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BHT-011 Basic Phlebotomy Assistance Indira Gandhi National Open University School of Health Sciences

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BHT-011 Basic Phlebotomy Assistance Indira Gandhi National Open University School of Health Sciences BHT-011 Basic Phlebotomy Assistance Indira Gandhi National Open University School of Health Sciences Block 4 TECHNIQUE OF BLOOD COLLECTION UNIT 10 Patient Preparation for Venipuncture 5 UNIT 11 Site Selection and Venipuncture 19 UNIT 12 Techniques for Collection of Blood Specimens 31 UNIT 13 Blood Collection in Special Cases and Sites 41 Technique of Blood Collection CURRICULUM DESIGN COMMITTEE Dr. A. K. Mandal Prof. Kolte Sachin Prof. T. K. Jena HOD, Department of Department of Pathology SOHS, IGNOU, Pathology, Dr. Baba Saheb VMMC and Safdurjung Hospital Maidan Garhi, New Delhi Ambedkar Medical College New Delhi New Delhi Dr. Neerja Sood Dr. Reeta Devi Assistant Professor (Sr. Scale) Prof. Neelkamal Kapoor Assistant Professor (Sr. Scale) SOHS, IGNOU, Maidan Garhi HOD, Department of SOHS, IGNOU New Delhi Pathology, AIIMS, Bhopal Maidan Garhi, New Delhi Dr. Biplab Jamatia Dr. Archana Bajpai Ms Laxmi Assistant Professor (Sr. Scale) Associate Professor Assistant Professor (Sr. Scale) SOHS, IGNOU, Maidan Garhi Transfusion Medicine SOHS, IGNOU, Maidan Garhi New Delhi AIIMS, Jodhpur New Delhi BLOCK PREPARATION TEAM Writers Unit 10 & 13 Unit 11 & 12 Prof. Neelkamal Kapoor Dr. Sachin Kolte HOD, Department of Professor, Department of Pathology, AIIMS, Bhopal Pathology, VMMC & Safdarjung Medical College, New Delhi EDITORIALTEAM Dr. Biplab Jamatia Dr. A. K. Sood Dr Prasenjit Das Assistant Professor (Sr. Scale) Senior Consultant, Associate Professor, Dept of SOHS, IGNOU Skill Training Cell, Pathology, All India Institute of Maidan Garhi, New Delhi SOHS, IGNOU Medical Sciences, New Delhi Dr. D. C. Jain Senior Consultant, Skill Training Cell, SOHS, IGNOU, New Delhi CO-ORDINATION Course Coordinator Prof. T. K. Jena Dr. A. K. Sood Dr. Biplab Jamatia Project Director Senior Consultant Assistant Professor (Sr. Scale) Skill Training Cell, Skill Training Cell SOHS, IGNOU, SOHS, IGNOU SOHS, IGNOU Maidan Garhi, New Delhi Dr. D. C. Jain Senior Consultant Skill Training Cell, SOHS, IGNOU MATERIAL PRODUCTION Sh. Ajit Kumar Section Officer (Publication) School of Health Sciences, IGNOU The curriculum has been adapted from the “Short term Training Curriculum Handbook for Phlebotomy Assistance” prepared by MoHFW, 2017, whose Standards are on based the National Skills Qualifications Framework (NSQF), Ministry of Skill Development and Entrepreneurship (MSDE). July, 2019 © Indira Gandhi National Open University, 2019 ISBN : 978-93-89200-78-2 All rights reserved. No part of this work may be reproduced in any form, by mimeograph or any other means, without permission in writing from the Indira Gandhi National Open University. Further information on the Indira Gandhi National Open University courses may be obtained from the University’s office at Maidan Garhi, New Delhi-110 068 or the website of IGNOU www.ignou.ac.in Printed and Published on behalf of the Indira Gandhi National Open University, New Delhi, by Director, School of Health Sciences, IGNOU. LaserTypeset by : Rajshree Computers, V-166A, Bhagwati Vihar, (Near Sector 2, 2 Dwarka), Uttam Nagar, New Delhi-110059 BLOCK 4 INTRODUCTION The Block 4, Technique of Blood Collection, has four units (Unit-10 to Unit-13) The Patient preparation for venipuncture, such as Proper patient identification procedures and protocols to follow for different age group of patients, Patient interaction and reassurance, Patient preparation, Handling patient in special conditions, Patient positioning, Cleaning the venipuncture site and the factors affecting patient preparation are given in the Unit-10. The Unit 11 describes the Principles of site selection and process for drawing blood, proper site selection for venipuncture and follows the standard precautions. The Unit 12 deals with Needle insertion techniques, Order of draw, Tube filling (vacuum), Needle removal and sharp disposal (separate unit) and the treatment in case of emergencies during drawing of blood. The blood collection in special cases and sites such as adult patients, hospitalized patients paediatric patients, arterial blood sampling, capillary sampling, paediatric and neonatal blood sampling and the collection of blood in situations like Shock, Haemorrhage, Road Traffic Accidents etc. is covered in Unit-13. 