CLS 424 PHLEBOTOMY - Venipuncture Collection Competency Checklist - Student Laboratory

Rating System: OK = Satisfactory performance, NOT OK = Incorrect or needs improvement, NA = Not assessed Skill/Competency: 1. Washes hands prior to beginning venipuncture procedure 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Rating _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____ _____

Introduces him/herself to the patient.... Explains to the patient what procedure he/she is going to do . Properly identifies the patient . Inquires about latex allergies and acts accordingly ... Organizes the proper equipment without prompting (stick to eleven) ... Anticipates the need for additional equipment in case of problems .... Correctly positions arm, then applies tourniquet Locates appropriate vein to be drawn, then releases tourniquet (1 minute rule) ... Cleanses venipuncture area, in a circular/outward motion, allowing to air dry ~ 30 seconds Reapplies tourniquet taking care not to contaminate venipuncture site Performs the procedural steps, in proper sequence, for a venipuncture: Vacutainer / Syringe a. Isolates and anchors the selected vein using thumb and pulling taut .... b. Inspects needle and inserts needle, bevel up .. c. Anchors vacutainer or syringe blood drawing system ... d. For vacutainer draw, changes tubes smoothly without losing vein ... e. For syringe draw, pulls back on plunger smoothly without losing vein .... f. Uses correct order of draw when filling collection tubes .... g. Adequately fills tubes .... h. Mixes tubes when appropriate ... i. Releases tourniquet, applies gauze, then removes needle smoothly and quickly .. j. Uses appropriate safety technique to blunt or sheath the needle... k. Appropriately applies pressure to wound site (or asks patient to do so) ... l. Immediately discards needle into sharps container ... Labels collection tubes with black indelible marker (legal document) .... Documents venipuncture by signing the requisition/order slip, noting any problems .. Reexamines wound site ensuring bleeding has stopped Applies band-aid/gauze when appropriate.. Properly disposes of biohazards, sharps and non-biohazard supplies... Removes gloves and properly washes hands. Displays a professional, courteous manner/attitude at all times...

13. 14. 15. 16. 17. 18. 19.

Student being evaluated: _________________________________ Student being drawn: _____________________________________

Evaluator: __________________ Date of evaluation: ____________

CLS 424 Phlebotomy: Student Lab Rotation Competency Assessment Venipuncture