Nursing How To’s: Basic Venipuncture

Gina has always been amazed at how some nurses expertly hit a vein and/or draw blood. For her, it looks really cool that most of them get it done at the first shot like they’re born to do it and that finding a vein is just easy-peasy. She hopes that someday, when she finally gets to work in the clinical area as a staff nurse, she will be as efficient as they are. But for now, since she’s still a nursing student, she thinks what’s best to do is to just read about it in books and observe whenever she has a chance to.

Venipuncture: An overview

Venipuncture is a procedure that is performed by nursing and medical staff in a wide variety of clinical areas as a clinical and diagnostic aid in patient management. When performing venipuncture, nurses should avoid sites where there is:

  • Evidence of venous fibrosis
  • Evidence of hematoma/edema formation;
  • Evidence of localized infection/inflammation;
  • Any vascular access device;
  • Fistulae or vascular grafts.

They should also avoid the affected side of the body in patients post-mastectomy or post-cardiovascular accident as lymphatic drainage may be impaired.

The Procedure

Before anything else, the practitioner should prepare by undertaking thorough handwashing with an appropriate solution, donning a clean apron and ensuring the area where the procedure is to be undertaken is clean, safe and well lit.

Equipment required:

– Clean disposable gloves;

– Disposable apron;

– Alcohol wipe;

– Tourniquet;

– Clean tray or receiver;

– Plastic holder;

– Needle;

– Sharps bin

– Hypoallergenic tape or plaster as appropriate;

– Gauze;

– Required blood bottles;

– Request forms clearly signed, dated and labelled.

Steps in performing venipuncture:

  1. Prepare equipment and self for the procedure;
  2. Correctly identify the patient. Explain the procedure to the patient and obtain consent. Ensure the patient is seated or lying down and comfortable;
  3. Verify diet restrictions & latex sensitivity
  4. Wash hands and don apron;
  5. Assemble equipment;
  6. Extend the patient’s arm and place on a pillow to enhance visibility of veins;
  7. Apply tourniquet (5-10cm above the puncture site);
  8. After palpation and vein selection, clean the skin with alcohol and allow to dry;
  9. Ask patient to remake a fist, anchor vein, and insert needle
  10. Establish blood flow, release tourniquet, and ask patient to open fist
  11. Abort if hematoma develops;
  12. Fill, remove, & mix tubes in order of draw or fill syringe
  13. Apply plaster/gauze if necessary;
  14. Document procedure;
  15. Ensure samples are collected.
  16. Dispose of contaminated materials
  17. Thank patient, remove gloves, sanitize hands
  18. Transport specimen to lab

Note: All nurses who practice venipuncture must have received approved training and documented, supervised practice. All practitioners must operate within the protocols/guidelines of their particular organization.

 

Sources:

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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