Procedure 3-1: Venipuncture

Name______Date______Time______

Procedure 3-1: Venipuncture

Equipment/Supplies: Multisample needle and adaptor or winged infusion set, evacuated tubes, tourniquet, sterile gauze pads, bandages, sharps container, 70% alcohol pad, permanent marker or pen, appropriate personal protective equipment (e.g., gloves, impervious gown, face shield)

Standards: Given the needed equipment and a place to work, the student will perform this skill with _____ % accuracy in a total of _____ minutes. (Your instructor will tell you what the percentage and time limits will be before you begin.)

Key: 4 = Satisfactory0 = UnsatisfactoryNA = This step is not counted

Procedure Steps / self / PARTNER / INSTRUCTOR
1. Checked the physician order and complete the requisition slip if appropriate. /  /  / 
2. Washed your hands /  /  / 
3. Assembled the equipment; checked the expiration date on the tubes /  /  / 
4. Greeted and identified the patient and identify yourself; explained the procedure; asked for and answered any questions
5. Ask the patient about any dietary restrictions and the use of medications that increase bleeding time /  /  / 
6. If a fasting specimen was required, asked the patient the last time he or she ate or drank anything other than water /  /  / 
7. Put on nonsterile latex or vinyl gloves /  /  / 
8. Used the correct method depending on the available equipment:
a. For evacuated tube collection: Broke the seal of the needle cover and threaded the sleeved needle into the adaptor, using the needle cover as a wrench
b. For winged infusion set collection: Extended the tubing; threaded the sleeved needle into the adaptor
c. For both methods: Tapped the tubes that contained additives to ensure that the additive was dislodged from the stopper and wall of the tube; inserted the tube into the adaptor until the needle slightly entered the stopper; did not push the top of the tube stopper beyond the indentation mark; if the tube retracted slightly, left it in the retracted position /  /  / 
9. Instructed the patient to sit with a well-supported arm /  /  / 
a. Applied the tourniquet 3 to 4 inches above the elbow
b. Applied the tourniquet snugly but not too tightly
c. Secured the tourniquet by using the half-bow knot
d. Made sure the tails of the tourniquet extended upward to avoid contaminating the venipuncture site
e. Asked the patient to make a fist and hold it but not to pump the fist /  /  / 
10. Selected a vein by palpating; used your gloved index finger to trace the path of the vein and judge its depth /  /  / 
11. Released the tourniquet after palpating the vein if it was left on for more than 1 minute; had the patient release the fist /  /  / 
12. Cleansed the venipuncture site with an alcohol pad, starting in the center of puncture site and working outward in a circular motion; allowed the site to dry or dry the site with sterile gauze; did not touch the area after cleansing /  /  / 
13. If blood drawn for blood culture, make sure the area is cleansed using a 2% iodine solution for 2 full minutes. /  /  / 
14. Reapplied the tourniquet if it was removed after palpation; asked the patient to make a fist /  /  / 
15. Removed the needle cover; held the needle assembly in your dominant hand, with the thumb on top of the adaptor and fingers under it; grasped the patient’s arm with the other hand, using your thumb to draw the skin taut over the site (this anchors the vein about 1 to 2 inches below the puncture site and helps keep it in place during needle insertion) /  /  / 
16. With the bevel up, lined up the needle with the vein approximately 0.25 to 0.5 inch below the site where the vein was to be entered; at a 15- to 30-degree angle, rapidly and smoothly inserted the needle through the skin (used a lesser angle for winged infusion set collections); placed two fingers on the flanges of the adapter, and with the thumb, pushed the tube onto the needle inside the adapter; allowed the tube to fill to capacity; released the tourniquet and allowed the patient to release the fist; when blood flow ceased, removed the tube from the adapter by gripping the tube with your nondominant hand and placing your thumb against the flange during removal; twisted and gently pulled out the tube; steadied the needle in the vein; avoided pulling up or pressing down on the needle while it was in the vein; inserted any other necessary tubes into adapter and allowed each to fill to capacity /  /  / 
17. With the tourniquet released, removed the tube from the adapter and then removed the needle from the arm /  /  / 
18. Placed a sterile gauze pad over the puncture site at the time of needle withdrawal; did not apply any pressure to the site until the needle was completely removed
19. After the needle was removed, immediately activated the safety device and applied pressure or had the patient apply direct pressure for 3 to 5 minutes; did not bend the arm at the elbow /  /  / 
20. If the vacuum tubes contained an anticoagulant, mixed them immediately by gently inverting the tube eight to 10 times, not shaking the tube /  /  / 
21. Labeled the tubes with patient information as defined in the facility protocol /  /  / 
22. Checked the puncture site for bleeding; applied a dressing (a clean 2×2 gauze pad folded in quarters and held in place by an adhesive bandage or 3-inch strip of tape) /  /  / 
23. Thanked the patient and instructed him or her to leave the bandage in place at least 15 minutes and to not carry a heavy object (such as a purse) or lift heavy objects with that arm for 1 hour /  /  / 
24. Properly cared for or disposed of all equipment and supplies; cleaned the work area; removed personal protective equipment and washed your hands /  /  / 
25. Tested, transferred, or stored the blood specimen according to the medical office policy /  /  / 
26. Recorded the procedure in the paper medical record or the electronic medical record. /  /  / 

Calculation

Total Possible Points: _____

Total Points Earned: _____ Multiplied by 100 = _____

Divided by Total Possible Points = _____%

PassFail



Student’s signature ______Date ______

Partner’s signature ______Date ______

Instructor’s signature ______Date ______