Table 1.
Procedures for the collection of diagnostic blood specimens by venipuncture from CLSI H03-A6 document (36) used during phlebotomy training program.
| Steps | Procedures | Importance of the procedures |
|---|---|---|
| i | prepare accession order | to guarantee patient identity assurance (11–13,41) |
| ii | approach and indentify the patient; sanitize hands | |
| iii | verify the patient’s fasting status or diet restrictions, as appropriate, and inquire | fasting status is a important source of variability (17,42,43) |
| if the patient has a latex sensitivity; select appropriate gloves and tourniquet | to prevent allergic reaction and/or anaphylactic shock attributed to latex allergy (44–46) | |
| iv | assemble necessary supplies and select appropriate tubes according to the requests | to prevent errors in laboratory medicine induced by supplies and addictives such anticoagulants and clot activators (26–28,47–49) |
| v | position the patient | to eliminate possible interferences of blood distribution due to different posture (50) |
| vi | apply the tourniquet and select the venipuncture site and vein | See discussion |
| vii | put on gloves | preventing phlebotomists’ exposure to potentially infectious blood pathogens (51,52) |
| viii | cleanse the venipuncture site and allow to dry | cleaning prevents infection by skin microorganisms, waiting for drying prevents hemolysis (32,35) |
| ix | perform venipuncture; once blood flow begins, request the patient to open his/her hand | See discussion |
| x | fill tubes using the correct order of draw | to prevent errors by cross contamination between addictives (53–56) |
| xi | release and remove the tourniquet | See discussion |
| xii | place the gauze pad over the puncture site | safe feature for preventing phlebotomists’ exposure to potentially infections by bloodbome pathogens (51,52). applying pressure to the site is a efficient prevention of bruise (57) |
| xiii | remove the needle, activate any safety feature, and dispose of the device | |
| xiv | apply pressure to the site, making sure bleeding has stopped, and then bandage the arm | |
| xv | label the tubes and record the time of collection; some facilities also specify phlebotomist | to reduce missing identification and guarantee the traceability of the process (11,12,40,41) |
| identification on the tubes | ||
| xvi | observe special handling requirements (if any required) | to guarantee diagnostic blood specimens stability (58–61) |
| xvii | send properly labeled blood collection tubes to the appropriate laboratories |