Healthcare Phlebotomy Guide

HEALTHCARE PHLEBOTOMY GUIDE

Patient Information

Date of Birth:    Gender:    Medical Record / Patient ID:

Phone:    Alternate Phone:

Insurance Information

Policy Number:    Group Number:    Subscriber Name:

Medical History & Pre-Collection Screening

Screening: (check all that apply)

Patient fasting

On anticoagulant therapy or antiplatelet agents

Known bleeding disorder

History of difficult venous access

Recent blood donation or transfusion within past 24 hours

Procedure: Materials and Technique

Standard materials for routine venipuncture include sterile needle or vacutainer holder, appropriate collection tubes, tourniquet, alcohol prep, gauze, adhesive bandage and sharps container. Phlebotomist must verify order, patient identity, and allergy status prior to collection.

Site selection: Preferred site is antecubital fossa; avoid arm with IV infusion or lymph node dissection. If drawing distal to an IV, document site and note IV status.

Collection Date:    Collection Time:

Order of Draw (Reference Checklist)

Select tube types collected in order according to facility protocol and test requirements:

Blood culture bottles

Sodium citrate (blue)

Serum tubes (red/gel)

Heparin (green)

EDTA (lavender)

Glycolytic inhibitor (gray)

Specimen Labeling & Documentation

Label specimen at bedside with two patient identifiers and date/time. Labels must include collector initials and test request code where applicable.

Post-Collection Care and Potential Complications

Apply direct pressure to puncture site until bleeding stops. Provide patient with aftercare instructions and observe for adverse events such as syncope, hematoma, or prolonged bleeding.

Apply bandage:    Observe for syncope for 5 minutes:    Hematoma developed:

Specimen Handling, Transport, and Storage

Ensure tubes are inverted as required, store at required temperature, and transport within facility timeframes. Document any deviations from standard handling.

Quality Control & Safety

Hemolysis, clotting, insufficient volume and mislabeled specimens compromise testing. Report and document quality incidents. Follow standard sharps disposal procedures; never recap needles by hand.

Hemolysis observed:    Insufficient volume:    Recollection required:

Confidentiality and Authorization

By signing below the patient or authorized representative authorizes collection of blood specimens for testing as ordered by the treating clinician. Information obtained is protected and will be released only in accordance with applicable privacy laws and facility policy.

I acknowledge that the procedure, risks (including bruising, infection, fainting, hematoma), and alternatives have been explained and I have had the opportunity to ask questions. I understand I may withdraw consent at any time prior to collection.

Patient acknowledges receipt of privacy notice and understands specimen results will be handled per facility policy.

Patient Acknowledgment:    Interpreter used:    Language:

Training and Competency

All personnel performing phlebotomy must demonstrate training and competency per facility protocols. Any deviation or incident must be reported to supervisory staff immediately.

Sign Now