BEST PRACTICES :: IMPROVING THE PATIENT EXPERIENCE
However, with the introduction of devices designed for drawing from IV lines that reduce the risk of hemolysis and IV contamination, the biggest arguments against drawing from VADs have been neutralized. One device specifically designed to draw blood from peripheral lines attaches to the luer adapter of the VAD. If necessary, a nurse may pause infusing fluids and flush the line. Then the phlebotomist or nurse advances a flex- ible tubing engineered for blood collection through the line, beyond the catheter tip and into the vein. The user then aspirates the blood sample with a syringe or evacu- ated tube system. Following a blood collection, the nurse may restart fluids as necessary.
One healthcare system implementing this line-draw technology is Intermountain Healthcare in Utah. By training phlebotomists and nurses to draw from lines throughout their dwell with devices engineered to improve sample quality, a retrospective analysis showed they were able to reduce hemolysis 39 percent. With a success rate for drawing from VADs up to 95 percent, Intermountain has reduced the number of venipunctures performed by up to 50 percent system-wide. Much like the Mayo Clinic, Intermountain engages their phlebotomists in intensive training prior to allow- ing line draws. The training begins with a one-hour classroom review of the required technology, venous anatomy, and peripheral IV functions. A thorough review of roles and responsibilities ensures that nurses remain solely responsible for assessing IV catheters and pausing infusions.
VACUETTE®
An adaptable skill set Teaching phlebotomists to become part of an IV access team is not as difficult as some may think. Many of the necessary skills are already in place such as preparing the site, locat- ing veins, anchoring, inserting the needle, troubleshooting needle placement, and more. Since phlebotomists perform- ing venipunctures are skilled at advancing needles into veins and withdrawing blood via a tube holder assembly or syringe, there is a familiarity with technique that makes their cross-training a natural extension of an existing skill set. In addition, they bring their vast knowledge of preanalytic error prevention to the table.
“Phlebotomists are well-suited to be given IV-access responsibilities because of their initial training and hav- ing mastered vascular accessing via venipuncture,” says Johnson. “But what’s key to their success is their under- standing of all the preanalytical variables associated with blood collection.”
Patients with difficult veins are the most obvious benefac- tors of devices that draw successfully from existing or newly inserted lines. With the first-stick failure rates for venipunc- tures being as high as 20 percent for some groups, obtaining high-quality samples from an established point of access not only expedites the process, but reduces frustration on both sides of the encounter.
The University Hospitals of Cleveland’s Medical Center (UHCMC) has also implemented technology to draw blood from VADs. UHCMC has conducted over 40,000 successful draws from lines reducing the number of venipunctures performed by 30 percent or more.
Safety Blood Collection Set Winged blood collection needle with safety shield
g Designed to activate as the needle is being removed from the vein
g g
Audible click assures the safety mechanism is properly engaged
Clear body for ‘flash’ visibility
Greiner Bio-One, Inc. | 4238 Capital Drive | Monroe, NC 28110 | Phone: (888) 286 3883 |
Marketing@us.gbo.com |
www.gbo.com
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