PHLEB LEC MODULE 6 - VENIPUNCTURE

• Venipuncture is the process of collecting or “drawing” blood from a vein and the most common way to collect blood specimens for laboratory testing.
• It is the most frequent procedure performed by a phlebotomist and the most important step in this procedure is patient identification.
• Blood collection procedures legally begin with the test request. This is the fi rst step for the

  laboratory in the preanalytical (before analysis) or pre-examination phase of the testing process.
• Direct Access Testing” (DAT), in which patients are allowed to order some of their own blood tests.
• The form on which test orders are entered is called a requisition.
• 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
• Manual Requisitions- One type is a three part (3 part way) form that serves as a request, report, and billing form.
• Computer Requisitions- actual labels that are placed on the specimen tubes immediately after collection.
• Computer Requisitions- indicate the type of tube needed for the specimen and some indicate additional patient information such as “potential bleeder” or “no venipuncture right
• Bar-Code Requisitions -contain a bar code, a series of black stripes and white spaces serves as patient names, identification numbers, or laboratory tests
• Bar-code Requisitions- Bar-code systems allow for fast, accurate processing, and their use has been shown to decrease laboratory errors associated with
• RECEIPT OF THE TEST REQUEST :

  Outpatients are given laboratory requisitions or prescription slips with test orders written on them by their physicians and are responsible for taking them to a blood collection site.
• REVIEWING THE REQUISITION:

  A thorough review of the test requisition helps to avoid duplication of orders, ensures that the specimen is collected at the right time and under the proper conditions, and identifies special equipment that may be required.
• REVIEWING THE REQUISITION

  • Check to see that all required information is present and complete. • Verify the tests to be collected and time and date of collection. • Identify diet restrictions or other special circumstances that must be met prior to collection. • Determine test status or collection priority
• Accessioning the Test Request:

  The definition of accession is the process of recording in the order received.
• Approaching the Patient:

  Before collecting the specimens, the phlebotomist should arrange the requisitions according to priority and review them to see that needed equipment is on the blood-collecting tray or cart before proceeding to the patient’s room.
• Approaching the Patient:

  Outpatients are typically summoned into the drawing area from the waiting room in order of arrival and check-in.
• Approaching the Patient:

  inpatients, stat requests take priority over all others.
• Stat - "immediately"  Urgently needed in critical patients FIRST PRIORITY
• Stats- ER stats are priority over other stats
• Stats test examples:

  • glucose

  • H&H

  • Electrolytes

  • cardiac enzymes
• Timed- collect at a specific time , SECOND PRIORITY

  • Record actual time collected
• Timed test examples-

  • 2-hour PP

  • GTT cortisol

  • Cardiac Enzymes

  • TDM

  • Blood cultures