Venipuncture by Vacuum Tube
Instructor skill checklist for submission
Not Performed / SatisfactoryPrepare requisition/doctors order
Greet and Identify Client and yourself
Explain Procedure
Verify the order
Verify compliance with dietary restriction, if applicable, note any medication patient maybe taking
Assemble all supplies and equipment
Position equipment
a)Assemble the needle and tube holder
b)Position tubes in the correct order of draw
c)Position supplies in reach of your dominant hand
Wash hands and apply gloves
Position the client
Apply the tourniquet
a)Release within 1 minute
b)If applied for site selection remove and reapply after 2 minutes and when antiseptic has dried
c)Should be tight enough to impede venous blood flow but not so tight it causes discomfort to the client or impedes arterial blood flow
Select the vein
a)Ask the client to close the fist-do not pump
b)Locate vein, follow its direction and estimate size
c)If suitable vein is not located repeat this procedure using the other arm
Cleanse the site- release the tourniquet
a)Allow the site to air dry to kill organisms
b)Do not puncture a site that is wet with alcohol
c)Do not blow on the site
d)Do not wipe the alcohol with an unsterile gauze pad
e)Do not touch the site after cleansing
Reapply the tourniquet remove the needle cover
Anchor the vein
a)If necessary relocate the vein with the cleaned, gloved index finger
b)Drag the finger or thumb of the non-drawing hand 1 – 2 inches below the puncture site while still securing the vein
c)Anchor with either one or two finger technique
Insert the needle
a)15 degree angle with bevel up following the direction of the vein
b)Thread the needle ¼ inch within the vein
c)Engage vacuum tube without moving the needle
Fill the vacuum tubes following correct order of draw
a)Use non-drawing hand to insert each tube into the holder until blood flows
b)Remove each tube when filled without moving the needle
c)Invert additive tubes 10-12 times
Release the tourniquet once there is evidence that blood is coming from the vein
a)Continue filling, changing tubes until complete
b)Remove the last filled tube from holder
Withdraw the needle
a)Immediately apply pressure with clean gauze pad for 3-5 minutes
b)Ask client to continue holding pressure
Dispose of needle immediately-biohazard container
Label the tubes with clients name, ID, date, time of collection and your initials
Examine clients arm for bleeding and apply pressure bandage if needed
Remove all collection materials, remove gloves and discard
Wash hands
Thank client