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BC: Infusion Therapy BC-07: Phlebotomy
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:          
  • 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:          
  • 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:          
  • 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:          
  • 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.
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