– Thu. Comments:15. Select a vein other than the one with the IV. Maintain tourniquet only 1�2 minutes. � Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. � Draw 5 ml of blood and discard before drawing the Our state online blanks and clear instructions eliminate human-prone faults. T Check for allergies to any materials used, e.g., povidone-iodine. 2. � Dispose of equipment in appropriate manner. � Remove gloves. Comments:13. Comments:17. h�bbd``b`J�@������3012�I00b%�3.� ` ��� If any, wipe away with alcohol. Check with your location’s dress code. 1. Time, source/site, specimen sent to lab (specify for what test). Prepare participant by telling them what you will be doing. C. Placed towel or bed protector under extremity to protect linens. 2. Comments: 3. � The phlebotomy course is used to certify individuals in the task of venipuncture and blood draw. Competency Checklist Procedure SL 07 Phlebotomy Competency Checklist Procedure Goal: After the clinical laboratory science student has completed each of the following activities, he/she will be able to complete the Student Laboratory Phlebotomy Competency Checklist Procedure: 1. ������������������޻޳ޫޣޛޓދރ�{�s�k� j�* hZ� Uj ' hZ� Uj3# hZ� Ujf hZ� Uj� hZ� Uj� hZ� Uj� hZ� Uj2 hZ� Uje hZ� Uj� hZ� Uj� hZ� Uj� hZ� Uh�D hZ� 5�CJ OJ QJ \�^J hZ� hZ� 5�CJ OJ QJ \�^J h�D 5�CJ OJ QJ \�^J ) 9 � � � � � + = O � � � � � � � � � � $$If a$ $If � � �x Comments:11. T � 43 0 obj <>stream Please use the scale below Please use the scale below to describe your experience/expertise in each area listed below. Patient begins to cause a scene in a very crowded drawing area, stating if she can’t have a butterfly she will leave. Competency Assessment/Training Needs Assessment and Implementation Guide Guideline: From the checklist, determine the prerequisite activities (if any) required to fulfil the competency. Phlebotomy is the practice of obtaining venous blood (i.e. Placed ACC Eastview Campus Building 8000, Room 8356 3401 Webberville Road Austin, TX 78702 Phone: (512) 223-5700 Toll-free: (888) 626-1697 Hours: Mon. Comments:25. 0 � l a� f4 � Phlebotomist nicely asks to look at her arm to determine if a butterfly is necessary. Phlebotomy Training Checklist. The theory and suggested methods of evaluation are provided as a curricular guide for educators in developing cognitive objectives, performance . Apply the tourniquet below the IV site. O P { � 3 Prepare equipment so you are ready to obtain sample. AECA: Evacuated Tube Venipuncture Competency Check (P-CS5) Important Note: The competency checklist has been designed only to provide general information. � endstream endobj 32 0 obj <> endobj 33 0 obj <> endobj 34 0 obj <>stream Competency will be determined at the end of the clinical experience when, in the professional opinion/judgement of the clinical instructor(s), the concepts and basic skills on this checklist have been completed at an 85% level. � Some of our publications are also available in hard copy, but this may entail a small charge. 2. Allow to dry. Ideal site is straight, prominent vein that feels firm and slightly rebounds when palpated. � This competency booklet is your personal record of development in performing venepuncture competently in clinical practice. Comments:21. 9. PRIMARY CERTIFICATION AND REGISTRATION DIDACTIC AND CLINICAL COMPETENCY REQUIREMENTS ARRT® BOARD APPROVED: JANUARY 2016 EFFECTIVE: JANUARY 2017 1 COPYRIGHT© 2015 BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS® ALL RIGHTS RESERVED. Reapply a clean tape and gauze if necessary. S List the names of three (3) regulatory bodies setting documentation standards 4. Hold needle at 15��30� angle from skin, bevel up. � State the names of different types of nursing documentation 5. … Blood should flow into the collection tube. � This form is to describe what is entailed in completing the initial competency assessment for Intravenous Insertion and Venipuncture. 