CHS131 Obtain and test capillary blood samples

Overview

This standard covers the collection of capillary blood samples using either manual or automated lancets, testing of the sample where this is required or sending it elsewhere for laboratory testing. Samples may include those for blood sugar determination, haemoglobin levels and neonatal blood spot testing of the newborn. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. The current European and National legislation, national guidelines, organisational policies and protocols in accordance with Clinical/Corporate Governance which affect your work practice in relation to obtaining and testing capillary blood samples
2. Your responsibilities and accountability in relation to the current European and National legislation, national guidelines and local policies and protocols and Clinical/Corporate Governance
3. The duty to report any acts or omissions in care that could be detrimental to yourself, other individuals or your employer
4. The importance of obtaining positive confirmation of individuals� identity and consent before starting the procedure, and effective ways of getting positive identification
5. The importance of confidentiality and the measures taken to ensure it is appropriately maintained
6. The importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence
7. The importance of applying standard precautions to obtaining and testing capillary blood samples and the potential consequences of poor practice
8. 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
9. The structure and purpose of capillary blood vessels
10. Blood clotting processes and factors influencing blood clotting
11. The normal or expected results for particular tests and therefore what constitutes an abnormal result
12. The different reasons for obtaining capillary blood samples taken
13. The concerns that individuals may have in relation to capillary blood sampling
14. The sites which can be used for capillary sampling and what the factors that need to be considered in selecting the best site to use including the individual�s own preference
15. Why it is important to clean the sites from which you will obtain samples, and the appropriate ways of doing this
16. The limits of your role and the circumstances in which you would need to refer to another person
17. The contra-indications which indicate that capillary sampling should be stopped and advice sought
18. What is likely to cause discomfort to individuals during and after the collection of capillary blood samples, and how such discomfort can be minimised
19. What can cause problems in obtaining capillary blood samples, what can be done to stimulate blood flow and when another site should be used
20. The common adverse reactions/events which individuals may have to blood sampling, how to recognise them and action(s) to take if they occur
21. The equipment and materials are needed for capillary blood sampling and testing
22. The sorts of equipment and materials which are sensitive to environmental changes and how this affects their storage and use
23. Which equipment and instruments are re-usable and which must be discarded after one use
24. How and when to label samples if required
25. The importance of ensuring sites for capillary blood sampling are cleaned effectively, and how and when this should be done
26. The process and procedure for obtaining capillary blood samples, including the correct sequence of actions
27. The factors involved in the procedures which could affect the quality of the blood
28. The importance of collecting capillary blood samples of the right quality, and how to achieve this
29. The complications and problems may occur during the collection of capillary blood samples, how to recognise them and what action(s) to take
30. How to perform relevant tests of capillary blood samples
31. How to record test results, and the importance of clear and accurate documentation
32. The information that needs to be recorded on labels and other documentation when sending capillary blood samples to the laboratory
33. The importance of completing labels and documentation clearly, legibly and accurately, and the possible consequences of confusing samples or incorrect labelling
34. The importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff

Performance Criteria

You must be able to do the following:

1. apply standard precautions for infection prevention and control and any other relevant health and safety measures
2. give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
3. gain valid consent to carry out the planned activity
4. select and prepare the site for obtaining the capillary blood sample immediately before the blood is obtained, in line with organisational procedures
5. obtain the required amount of blood of the required quality, using the selected materials and equipment into the container(s) and/or onto the appropriate strips or slides, in the correct order and in a manner which will cause minimum discomfort to the individual
6. 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
7. apply pressure to the puncture site following completion to encourage closure and blood clotting
8. promptly identify any indication that the individual may be suffering any adverse reaction/event to the procedure and act accordingly
9. where the sample is to be sent for laboratory testing:
   1. label the sample, if it is not to be tested immediately clearly, accurately and legibly, using computer prepared labels where appropriate
   2. place sample in the appropriate packaging, ensure the correct request forms are attached and put in the appropriate place for transport or storage if required
   3. ensure immediate transport of the sample to the relevant department when blood sampling and investigations are urgent
10. document all relevant information clearly, accurately and correctly in the appropriate records
11. when appropriate, test the blood sample correctly using the appropriate method in line with organisational procedure
12. recognise and interpret results accurately or pass them onto an appropriate staff member for interpretation
13. record results fully and accurately in the appropriate manner and place and report to the appropriate staff member
14. give clear and accurate information to the individual about the results of tests, if available and within the limits of your responsibility
15. respond to questions from the individual clearly and accurately in an appropriate manner, level and pace or refer them to an appropriate staff member
16. ensure that the individual is informed if any further action is required/the next stage in the process

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB6 Assessment and treatment planning This standard has replaced Diab_FA3, BDS2, and HCS_PHO5