Policy Manual sample

MDT Home Health Care Agency, Inc. 92 PERIPHERAL VENIPUNCTURE-BLOOD DRAW PURPOSE: When required to obtain blood specimens for laboratory analysis, all blood sampling will be drawn per peripheral venipuncture unless order received from physician for blood sampling from alternate route (i.e., central line). All blood samples should be identified with the patient’s name, date collected and transported in plastic bags to the lab. All lab requisition slips should be completed fully and accurately. If a specimen cannot be obtained after two attempts, the nurse should contact their supervisor for further instructions. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: Vacutainer or butterfly with adapter, tubes, needles, tourniquet, alcohol swabs, Bandaid, sharps container. PROCEDURE: 1. Assemble all necessary equipment. 2. Wash hands thoroughly. 3. Explain procedure to patient. 4. Assess upper extremities for venipuncture site and apply tourniquet. Measures to distend vein include: a. Have patient make a fist. b. Place patient's arm in dependent position. c. Apply warm packs to site. d. Tap area gently. e. Have patient pump fist. f. Use blood pressure cuff in conjunction with warm packs. 5. Don gloves. Clean area with alcohol swab and allow to dry. 6. Make venipuncture with needle bevel up. Enter the skin at approximately a 30 degree angle. Once the needle is through the skin, decrease angle by lowering the needle hub nearly flush with the skin, and continue inserting with a straight, forward motion. 7. Withdraw appropriate amount of blood, changing blood tubes, if necessary. 8. Syringe and needle : Once in vein, withdraw blood into syringe, remove needle, and transfer blood into tubes in a timely manner. Fill tubes that have preservative in them first. Vacutainer : Gently push specimen tubes into Vacutainer holder until tubes fill to capacity. 9. Gently rotate tubes to ensure proper mixing of preservatives especially purple top tubes. 10. Remove tourniquet. 11. Remove needle and apply pressure to site for at least 3-5 minutes. Patients receiving anticoagulant therapy may require pressure for up to 10 minutes. When bleeding stopped, apply Band-Aid.