Procedures up to date? Fighting injury in phlebotomy

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Erickson

The elevated angle of the needle resulted in a transfixed vein, where the needle pierces both top and bottom vein walls, causing a compression injury, “which can be just as painful as a nerve injury,” she says. The patient also was taking an anticoagulant and continued to bleed after the blood draw. “She was a young woman, only 24, but you can’t assume that only 60-year-old people are on blood thinners,” she says.

Other examples of substandard care include not adhering to the one-minute rule with the tourniquet, slapping a patient’s arm to get a vein to swell, and shaking the specimen.

“The word ‘shake’ was used recently in a trial I went to,” Erickson says, “and the difference between ‘shake’ and ‘gently invert’ is huge.” If there is a trial, “does the staff know how to use proper terminology?” Erickson says. “It comes down to training the trainer.”

Erickson’s advice for laboratory managers is to get phlebotomists into conference rooms for continuing education.

“Quite often people will send their managers,” Erickson says. But “there are some people who have been drawing blood for 20 years and they had no idea that blood cultures were supposed to be collected first instead of last, and that’s key,” she says.

Training for all phlebotomy staff on the new edition of GP41, at a conference or in-house, will go a long way toward avoiding litigation.

“In about 70 percent of the cases I review, something was done against the standards,” Ernst says.
Amy Carpenter Aquino is CAP TODAY senior editor. A new edition of the CAP’s So You’re Going to Collect a Blood Specimen was released last year. To order (PUB225), call the CAP at 800-323-4040 option 1. For members, $28; for others, $35 ($25 at ebooks.cap.org).[hr]