Phlebotomy (Venipuncture)

No.	Competency Item	NAC	DEV	COM	DTE	EXC
BC-07-01	Demonstrate knowledge of anatomy and physiology (circulatory system), microbiology, and universal precautions.
	Demonstrate ability to prepare for the phlebotomy procedure:
BC-07-02	check physician's order
BC-07-03	prepare requisition and labels
BC-07-04	collect phlebotomy equipment and supplies
BC-07-05	assess whether client has known history of bleeding disorders, infectious diseases, anticoagulant use, dialysis, mastectomy
	Demonstrate ability to prepare client for the phlebotomy procedure:
BC-07-06	check the client's identification / band to ensure correct identity
BC-07-07	explain the purpose of the procedure is to obtain blood samples for laboratory analysis
BC-07-08	explain the steps of the procedure
BC-07-09	inspect the clients arm for possible venipuncture sites
BC-07-10	apply tourniquet and have client squeeze hand
BC-07-11	select the venipuncture site from suitable sites for adult: cephalic vein and branches, basilic vein and branches ,median cubital and median antebrachial vein
BC-07-12	consider alternate sites for clients (elderly, critical ill, or children)
BC-07-13	release the tourniquet and note site selection.
	Demonstrate ability to perform the phlebotomy and collect the blood sample:
BC-07-14	select appropriate size needle for client
BC-07-15	apply the tourniquet properly
BC-07-16	cleanse the site
BC-07-17	using a vacutainer insert the needle with the bevel up at 15-30 degree angle to skin
BC-07-18	pull the skin taught over the vessel
BC-07-19	anchor the vacutainer and fill the appropriate blood tubes
BC-07-20	fill tubes in proper order
BC-07-21	release tourniquet as last tube is filling
BC-07-22	remove needle and apply gauze with pressure over puncture site 2-3 minutes
BC-07-23	use small collection tubes and butterfly needle if drawing blood from small veins
BC-07-24	after 2-3 minutes, check site for signs of bleeding, hematoma or ecchymosis
BC-07-25	apply taped gauze to site
BC-07-26	discard sharps in proper manner
BC-07-27	clean up and store equipment and supplies.
BC-07-28	Label the collection tubes and verify client identity.
BC-07-29	Document the phlebotomy and collection of blood samples.
BC-07-30	Transport labelled blood samples to the lab, with requisitions, according to agency protocol.
	Follow specific precautions to prevent complications:
BC-07-31	meticulous aseptic technique
BC-07-32	avoid repeated punctures into same vein
BC-07-33	avoid using large bore needle
BC-07-34	use gloves to protect self if necessary (standard precautions)
BC-07-35	report and record any untoward events in the procedures.
BC-07-36	Ensure patient safety by making only two attempts at venipuncture before seeking guidance and assistance.