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Phlebotomy Competency Skills Checklist

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Lisa Graf
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566 views

Phlebotomy Competency Skills Checklist

Uploaded by

Lisa Graf
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Phlebotomy Competency Checklist Patient Patient Patient Patient Patient

1 2 3 4 5
Name:
Preparation
1 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).
2
Compare patient ID information with barcode label. � � � � �
3 Checks testing requirements (ie fasting). � � � � �
4 Prepares supplies and tube selection. � � � � �
5 Washes hands, dons gloves. � � � � �
Getting Started
6 Positions Patient and applies tourniquet. � � � � �
7 Palpates antecubital area to select venipuncture site. � � � � �
8 Properly cleanses venipuncture site. � � � � �
Sample Collection
Venipuncture Procedure 9 Stablizes vein. � � � � �
10 Inserts needle, bevel up at a 30 degree angle or less. � � � � �
11 Smoothly pushes tube(s) into holder without changing needle position. � � � � �
12 Adjusts needle, if necessary, to obtain flow then stablizes vacutainer. � � � � �
13 Releases tourniquet as blood begins to flow. � � � � �
14 Changes vacutubes without changing needle position. � � � � �
15 Fills vacutubes in correct order. � � � � �
16 Mixes anticoagulated vacutubes properly. � � � � �
17 Removes last tube from needle before withdrawing needle. � � � � �
18 Withdraws needle from arm smoothly. � � � � �
19 Applies pressure to site after withdrawing needle. � � � � �
20 Disposes of needle properly and safely. Discards tourniquet. � � � � �
Handling & Processing
21 Labels tubes immediately (ie at bedside). � � � � �
22 Legibly completes label/requisition with username and date/time of collection. � � � � �
23 Observe special handling requirements. � � � � �
24 Checks puncture site to ascertain bleeding has stopped. Applies bandage. � � � � �
25 Places tubes into biohazard bag. Label(s)/requisiton are placed in sleeve of bag. � � � � �
26 Removes gloves and practice hand hygiene. � � � � �
27 Transport specimens to lab via porter or pneumatic tube system. STATs are sent immediately. � � � � �
Trainers’s Initials indicating a successful venipuncture
Other
28 Resource location – Lab Test information Guide. �
29 Blood Ethanol Collection – cleanse site with soap and water. �
30 Blood Culture Collection Review. �

_____________________________________ has successfully met the above criteria and is deemed competent to perform
(Name ) phlebotomy by means of veinipuncture.

Trainer’s Name (please print) ________________________________________ Date: __________________________

Trainer’s Signature _______________________________________________

V1.2 Revised January 2015


Phlebotomy Competency Checklist Patient Patient Patient Patient Patient
1 2 3 4 5
Name:
Preparation
1 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).
2
Compare patient ID information with barcode label. � � � � �
3 Checks testing requirements (ie fasting). � � � � �
4 Prepares supplies and tube selection. � � � � �
5 Washes hands, dons gloves. � � � � �
Getting Started
6 Positions Patient and applies tourniquet. � � � � �
7 Palpates antecubital area to select venipuncture site. � � � � �
8 Properly cleanses venipuncture site. � � � � �
Sample Collection
Venipuncture Procedure 9 Stablizes vein. � � � � �
10 Inserts needle, bevel up at a 30 degree angle or less. � � � � �
11 Smoothly pushes tube(s) into holder without changing needle position. � � � � �
12 Adjusts needle, if necessary, to obtain flow then stablizes vacutainer. � � � � �
13 Releases tourniquet as blood begins to flow. � � � � �
14 Changes vacutubes without changing needle position. � � � � �
15 Fills vacutubes in correct order. � � � � �
16 Mixes anticoagulated vacutubes properly. � � � � �
17 Removes last tube from needle before withdrawing needle. � � � � �
18 Withdraws needle from arm smoothly. � � � � �
19 Applies pressure to site after withdrawing needle. � � � � �
20 Disposes of needle properly and safely. Discards tourniquet. � � � � �
Handling & Processing
21 Labels tubes immediately (ie at bedside). � � � � �
22 Legibly completes label/requisition with username and date/time of collection. � � � � �
23 Observe special handling requirements. � � � � �
24 Checks puncture site to ascertain bleeding has stopped. Applies bandage. � � � � �
25 Places tubes into biohazard bag. Label(s)/requisiton are placed in sleeve of bag. � � � � �
26 Removes gloves and practice hand hygiene. � � � � �
27 Transport specimens to lab via porter or pneumatic tube system. STATs are sent immediately. � � � � �
Trainers’s Initials indicating a successful venipuncture
Other
28 Resource location – Lab Test information Guide. �
29 Blood Ethanol Collection – cleanse site with soap and water. �
30 Blood Culture Collection Review. �

_____________________________________ has successfully met the above criteria and is deemed competent to perform
(Name ) phlebotomy by means of veinipuncture.

Trainer’s Name (please print) ________________________________________ Date: __________________________

Trainer’s Signature _______________________________________________

V1.2 Revised January 2015

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