1. � Comments:12. � � You may also hear it referred to as ‘venepuncture’. Place tubes in appropriate bag or container along with laboratory requisition slips. Phlebotomy: A Competency-Based ApproachThe third edition of Phlebotomy: A Competency-Based Approach was designed to provide a complete introduction to the practice of phlebotomy, with complete coverage of safety procedures, equipment, point-of-care testing, and other skills. from a vein) samples from patients. Use a butterfly. Comments: 5. Procedure 1. 9 ? � hޜS[k�0�+z�pں,]��:y�-18v�UH��t$�IS��!�������G� �(A. (In front of … � Name: Phlebotomy Skills Verification. Comments:7. � A belligerent patient presents for blood draw; insisting on a butterfly needle. Hold Vacutainer securely and advance specimen tube into needle of holder, being careful not to advance the needle further into the vein. Name: _____ Phlebotomy Skills Verification Each venipuncture must be observed by an RN and evaluated according to the following performance criteria. It is your assigned mentor who has the responsibility to ensure that you have successfully performed all applicable to facilities that have a phlebotomy team) PA.001 … � 3. � � � � � � � � � � � � � � � � � � � � $If $If �. Evaluees will not double stick their patient 6. � Allowing the disinfectant to air-dry on the venipuncture site before drawing the blood specimens Allowing the blood tube to fill until the vacuum is exhausted before removing the tube from the needle and its holder assembly Keeping the tourniquet tightened on the patient's arm for a prolonged period of time before performing the venipuncture Hold arm straight. 4 Comments:27. � Fill out, securely sign, print or email your Phlebotomy skills competency checklist - collin instantly with SignNow. Record results of any test performed on the unit. Evaluees will notify an … Check tubes for external blood. 2. � Training Checklist Inpatient/Outpatient Capillary Collection Training For Adults and Pediatrics Inpatient/Outpatient Venipuncture Collection Training For Adults and Pediatrics Phlebotomy Venous Blood Gas Collection Place thumb or forefinger of nondominant hand 1 inch below site and pull skin taut. 1. > d : Competency Checklist for Venipuncture: Vacutainer Method Name _________________________________________________________________ Date ____________________________ Instructor ______________________________________________________________ VenipunctureAble to PerformAble to Perform with AssistanceUnable to PerformInitials and DateGeneral Guidelines for Specimen Collection 1. PERFORMANCE CHECKLIST (PCL) VENIPUNCTURE 2 5. Comments:8. Cleanses venipuncture site with alcohol pad in outward circular motion. H Slowly insert needle. $If $If gd�D $If � kd $$If �l 44� �r ��B-f!�%w) � �������� � ������������ 9 ������������ 9 �������� � ���� �0 � � � � � � � 6� � � � � � � �� ������������� ����������������������������������� � �4� ? Wash hands. Do not recap any DIRTY needles 7. Washes hands. Perform the venipuncture. Extend arm to form a straight line from shoulder to wrist. � � � � � ���� � � � 8 � D . 2. Professional Behavior. Identify best venipuncture site by palpation. Apply tourniquet 3�4 inches above venipuncture site. NOTE: Tourniquet should be able to be removed by pulling the end with a single motion. Check tubes for proper labeling. The Venipuncture Competency For Independent Phlebotomists (IP) Assessment Program is a one-hour assessment to: Act as an assessment for independent phlebotomy (IP) venipuncture competencies in Nova Scotia, which is a requirement of their specimen acceptance Agreement with the Nova Scotia Health Authority and IWK. Check the accuracy of participant�s name and birthdate per identification policy before starting the procedure 2. 