Order of Draw in Phlebotomy Procedures: Importance, Guidelines, and Steps in the United States

Summary

• Proper order of draw is crucial in phlebotomy procedures to prevent Cross-Contamination and ensure accurate Test Results.
• The specific steps and guidelines for order of draw in the United States follow the CLSI standards to maintain patient safety and quality of care.
• Healthcare professionals must be trained and well-versed in these guidelines to effectively collect blood samples and maintain Patient Satisfaction.

Introduction

Phlebotomy is a crucial aspect of healthcare, where blood samples are collected from patients for diagnostic purposes. It is essential for healthcare professionals, such as phlebotomists, nurses, and lab technicians, to follow proper procedures to ensure accurate Test Results and maintain patient safety. One crucial aspect of phlebotomy procedures is the order of draw, which refers to the specific sequence in which different blood collection tubes should be filled during Venipuncture. In the United States, there are specific steps and guidelines that healthcare professionals must follow to adhere to the Clinical and Laboratory Standards Institute (CLSI) standards.

Importance of Proper Order of Draw

The order of draw is crucial in phlebotomy procedures for several reasons:

1. Prevents Cross-Contamination: By following a specific order of draw, healthcare professionals can prevent contamination of blood samples with additives from other tubes.
2. Ensures accurate Test Results: Different blood collection tubes contain various additives and anticoagulants that are specific to certain tests. Adhering to the proper order of draw helps in maintaining the integrity of the blood samples and ensures accurate Test Results.
3. Patient safety: Following the correct order of draw minimizes the risk of errors in blood collection, which can lead to misdiagnosis and inappropriate treatment of patients.

Specific Steps and Guidelines for Proper Order of Draw

The following are the specific steps and guidelines for proper order of draw in phlebotomy procedures in the United States:

Step 1: Gather Necessary Supplies

Before beginning the Venipuncture procedure, healthcare professionals must gather all the necessary supplies, including:

1. Gloves
2. Needles
3. Multiple blood collection tubes with different additives
4. Tourniquet
5. Alcohol swabs
6. Gauze
7. Adhesive bandages

Step 2: Identify and Prepare the Patient

Healthcare professionals should properly identify the patient using two unique identifiers, such as the patient's full name and date of birth. It is crucial to verify the patient's identity to prevent sample mix-ups. Explain the procedure to the patient and ensure their consent before proceeding with the Venipuncture.

Step 3: Perform Hand Hygiene and Put on Gloves

Wash hands thoroughly with soap and water or use hand sanitizer to ensure proper Hand Hygiene. Put on gloves to prevent the risk of infection and protect both the healthcare professional and the patient.

Step 4: Select the Vein and Perform Venipuncture

Select a suitable vein for Venipuncture, typically in the antecubital area of the arm. Clean the site with an alcohol swab and allow it to dry before performing the Venipuncture. Insert the needle into the vein and collect the required blood samples in the appropriate order of draw.

Step 5: Follow the Proper Order of Draw

Following the proper order of draw is essential in phlebotomy procedures. The typical order of draw in the United States follows the CLSI standards and is as follows:

1. Blood Culture tubes (yellow or yellow-black top)
2. Citrate tubes (Light Blue Top)
3. Serum tubes with or without Clot Activator or gel separator (red or red-gray top)
4. Heparin tubes with or without gel separator (green or Light Green Top)
5. EDTA tubes (Lavender Top)
6. Glycolytic inhibitor tubes (gray top)

Step 6: Label the Blood Collection Tubes

After filling each blood collection tube in the proper order of draw, label them with the patient's full name, date of birth, and the date and time of collection. Proper labeling is crucial for accurate identification of blood samples and preventing mix-ups in the lab.

Step 7: Apply Pressure and Bandage the Site

After collecting the blood samples, apply pressure to the Venipuncture site with gauze to stop any bleeding. Secure the site with an adhesive bandage to protect it and ensure the patient's comfort.

Step 8: Dispose of Sharps and Biohazard Waste Properly

Dispose of used needles and other sharps in designated sharps containers to prevent accidental needlesticks and infections. Dispose of biohazard waste according to healthcare facility guidelines to maintain a safe and clean environment.

Step 9: Document the Procedure

Proper documentation of the phlebotomy procedure is essential for accurate record-keeping and patient care. Document the date, time, site of Venipuncture, blood collection tubes used, and any complications or observations during the procedure.

Step 10: Educate the Patient

After completing the Venipuncture procedure, educate the patient about post-care instructions, such as keeping the site clean and dry, avoiding heavy lifting with the arm, and monitoring for any signs of infection. Answer any questions or concerns the patient may have regarding the procedure.

Conclusion

Proper order of draw is essential in phlebotomy procedures to maintain patient safety, prevent Cross-Contamination, and ensure accurate Test Results. Healthcare professionals in the United States must adhere to the CLSI standards and follow specific steps and guidelines for the proper order of draw during Venipuncture. By following these procedures diligently, healthcare professionals can provide quality care to patients and contribute to the overall efficiency and effectiveness of the healthcare system.

Disclaimer: The content provided on this blog is for informational purposes only, reflecting the personal opinions and insights of the author(s) on the topics. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. No physician-patient relationship is created by this web site or its use. No contributors to this web site make any representations, express or implied, with respect to the information provided herein or to its use. While we strive to share accurate and up-to-date information, we cannot guarantee the completeness, reliability, or accuracy of the content. The blog may also include links to external websites and resources for the convenience of our readers. Please note that linking to other sites does not imply endorsement of their content, practices, or services by us. Readers should use their discretion and judgment while exploring any external links and resources mentioned on this blog.

Related Videos