet where it crosses
    over itself and grasps the lower tubing end with right
    hand.
    15. Pulls the end in right hand until it is taut and uses left
    hand to maintain the tension where the two ends cross.
    16. Cleans the site with 70% alcohol, chlorhexidine, or as
    designated by facility policy.
    17. Allows the site to dry for 30 seconds:
    Evacuated tube system: places the first tube loosely into
    the plastic tube holder.
    Needle and syringe system: pulls back and forth on the
    syringe plunger two or three times to make certain it is not
    stuck.

    Copyright © 2015, F. A. Davis Company


    18. Uncaps the needle, maintaining sterile technique.
    Positions the needle so that the bevel is up.
    If Using an Evacuated Tube System:
    19. Holds the plastic tube holder so that it rests on
    fingertips and thumb is on top of the holder, letting the
    tube lay loosely in the holder.
    20. Uses an angle between 15 and 30 degrees, piercing the
    skin in a swift, continuous motion.
    21. Once in the vein, braces hand that is holding the
    phlebotomy device firmly against the patient’s arm and
    pushes the tube onto the needle carefully.
    22. When the tube stops filling, gently removes the tube
    from the holder with nondominant hand without pulling
    needle out of the vein.
    23. Inverts the tube of blood two to three times and put it
    aside. Picks up the next tube to be filled and repeats the
    process.
    24. When tube stops filling, removes it from holder.
    25. Releases the tourniquet before removing needle from
    vein.
    26. Uses nondominant hand to place a 2 × 2-inch gauze
    pad over the needle insertion site while removing the
    needle from the patient’s arm, applying firm pressure to
    the site immediately after the needle is withdrawn.
    27. Holds pressure over site long enough to prevent
    bleeding. Places a piece of tape over the gauze. May
    elevate the outstretched arm above the heart. Does not
    allow the patient to bend arm.
    If Using a Needle and Syringe System:
    19. Holds the syringe so that it rests on fingertips with
    thumb on top of the syringe, needle bevel up.
    20. Uses an angle between 15 and 30 degrees and pierces
    the skin in a swift, continuous motion.
    21. Once in the vein, braces hand that is holding the
    syringe firmly against the patient’s arm.
    22. Pulls the plunger back slowly and gently begins
    drawing blood into the syringe without pulling needle
    from vein. Avoids pulling the plunger back too quickly, as
    this can collapse fragile veins. Fills the syringe to the
    required volume to fill all needed tubes.
    23. Releases the tourniquet before removing needle from
    vein.
    24. Uses nondominant hand to place a 2 × 2-inch gauze
    pad over the needle insertion site while removing the
    needle from the patient’s arm, applying firm pressure to
    the site immediately after the needle is withdrawn.

    Copyright © 2015, F. A. Davis Company


    25. Holds pressure over site long enough to prevent
    bleeding. Places a piece of tape over the gauze. May
    elevate the outstretched arm above the heart. Does not
    allow the patient to bend arm.
    26. Applies a clean 18- to 20-gauge needle to the syringe.
    27. Punctures the rubber stopper of the first tube to be
    filled. Enters the stopper at an angle, placing the tip of the
    needle against the inside of the tube to allow the blood to
    trickle down the side of the tube. Continues to fill the
    tubes in the correct order of draw.
    For either system:
    28. Disposes of the contaminated needle, syringe, and
    disposable plastic tube holder in the sharps container.
    29. Labels each tube of blood according to facility policy
    before leaving the patient’s bedside.
    30. Places specimens in a plastic bag or specified
    container, along with the requisition.
    31. Removes gloves and washes hands.
    32. Reassesses the puncture site to ensure that bleeding
    has stopped before leaving the room.
    33. Follows the “Ending Steps.”
    34. Documents the procedure in the patient’s chart.
    35. Delivers the specimens to the laboratory per facility
    policy.

    Recommendation: Pass _____ Needs more practice _____

    Student: Date:

    Instructor: Date:

    Copyright © 2015, F. A. Davis Company

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