Phlebotomy Skills

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Phlebotomy Skills

Adequate education and training of the person responsible for the collection of quality specimens is essential! Otherwise, an improperly collected sample will lead to false lab results and errors that can harm the patient, or even cause their death. Almost certainly it will increase the cost of care. Only through skillful and careful blood drawing procedure can a quality blood sample be obtained., and reliable results be recorded, such as timed tests , e.g. glucose tolerance and drug levels, and special tests such as STATS, blood culture, and tests required to be obtained in a fasting state. If required for the test, they will administer oral diagnostic medications such as glucose, and xylose to patients per the doctor's instructions.

The right technique will...

prevent errors (e.g. false lab results)

prevent injuries (e.g. anticoagulant reflux, nerve injury)

prevent compromised samples (e.g. hemolysis, hemoconcentration, or agglutination)

The phlebotomist must...

properly identify the patient

give proper instructions

properly label the collection tubes

use the right blood collection devices and tubes

properly handle the collection tubes

properly secure and accesse the blood vessel

follow the right order of draw

maintain the sample's integrity while drawing

sufficiently fill the collection tubes

properly process the blood sample

properly invert the collection tubes

properly record all information about the sample

and properly store or transport the tubes to maintain specimen quality.

Other areas of concerns are...

diurnal and circadian variations

patient preparation

patient general health and gender

physiologic variables

medications a patient is taking

patient's position when drawing

touniquet placement and venous stasis

puncture of a secondary site

safety and infection control to prevent complications or injury to self and others.

A phlebotomist must understand that each person is different, each situation is unique, know all possible problem areas and complications, and prevent procedural errors from ever happening. Special challenges arise when collecting blood from the antecubital fossa area is not possible because of the presence of indwelling intravenous lines (IV), or an arterial vessel must be accessed for arterial blood gas tests and there is a vascular access device (VAD) in place.

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