CHS132.2012 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. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You will need to know and understand:

the current European and National legislation, national guidelines, organisational policies and protocols in accordance with any Clinical/Corporate Governance which affect your work practice in relation to obtaining venous blood samples
your responsibilities and accountability in relation to the current European and National legislation, national guidelines and local policies and protocols and any Clinical/Corporate Governance
the duty to report any acts or omissions in care that could be detrimental to yourself, other individuals or your employer
the importance of obtaining positive confirmation of individuals' identity and consent before starting the procedure, and effective ways of getting positive identification
the importance of working within your own sphere of competence and seeking advice when faced with situations outside your sphere of competence
the importance of applying standard precautions to obtaining venous blood samples and the potential consequences of poor practice
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
the structure of blood vessels
the position of accessible veins for venous access in relation to arteries, nerves and other anatomical structures
blood clotting processes and factors influencing blood clotting
the contra-indications and changes in behaviour and condition, which indicate that the procedure should be stopped, and advice sought
the concerns which individuals may have in relation to you obtaining venous blood
how to prepare individuals for obtaining venous blood, including how their personal beliefs and preferences may affect their preparation
what is likely to cause discomfort to individuals during and after obtaining venous blood, and how such discomfort can be minimised
common adverse reactions/events to blood sampling, how to recognise them and the action(s) to take if they occur
the type and function of different blood collection systems
what dressings are needed for different types of puncture sites, how to apply and what advice to give individuals on caring for the site
the factors to consider in selecting the best site to use for venous access
the equipment and materials needed for venepuncture/phlebotomy and how to check and prepare blood collection systems
the importance of ensuring venous access sites are cleaned effectively, and how and when this should be done
the correct use of tourniquets
the importance of correctly and safely inserting and removing needles
how to recognise an arterial puncture, and the action to take if this occurs
the factors involved in the procedure which could affect the quality of the blood
the remedial action you can take if there are problems in obtaining blood
the complications and problems may occur during venepuncture, how to recognise them and what action(s) to take
when and how to dress venous puncture sites
the information that needs to be recorded on labels and other documentation
the importance of completing labels and documentation clearly, legibly and accurately
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:

apply standard precautions for infection prevention and control any other relevant health and safety measures
give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
gain valid consent to carry out the planned activity
select and prepare:
1. an appropriate site
2. appropriate equipment for obtaining the venous blood
apply, use and release a tourniquet at appropriate stages of the procedure
gain venous access using the selected blood collection system, in a manner which will cause minimum discomfort to the individual
obtain the blood from the selected site:
1. in the correct container according to investigation required
2. in the correct volume
3. in the correct order when taking multiple samples
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
mix the blood and anti-coagulant thoroughly when anti-coagulated blood is needed
promptly identify any indication that the individual may be suffering any adverse reaction/event to the procedure and act accordingly
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
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
label blood samples clearly, accurately and legibly, using computer prepared labels where appropriate
place samples in the appropriate packaging and ensure the correct request forms are attached
place samples in the nominated place for collection and transportation, ensuring the blood is kept at the required temperature to maintain its integrity
document all relevant information clearly, accurately and correctly in the appropriate records
ensure immediate transport of the blood to the relevant department when blood sampling and investigations are urgent

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