venepuncture training. aim of the session to ensure staff will have the knowledge and skills to...
TRANSCRIPT
Venepuncture Training
Aim of The Session
To ensure staff will have the knowledge and skills to perform venepuncture safely and effectively
Learning Objectives
• Outline current legislation, local policies and procedures relevant to venepuncture practice
• Distinguish between when to perform venepuncture and when it should not be performed
• Describe the relevant anatomy and physiology of the arm and name the common veins used for venepuncture.
Demonstrate the correct procedure for obtaining venous blood samples
Venepuncture Competency Requires You to
Understand your Role & Responsibilities
Knowledge of Procedure and all related Policies
Trained to Undertake Venepuncture
Assessed prior to undertaking Venepuncture
Record your competency and keep Updated
Legal Framework
Duty of Care
responsibility to deliver high quality safe care to required standard
Accountability
being responsible for acts or omissions
Incident Reporting
Risk Assessment
RecordKeeping
Consent
InfectionPrevention
Control
Health And Safety
Venepuncture
Policies And Guidelines
Underpinning Policies and Guidelines
Venepuncture
Introduction of a needle into a vein in order to obtain a blood sample
Reasons For Undertaking Venepuncture
>Investigative purposes
>To detect a disease or illness
>Monitoring clinical conditions or medications
ANATOMY & PHYSIOLOGY OF BLOOD AND BLOOD VESSELS
DIFFERENT APPROACHES
BLOOD COLLECTION SYSTEMS
UNIVERSAL PRECAUTIONS
RIGHT EQUIPMENT
CONTRAINDICATIONS
POTENTIAL PROBLEMS
WHEN TO SEEK ASSISTANCE
REPORT INCIDENTS
PROCEDURE
Venepuncture Knowledge
Blood - Three Main Functions
1.Transports oxygen, waste products and nutrients
2. Regulates body temperature
3. Protects against blood loss through clotting mechanisms
ARTERIES
To The Heart
Oxygenated Blood
Thicker Wall
Muscular
VEINS
From The Heart
Deoxygenated Blood
Thinner Wall
Less Muscular
Blood Vessels
Veins commonly used
Median Cubital Accessory Cephalic Basilic
Easily Accessible Less Painful.
Number of Attempts
Median Nerve
Shooting Pain in arm
> Abnormal sensation (Dysethesia)
Special Precautions
Alternative Sites used in LCH but only after training !
Systems in Use in LCH
VACUTAINER
MONOVETTE
Infection Control
Attend Mandatory Training 2 yearly
Follow LCH Trust Policy
Decontamination Clinical AreaDecontamination of HandsUse of PPEDisposal of Waste
Waste Disposal
Attend Health and Safety Training 3 yearly
Follow LCH Trust Policy.Safe Use and Disposal of Sharps
GOOD
SoftBouncyRefills when depressedVisible
Characteristics of Veins
POOR
FirmRoll easilyFeel Cord Like
CAUTION HERE
if it PULSATES, feels ELASTIC (ARTERY)
X XSites to Avoid
Scars from burns and surgery
Arm on side of a Mastectomy
Haematoma/ Bruising
IV / Transfusion arm
Oedema
Site of previous venepuncture attempts
( RCN 2003)
Blood Form not Completed in full
Patient is Unwell
Child under ??
Patient cannot consent to procedure
3 attempts have been made
X XWhen Not Perform if ……………
Gloves Tourniquet – (disposable or decontaminate between use)Needles butterflies /adaptersBlood Collection system Alcohol hand gel/rubReceiversSharps boxAdhesive Spot PlastersLow Linting gauze
Equipment
RLBUHT – Handout 1AINTREE – Handout 2
Order of Draw
Specific Test
Testosterone take sample before noon.
Carbamazepine, Phenobarbitone and Phenytoin ranges are for pre dose samples
Lithium range is for 12 hours post dose
Digoxin at least 6 hours post dose.
Hematoma formed
Vein collapsed
Bevel near or in vein wall
Needle passed through vein
Trouble Shooting - No blood flow
Trouble shooting - Small veins
• Costly• Safety device• Used when vacuum in
evacuated system may be too much for fragile veins
Bright Red Blood. Arterial Puncture Remove needle Tube fills fast
quickly, apply pressure IR1
Uncontrolled Bleeding Anticoagulant therapy Apply Pressure at puncture site
Haematoma Trauma to vein or late Apply pressure release of tourniquet
Pain Needle hits nerve STOP PROCEDURE seek advice form senior colleague IR1
Adverse Events Possible Causes First Aid
Adverse Events Possible Causes First Aid
Nausea, Giddiness Needle phobia Don’t Panic, StopSweating, Pallor Anxiety, Stress procedure. Sit or lie Rapid Pulse, sudden Heat, Pain, Hunger down if possible, raise loss of consciousness Medical Conditions legs, loosen clothing,
call for assistance, monitor airway until patient recovers, givewater, reassure, contactrelative to accompany home. IR1
FAINTING
Specific Individual Needs
Alternative or Additional Communication Needs
Adjustment to Appointments
Alternative types of appointments
Different Practitioners
Disabled access
Best Interest Assessment
Other
Contact Equality and Diversity Team either via the internet or
Tel: 0151 295 3041
YOU Request Form is completedCollect equipmentInfection Control Procedures
ENVIRONMENT Clean, Well lit
Appropriate
PATIENT Consent and Agree to procedurePositive Patient IdentificationNo Contraindications
Before You Begin - Prepare and Protect
Step by Step Guide to Venepuncture
Over To You
Venepuncture is a common Procedure
Undertaken by a Range of Healthcare Staff
Duty of Care to provide High Quality Safe Care
Practical skill requires updating and assessing regularly
Work within Policy and Guidelines
Summary Learning
Laboratory Test Results are only as good as the specimen and the specimen is only as good as the method by which it is collected, handled and processed.
Competency Assessment
Practice, Practice, Practice