By establishing a procedure for the correct collection of blood by venipuncture many pre-
analytical errors and patient management complications can be avoided. Patient safety is the ultimate goal above all other considerations. Cost, efficiency, etc are secondary to ensuring that in no way will the patient be harmed by the phlebotomy procedure. This includes all aspects of the procedure including ordering, drawing, labeling, handling and transporting the specimen. The quality of the patient results is directly dependent upon the quality of the specimen. By providing the highest standard of safety and quality of care customer service satisfaction can be achieved.
Supplies and use of supplies –(Refer to Standard Phlebotomy Tray policy)
1. Blood Collecting Trays
- Blood collecting trays should be lightweight and easy to handle with enough space and compartments for the various supplies.
2. Gloves
- Disposable latex, vinyl, polyethylene, or nitrile gloves provide barrier protection and must be worn for all venipuncture procedures to comply with OSHA regulations.
Latex free gloves must be worn for all patients with a hypersensitivity to latex proteins.
3. Hubs
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a. All Vacutainer holders are to be SINGLE USE.
OSHA states “Blood tube holders, with needle attached, must be immediately discarded into an accessible sharps container after safety feature has been activated”. The re-use of vacutainer blood tube holders is strictly prohibited by OSHA and BVHS. (According to OSHA, “removing contaminated needles and re-using blood tube holders can expose workers to multiple hazards.”
b. Specimen transfer hubs are also available and, for our safety, are to be used before attempting to use a transfer needle. To use this device, simply attach it to the syringe and place the/each necessary vacutainer tube in the in the vacutainer holder until the appropriate amount of specimen is transferred.
4. Needles
- A large gauge (G) number indicates a small needle, while a small gauge number indicates alarge needle.
Needles must always be sterile and should never be recapped.
In order to prevent potential worker exposure, the needle safety feature should be activated immediately after specimen collection and discarded without disassembly into a sharps container. Needles are single use only.
a. BD Hypodermic needles
b. Butterfly “Push Button”
5. Sterile Syringes
-Sterile syringes must remain sterile. If removed from their container and not used immediately they are no longer considered sterile and are not to be used.
6. Blood Collection Tubes
- Venous blood collection tubes are manufactured to withdraw a predetermined volume of blood.
7. Tourniquets
-Tourniquets must be discarded immediately when contamination with blood or body fluids is obvious or suspected. Before drawing any in-patients, be sure to look around the room,
typically next to the sharps container, for a tourniquet that is specific for that patient. Out-patient draws and off-site tourniquets are replaced daily, or upon any sign of obvious or suspectedcontamination.
8. Antiseptics
- 70% isopropyl, PVP iodine prep pads, or 2% Iodine Tincture.
9. Gauze Pads
-Small, gauze pads should be available. Cotton balls may also be used.
10. Puncture-Resistant Disposable Container
-An approved puncture-resistant disposable container that is compliant with national or local regulations must be available for the disposal of the contaminated needle assembly. Such containers typically have a color regulated by each country, and a biohazard symbol.
11. Ice
-Ice or refrigerant should be available for specimens that require immediate chilling.
12. Bandages/Tape
- Adhesive bandages, preferably hypoallergenic, should be available, as well as gauze wraps for sensitive or fragile skin.
13. Warming Devices
- Warming devices may be used to dilate blood vessels and increase flow. When using commercial warmers follow the manufacturer’s recommendation. Warming devices should not exceed 42ยบ C.
14. Specimen Collection Manual/Reference Lab Manual
- A test manual listing the tube(s) and volume requirements for various tests, specimen handling instructions, and precautions is available on all computers.
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