Venipuncture Syringe Method

• The plunger is a sterile rubber stopper that fits snugly into the syringe barrel and is depressed to administer the liquid or to draw blood into the syringe.
• Importance of timed, fasting, and STAT specimens

  Related to specimen integrity and patient care
• Proper needle insertion and withdrawal techniques for venipuncture

  1. Direction

  2. Angle

  3. Depth

  4. Aspiration
• Maintaining confidentiality of privileged information on individuals


  According to federal regulations (e.g., HIPAA)
• Venipuncture is the process of collecting or "drawing" blood from a vein
• Venipuncture is the most common way to collect blood specimens for laboratory testing
• Venipuncture techniques include ETS, butterfly needle, and syringe procedures on arm and hand veins
• Challenges and unique aspects associated with collecting specimens from pediatric and geriatric patients
• Awareness of the type of care provided for long-term care, home care, and hospice patients
• Patient registration process
• Patient registration involves establishing the patient's identity and entering it into the facility database
• Patient-specific identifier is a unique number assigned to the patient to avoid confusion
• Patient Specific Identifier helps eliminate mistakes caused by confusing patients with the same or similar names or even the same name and date of birth
• Patient Registration

  1. Registered with the healthcare facility or specimen collection

  2. Registered before specimen collection
• Registration


  A routine process of collection of data
• Patient ID composed of

  • Full name
  • Date of birth
  • Sex
  • Address
  • Proof ID
• Patient Specific Identifier

  • Medical Record Number
  • Set of characters that is unique
• Requests for Testing are typically made by a physician or other qualified healthcare professional
• Exceptions are certain rapid tests that can be purchased and performed at home by consumers and blood specimens requested by law enforcement officials that are used for evidence
• Some states have legalized “direct access testing” (DAT), in which patients can order some of their own blood tests. So far, DAT is not widespread, and the number of tests that can be requested is limited
• Request for testing

  Exceptions are certain rapid tests (Purchased and performed at home)
• Direct Access Testing (DAT)


  1. Patient can order their own blood test

  2. This is not widespread

  3. Limited Number of Tests
• The Test Requisition

  1. The form on which test orders are entered is called a requisition

  2. Test requisitions become part of a patient’s medical record and require specific information to ensure that the right patient is tested, the physician’s orders are met, the correct tests are performed at the proper time under the required conditions, and the patient is billed properly
• Required Requisition Information

  • Ordering healthcare provider or another authorized person’s name
  • Patient’s full name (first, last, and middle name or initial if applicable or available)
  • Patient-specific identifier (e.g., inpatient medical record number)
  • Patient’s sex
  • Patient’s date of birth or age (per facility policy)
  • Room number and bed (if inpatient)
  • Test(s) that are to be performed
  • Collection site, if appropriate
  • Date test is to be performed (and time if applicable)
  • Test status (e.g., timed, fasting, priority)
  • Other relevant information and instructions (e.g., special precautions like latex sensitivity)
  • Billing information and ICD-10 codes (if outpatient)
• Verbal test requests are sometimes used in emergencies; however, the request is usually documented on standard request forms or entered in the computer by the time the phlebotomist arrives to collect the specimen
• Manual Requisitions

  1. Written in a prescription pad

  2. Special form that has been issued by a reference laboratory

  3. Backup if computer fails

  4. Usage is declining
• Verbal Test Request

  1. Used in emergencies

  2. However, it is still documented in standard request forms or entered in the computer
• Test Requisition Form

  1. Requires specific information

  2. Part of the medical record
• Computer-Generated Requisitions

  1. Electronically submitted computer-generated and printed requisitions typically contain the actual labels that are placed on the specimen tubes immediately after collection

  2. In addition to patient identification and test status information, many indicate the type of tube needed for the specimen and some indicate additional patient information such as “potential bleeder” or “no venipuncture right arm”
• When a computer-generated label is used, the phlebotomist is typically required to write the time of collection and his or her initials on the label after collecting the specimen
• Barcode Requisitions

  • Either type may contain a one-dimensional or two-dimensional barcode
  • One-dimensional barcode has black stripes and white spaces representing patient information
  • Two-dimensional barcodes use geometric patterns to represent patient information
  • Barcode information can be scanned into a computer for fast, accurate processing
  • Barcode systems decrease laboratory errors associated with clerical mistakes
• Both types of Barcodes contain

  • Patient Names
  • Identification Numbers
  • Laboratory Tests
• Manual Requisitions with barcodes

  • Contain copies of the barcode that can be peeled off and placed on the specimens
• Computer Requisitions with barcodes

  • Have the barcode printed on each label
  • Barcode information can be scanned into a computer for fast, accurate processing
• Barcode Systems

  • Fast
  • Accurate
  • Decrease laboratory errors associated with clerical mistakes
• Venipuncture Steps


  Series of steps to collect blood specimen correctly and professionally
• Steps 1 through 6 of venipuncture are the same for all laboratory specimen collections
• Test request is the first step for the laboratory in the preexamination phase of the testing process
• CLSI terminology change

  Using "preexamination," "examination," and "postexamination" instead of "preanalytical," "analytical," and "postanalytical" for global harmonization
• Computer requisitions for inpatients usually print out at a special computer terminal at the phlebotomist station in the laboratory