3 Technique of Blood Collection 4 UNIT 10 PATIENT PREPARATION FOR VENIPUNCTURE Structure 10.0 Objectives 10.1 Introduction 10.2 Advance Planning 10.2.1 Preparation of Phlebotomy Equipments 10.2.2 Setting for Blood Collection 10.2.3 Clear Instructions and Paperwork 10.3 Patient Education and Consent 10.4 Practical Guidelines and Steps 10.5 Special Circumstances 10.5.1 Pediatric Patients 10.5.2 Geriatric Patients 10.5.3 Patients on Dialysis 10.6 Quality Control 10.7 Let Us Sum Up 10.8 Answers to Check Your Progress 10.0 OBJECTIVES After reading this unit, you should be able to: arrange a phlebotomy set up; describe how to prepare the patient for phlebotomy procedure; describe how to prepare patients for venipuncture and how to answer their queries; describe how to check patient details and ensure various dietary requirements; describe in detail and be able to perform efficiently, each step in the venipuncture procedure; describe blood collection procedures, various needles used according to the patient and the order of draw of the samples; describe blood collection precautions to be followed in special situations; perform all the steps of phlebotomy according to standard guidelines; and describe quality control measures related to phlebotomy. 5 Technique of Blood Collection 10.1 INTRODUCTION To be an effective phlebotomist, you’ll need to know how to go about different parts of this process in a safe manner that protects the integrity of the samples, and the accuracy of the results, while keeping patient safety a priority. Here is an outline of what you’ll need to know about patient preparation for venipuncture. Excellence in patient care includes not only being efficient in our skills, but also having excellent bedside manners. One must also know various special situations and circumstances and how to tackle them efficiently. In this unit, you will be given an overview about patient preparation for venipuncture. The process is not only pricking the patient and collecting the blood, it involves a thorough preparation including mental make as well. Since childhood everyone is skeptical about a needle prick. Nobody likes to be get pricked. Many of the patients are apprehensive about the pain associated with needle prick. In fact some sensitive patient does not allow pricking in one request. You need to make a good conversation and make the patient feel assured that the needle prick is not very painful procedure. This is particularly applicable for the persons getting needle prick for the first time. You should also be ready to face such situations. Apart from the technical aspects about blood collection, this part should also be taken care of with due precautions. Particularly children are a difficult group to handle. They tend to resist needle prick. You really need to be very calm and composed in such situations. Even if you are working in a busy laboratory; you need to be courageous to clear the apprehensions of the children. If the children are small and cannot be counseled, you need to take help of parents of these children. Make a good conversation with the parents of the child. Explain them the procedure of blood collection procedure. The groups of patients which are a little problematic are the patients undergoing treatment for cancer of leukemia. These patients require frequent blood tests and are pricked repeatedly. Some of these patients get frequent blood transfusions and the veins at that place are thrombosed quite frequently. It is difficult to collect blood from these patients. Such patients need assurance and a good technique to with draw blood. You should be able to quickly identify such group of patients. We begin the unit with a discussion of the basic prerequisites for phlebotomy. Patient education and consent is an important part of phlebotomy, and are discussed in detail. The exact procedure and detailed steps are described next. Finally, special circumstances and quality control has also been touched upon. Check Your Progress 1 1. What are the important aspects of patient preparation for venipuncture? ........................................................................................................................... ........................................................................................................................... ........................................................................................................................... 6 Patient Preparation for 10.2 ADVANCE PLANNING Venipuncture This is the most important step in a phlebotomy procedure and involves advance planning measures that ensure safe, efficient and patient friendly atmosphere for phlebotomy. It involves arranging an appropriate set up for blood collection and preparing equipment and paperwork. 10.2.1 Preparing Phlebotomy Equipments (PPE) 1. Personal protective equipment: it is mandatory to use personal protective equipment while performing phlebotomy procedure. This prevents infection with any blood borne illness that the patient might have. The use of gloves also protects the patient from exposure to pathogens that the phlebotomist might bear on hands. Prior to wearing gloves, the phlebotomist should thoroughly wash and dry his/her hands. When putting on gloves, it is important to select the gloves of the right size
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