Blood collection - crosstraining for STNAs

1. INTRODUCTION TO
BLOOD COLLECTION
Blood Collection: A Short Course

2. Learning Objectives
 State the importance of correct blood
collection techniques in managing total
patient care.
 List the factors that influence the integrity
of a blood specimen.
 Discuss safety precautions as related to
blood collection.
 Differentiate between whole blood,
plasma, and serum.

3. Learning Objectives
 Explain the action of anticoagulants to
prevent blood coagulation.
 Describe the appearance of a hemolyzed,
icteric, and lipemic specimen.
 Differentiate between arterial, venous, and
capillary blood.
 State the purpose of quality assurance in
blood collection.

4. Redesigning the
Healthcare System
 Shifting of phlebotomy responsibility.
 New skills required.

5. Blood Collection: A Short Course
Purpose
 Collection of quality specimens
 Instructive information
 Technique
 Procedures in accordance with the
Clinical and Laboratory Standards
Institute, (CLSI) (Standard H3-A6) and
Occupational Safety & Health
Administration (OSHA) guidelines

6. Blood Collection: A Short Course
Course Overview
 Equipment
 Site selection
 Technique
 Complications
 Specimen handling
 Phlebotomy errors
 Venipuncture practice

7. IMPORTANCE OF CORRECT SPECIMEN
COLLECTION AND HANDLING
QUALITY SPECIMENS =
QUALITY RESULTS
 Diagnosis
 Treatment
 Monitoring
 Laboratory results constitute 70% of the
objective information for health-care providers

8. IMPORTANCE OF CORRECT SPECIMEN
COLLECTION AND HANDLING
Specimen Integrity
 Laboratory guidelines
 Never hesitate to check with
laboratory
 Clinical Laboratory Improvement
Amendments of 1988 (CLIA, 1988)
 Laboratory is responsible

9. IMPORTANCE OF CORRECT SPECIMEN
COLLECTION AND HANDLING
Preanalytical Factors
 56% of lab errors occur before the
specimen is tested
 Monitoring of specimen ordering
 Patient identification
 Patient communication and safety
 Patient preparation
 Timing of collections
 Collection technique
 Specimen labeling
 Specimen handling and transport

10. SAFETY PRECAUTIONS
Standard Precautions
 Personal protective equipment (PPE)
 Isolation Procedures
 Hand washing
 Properly activating needle safety devices
 Biohazard disposal
 Decontamination
 Sodium hypochlorite (1:10)

11. SAFETYPRECAUTIONS

12. SAFETYPRECAUTIONS

13. SAFETYPRECAUTIONS

14. SAFETYPRECAUTIONS

15. SAFETY PRECAUTIONS
Accidental Puncture
 Significant exposure potential
 Report all needlesticks
 Follow institution’s protocol for
source and employee testing

16. SAFETY PRECAUTIONS
Syringe-To-Tube Transfer
 Recommended procedure
 Use blood-transfer device
 Removal of stoppers not
recommended
 Direct puncture of tube with syringe
needle not recommended

17. SAFETY PRECAUTIONS
Specimen Processing
 Centrifugation
 Capped, balanced tubes
 Separation
 Removal of stoppers
 Aerosol production

18. SAFETY PRECAUTIONS
Specimen Transport
 Primary container
 Secondary container
 Labeling

19. TYPES OF SPECIMENS
Whole Blood
 Consists of:
 Erythrocytes
 Leukocytes
 Platelets
 Plasma
 Use anticoagulated (unclotted)
specimen

20. TYPES OF SPECIMENS
Plasma
 Liquid portion of unclotted blood
 Contains fibrinogen
 Use anticoagulated specimen

21. TYPES OF SPECIMENS
Serum
 Clotted blood
 Does not contain fibrinogen
 Use “clot” tube

22. TYPES OF SPECIMENS
Centrifugation

23. TYPES OF SPECIMENS
Anticoagulants
 Calcium binding
 EDTA
 Sodium citrate
 Potassium oxalate
 Thrombin inhibition
 Heparin

24. TYPES OF SPECIMENS
MIX ANTICOAGULATED
SPECIMENS THOROUGHLY
IMMEDIATELY AFTER
COLLECTION

25. TYPES OF SPECIMENS
Normal Plasma & Serum
 Appear clear & pale yellow
Hemolyzed Specimens
 Appear pink-red
 Erythrocyte
destruction

26. TYPES OF SPECIMENS
Icteric Specimens
 Appear dark yellow
 Increased bilirubin
Lipemic Specimens
 Appear milky
 Increased lipids

27. TYPES OF SPECIMENS
Venous Blood
 Specimen of choice
 Used to establish Normal values
Arterial Blood
 Blood gases
 Require special collection training

28. TYPES OF SPECIMENS
Capillary Blood
 Dermal puncture collection
 Mixture of arterial and venous blood
 Note on requisition if blood is collected by
dermal puncture