Blog – Page 20 – Phlebotomist Report

Being new to the profession you will definitely make a few mistakes. When I started doing phlebotomy I made a few mistakes myself. So, as a beginner phlebotomist don’t beat yourself if you do any of these. Just make sure you learn from it the first time and don’t repeat a second time. Success in phlebotomy is all about learning as you go about practicing every day. Having a knowledge of these mistakes beforehand will help you avoid them in the phlebotomy room. Here are the 12 common mistakes beginners make. They are not in any particular order: 1. Forgetting to Anchor the Vein Anchoring the vein is critical to being successful when drawing blood, even for the experienced phlebotomist, so much more for the beginner. If you want to have a successful draw anchor that vein. Hold the patient arm below and use your thumb to pull back on the skin. Doing so will stabilize the vein and prevent the vein from rolling. 2. Inserting the Needle too High up the Vein What happens if you missed the vein or you went above it? Getting the idea? So, you want to insert the needle lower which gives you more vein space. Incase of a miss you can pull back the needle, readjust and insert into the vein. 3. The Needle is Not Deep Enough in the Vein If you notice the patient’s blood coming out while the needle is still in the vein, it may be you did not insert the needle deep enough. That means the end of the needle or the bevel was only partially inside the vein. Also, not getting a flash in the needle can indicate that. 4. Leaving the Needle in the Patient Arm while Inverting the Tube This can be uncomfortable for the patient especially if you leave it more than a few seconds. You should always remove the needle and finish the procedure before inverting the tubes. Keeping the needle in the person’s vein could increase their anxiety and cause them to react. I have had a patient say to me that I was taking too long, in order words, the needle was in his vein for too long. The truth is, the needle was only for a few seconds in the patient vein but because of his fear of needles it seemed like forever. 5. Missing or Taking the Wrong Sample Sometimes it’s because you are not familiar with the requisition form or you are not knowledgeable enough about each test and the correct tube that goes with it or you were having a bad day and just messed up. In such cases take responsibility for your error. You will have to go back to or call the patient, explain what happened and ask if the procedure can be redone. 6. Not Following the Order of Draw There is a particular order you must follow when drawing blood, especially when you are doing multiple samples. If you are only doing one draw, it’s simple, but if many, you must follow the correct order. Doing so will help eliminate cross-contamination of additives between tubes. Below is a table showing the basic order of draw. Draw OrderTube TypeTube ColorAdditive in Tube1Blood CultureYellow/BlueSodium Polyanethol Sulfanate 2CoagulationLight Blue TopSodium Citrate3Serum Red TopNon Additive4Serum (SST)Gold or Red Gray (SST)Gel Separator, Clot Activator 4HeparinGreen TopSodium or Lithium Heparin5EDTALavender TopEthyleneDiamineTetraacetic Acid6Oxalate/FlorideGray TopPotassium Oxalate, Sodium Floride Want to remember the order of draw easily? Use this mnemonic. Be………………………..Blood cultures Loving……………….. Light Blue Respectful……………. Red Gracious………………..Green Lighthearted and……Lavender Gentle…………………….Gray 7. Forgetting to Put the Tourniquet or Removing the Tourniquet I have had this one happen to me! I was doing this one patient and it wasn't until I had inserted the needle into the vein that I realized I had not put on the tourniquet. I guess what really got me, was his vein. He had a really nice big vein and I just went for it. I inserted the needle and the blood came out like he had a tourniquet on. You are going to get a few patients like this man but remember to put the tourniquet on and to take it off as well. Here’s a tip! Always take off the tourniquet before removing the needle from the vein. 8. Forgetting to Clean the Site of Venipuncture Properly This one is important! After choosing a vein you need to ensure that you clean the site with 70% alcohol. Doing so will get rid of most if not all of the bacteria sitting there which can cause an infection if not cleaned properly. It’s easy when starting phlebotomy to miss a step but it’s critical that you don’t. Practice at home with family and friends doing each step. This will help you to become familiar with the procedure and when you are with a patient you will recall exactly what to do. 9. Not Taking Enough Blood Here’s another great tip! Full every tube to the max! That is a little crazy because for some tests you don’t need a full tube but doing it will save you from having to call back the patient to take another sample and also no one will ever tell you, you didn’t take enough blood. You need to also familiarize yourself with each test on the requisition form and the amount of sample you need for each test. Want an idea how much blood to collect for a test? Check out this article I wrote. 10. Forgetting to Write the Patient’s Details on the Sample If you forget to write the patient’s name, date of birth, the date and time on the sample then no one will know whose sample you took. You will then have to go back to the person or call them and retake the sample. There are two ways you can do this! Either write the patient’s personal information on the tube or use a printed label before you start the procedure or to do it after taking the sample. If you do it after taking the sample be sure you do it after removing the tourniquet and in front of the patient. 11. Never Do a Blind Stick or Go Fishing for a Vein I have heard it said, “sometimes you have to do a blind stick.” No! I say don’t ever do that! If you can’t locate a vein and feel anything DO NOT STICK the patient. Do not stick the patient and go ‘fishing’ around for a vein. Period! Doing so will cause bruising and hurting. 12. Never Recap a Used Needle Using Both Hands! DO NOT EVER recap a used needle using your both hands! Doing so is extremely dangerous and will put you at risk of getting a needle stick. If the equipment or device you are using doesn’t have a safety mechanism and you must recap a used needle then do this: Put the needle cap on the surface by itself. Insert the used sharp needle into the cap with one hand. Using a container or a solid object nearby secure the cap by pressing the cap against it. The cap is secured when you hear a clicking sound. Discard needle into sharps container.