CHS132 Obtain venous blood samples

Overview

This standard covers the use of venepuncture/phlebotomy techniques and procedures to obtain venous blood samples from individuals for investigations. Version No 3.

Knowledge and Understanding

You need to know and understand:

1. the current legislation, guidelines, policies, procedures and protocols which are relevant to your work practice and to which you must adhere
2. the scope and limitations of your own competence, responsibilities and accountability as it applies to your job role
3. how to access and interpret all relevant work instructions and information
4. specific procedures for reporting issues which are beyond your competence, responsibilities and accountability
5. the duty to report any acts or omissions that could be unsafe/detrimental to you or others
6. the hazards and risks which may arise during the execution of your work role and how you can minimise these
7. how to adapt communication styles in ways which are appropriate to the needs of the individual
8. the correct use of any equipment and PPE to protect the health and safety of you and others
9. the principles, practice and procedures associated with informed consent
10. the needs of individuals including issues relating to dignity, confidentiality, and privacy
11. organisational management structures, roles, and responsibilities
12. how to obtain positive confirmation of an individual’s identity before starting the procedure
13. the importance of applying standard precautions to obtaining venous blood samples and the potential consequences of poor practice
14. how infection is spread and how its spread may be limited - including how to use or apply the particular infection control measures needed when working with blood
15. the structure of blood vessels
16. the position of accessible veins for venous access in relation to arteries, nerves and other anatomical structures
17. blood clotting processes and factors influencing blood clotting
18. the contra-indications and changes in behaviour and condition, which indicate that the procedure should be stopped, and advice sought
19. the concerns which individuals may have in relation to you obtaining venous blood
20. how to prepare individuals for obtaining venous blood, including how their personal beliefs and preferences may affect their preparation
21. what is likely to cause discomfort to individuals during and after obtaining venous blood, and how such discomfort can be minimised
22. common adverse reactions to blood sampling, how to recognise them and the action(s) to take
23. the type and function of different blood collection systems
24. what dressings are needed for different types of puncture sites, how to apply and what advice to give individuals on caring for the site
25. the factors to consider in selecting the best site to use for venous access
26. the equipment and materials needed for venepuncture/phlebotomy and how to check and prepare blood collection systems
27. the importance of ensuring venous access sites are cleaned effectively, and how and when this should be done
28. the correct use of tourniquets
29. the importance of correctly and safely inserting and removing needles
30. how to recognise an arterial puncture, and the action to take if this occurs
31. the factors involved in the procedure which could affect the quality of the blood
32. the remedial action you can take if there are problems in obtaining blood
33. when and how to dress venous puncture sites
34. the information that needs to be recorded on labels and other documentation
35. the importance of completing labels and documentation clearly, legibly and accurately
36. how to dispose of waste in accordance with organisational procedures
37. how to complete and safely store all relevant documentation in accordance with organisational requirements

Performance Criteria

You must be able to:

1. access and accurately interpret all relevant work instructions and information
2. work safely at all times and in accordance with all relevant legislation, guidelines, policies, procedures and protocols
3. deal promptly and effectively with any problems within your control and report those which cannot be solved
4. identify and minimise hazards and risk in the workplace
5. confirm identity of the individual in accordance with organisational procedures
6. communicate with the individual and key people at a pace, in a manner and at a level appropriate to the individual’s understanding, preferences and needs
7. respect the individual’s rights and wishes relating to their privacy, beliefs, and dignity
8. gain valid, informed consent from the individual in accordance with specific procedures
9. apply standard precautions for infection prevention and control any other relevant health and safety measures
10. give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
11. select and prepare:

• an appropriate site
• appropriate equipment for obtaining the venous blood

12. apply, use and release a tourniquet at appropriate stages of the procedure
13. gain venous access using the selected blood collection system, in a manner which will cause minimum discomfort to the individual
14. obtain the blood from the selected site:

• in the correct container according to investigation required
• in the correct volume
• in the correct order when taking multiple samples

15. take appropriate action to stimulate the flow of blood if there is a problem obtaining blood from the selected site, or choose an alternative site
16. mix the blood and anti-coagulant thoroughly when anti-coagulated blood is needed
17. promptly identify any indication that the individual may be suffering any adverse reaction and take appropriate action
18. remove blood collection equipment and stop blood flow with sufficient pressure at the correct point and for the sufficient length of time to ensure bleeding has stopped
19. apply a suitable dressing to the puncture site according to guidelines and/or protocols, and advise the individual about how to care for the site
20. label blood samples in accordance with organisational procedures
21. place samples in the appropriate packaging with relevant documentation
22. place samples in the nominated place for collection and transportation, ensuring the blood is kept at the required temperature to maintain its integrity
23. ensure immediate transport of the blood to the relevant department when blood sampling and investigations are urgent
24. dispose of waste in accordance with organisational procedures
25. complete and store all relevant documentation in accordance with organisational requirements

Additional Information

This National Occupational Standard was developed by Skills for Health. Final version approved March 2021