Skill Checklists

Phelebotomy

This checklist was electronically signed on (Today’s date)

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

  • 1 = No Experience

  • 2 = Need Training

  • 3 = Able to perform with supervision

  • 4 = Able to perform independently

Preparation

Introduces self to patient and explains blood tests have been ordered by physician

Identifies the patient with two unique identifiers (armband, ask for name & DOB). Compare patient ID information with barcode label

Checks testing requirements (ie fasting)

Prepares supplies and tube selection.

Washes hand, dons gloves

Getting Started

Positions Patient and applies tourniquet

Palpates antecubital area to select venipuncture site

Properly cleanses venipuncture site

Sample Collection

Stablizes vein

Inserts needle, bevel up

Smoothly pushes tube(s) into holder without changing needle position

Adjusts needle, if necessary, to obtain flow then stablizes vacutainer

Releases tourniquet as blood begins to flow

Changes vacutubes without changing needle position

Fills vacutubes in correct order

Mixes anticoagulated vacutubes properly

Removes last tube from needle before withdrawing needle

Withdraws needle from arm smoothly

Applies pressure to site after withdrawing needle

Disposes of needle properly and safely, Discards tourniquet

Handling And Processing

Labels tubes immediately (ie at bedside)

Legibly completes label/requisition with username and date/time of collection

Observe special handling requirements

Checks puncture site to ascertain bleeding has stopped. Applies bandage

Places tubes into biohazard bag. Label(s)/requisiton are placed in sleeve of bag

Removes gloves and practice hand hygiene

Transport specimens to lab via porter or pneumatic tube system. STATs are sent immediately

Age Specific Competencies

Infant (Birth - 1 year)

Preschooler (ages 2-5 years)

Childhood (ages 6-12 years)

Adolescents (ages 13-21 years)

Young Adults (ages 22-39 years)

Adults (ages 40-64 years)

Older Adults (ages 65-79 years)

Elderly (ages 80+ years)

Certifications

Resource location – Lab Test information Guide.

Blood Ethanol Collection – cleanse site with soap and water.

Blood Culture Collection Review.

I hereby certify that ALL information I have provided on this skills checklist and all other documentation is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.