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.
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.
– Clean disposable gloves;
– Disposable apron;
– Alcohol wipe;
– Clean tray or receiver;
– Plastic holder;
– Sharps bin
– Hypoallergenic tape or plaster as appropriate;
– Required blood bottles;
– Request forms clearly signed, dated and labelled.
Steps in performing venipuncture:
- Prepare equipment and self for the procedure;
- Correctly identify the patient. Explain the procedure to the patient and obtain consent. Ensure the patient is seated or lying down and comfortable;
- Verify diet restrictions & latex sensitivity
- Wash hands and don apron;
- Assemble equipment;
- Extend the patient’s arm and place on a pillow to enhance visibility of veins;
- Apply tourniquet (5-10cm above the puncture site);
- After palpation and vein selection, clean the skin with alcohol and allow to dry;
- Ask patient to remake a fist, anchor vein, and insert needle
- Establish blood flow, release tourniquet, and ask patient to open fist
- Abort if hematoma develops;
- Fill, remove, & mix tubes in order of draw or fill syringe
- Apply plaster/gauze if necessary;
- Document procedure;
- Ensure samples are collected.
- Dispose of contaminated materials
- Thank patient, remove gloves, sanitize hands
- 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.