36 0 obj <>/Filter/FlateDecode/ID[<566A759B5E07A2439FBDB1271A27463C>]/Index[31 13]/Info 30 0 R/Length 48/Prev 17151/Root 32 0 R/Size 44/Type/XRef/W[1 2 1]>>stream Blood should flow into the collection tube. Check for blood flow. Comments:18. UCHC Competency Checklist: ORIENTATION Position Title: Phlebotomist Employee Name: Unit: Laboratory Medicine Initials Signature Initials Observes patient for adverse response to phlebotomy: Disposes of sharps according 3. � Follow the simple instructions below: The prep of legal documents can be high-priced and time-consuming. Inspect the puncture site for bleeding. Comments:23. Comments: 2. N H ? � After specimen collection complete, remove tourniquet. GUIDELINE FOR CLINICAL STAFF ON VENEPUNCTURE Version Number V2 Date of Issue December 2016 Reference Number VG-11-2016-ROSLPFON-V2 Review Interval 3 yearly Approved By Name: Fionnuala O’Neill Title YES NO 1. 4 � � b b ( � � � e e e � � � � � � � $ � � � � � e e e e e � � � � � � � 7 7 7 e F � � � � � 7 e � 7 7 7 � ���� Pk�En�� ���� � F 7 s � 0 7 @ � F @ 7 7 @ � K ( e e 7 e e e e e � � 7 e e e e e e e ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� @ e e e e e e e e e & � ��ࡱ� > �� : ���� 7 8 9 ������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������ ]� �� � bjbj۷۷ 2v ��&\��&\� � �� �� �� � & & Remove needle cover and let participant know they will feel needle stick. Comments: 19. 3. Venepuncture is a broader term, meaning puncturing a vein to draw blood but also for other procedures, such as … 4. Comments:24. � Apply 2 x 2 gauze over puncture site without applying pressure and quickly remove the needle from the vein. Put on nonsterile gloves. Wash hands. � � � Venipuncture Competency Form | Phlebotomists 101Get Venipuncture Competency Form … Now, working with a Phlebotomy Competency Checklist requires a maximum of 5 minutes. Phlebotomy Competency Checklist. Hold Vacutainer securely and advance specimen tube into needle of holder, being careful not to advance the needle further into the vein. Name _ Date _ Instructor _ Competency Checklist for VENIPUNCTURE Preparation 1. … Competency/Skills Checklist Skilled Nursing Employee Name Date October 29, 2007 THIS RESOURCE PROVIDED BY Nancy Cadieux, RN Homesights Consulting AHHIF Associate Member 941/921-8188 [email protected] Do not puncture the rubber stopper yet. Discuss the purpose of nursing documentation in health care. Comments:16. � B. endstream endobj startxref Comments:14. Competency are outlines of related theory and suggested methods of evaluation. Gather equipment. View Venipuncture Checkoff .docx from RN 42A at Fresno City College. Turn off the IV for at least 2 minutes before venipuncture. Send specimens to laboratory. � A. Comments:10. Peripheral Blood Draw Procedure Checklist 6 month assessment Strong Memorial Hospital Check YES only if step is completed to 100% accuracy. PRIMARY CERTIFICATION AND REGISTRATION DIDACTIC AND CLINICAL COMPETENCY REQUIREMENTS ARRT® BOARD APPROVED: JANUARY 2016 EFFECTIVE: JANUARY 2017 1 COPYRIGHT© 2015 BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS ® ALL RIGHTS RESERVED. � Get Venipuncture Competency Form now. � � After entering vein, slowly lower needle toward skin. Vacutainer method. Closed toed shoes are REQUIRED and flats or short (less than 1 in) heels. Have participant open and close fist several times, leaving fist clenched prior to venipuncture.. Page PAGE 1 of NUMPAGES 1 % 8 9 � O } � � � 3 Comments:20. � The line is open Monday-Friday (excluding � Immediately apply pressure over venipuncture site with gauze for 2�3 minutes or until the bleeding has stopped. Select site. After collection tube full, grasp Vacutainer firmly and remove tube; insert additional collection tubes as needed. � Hair must be tied back if the hair on both sides of your head if it is long enough to meet under your chin when you lean forward. Identify the components of complete documentation 3. � For more information and to order a hard copy please call 0345 772 6100 and select option five. B.9 Releases tourniquet and allows swabbed area to air dry while preparing equipment B.10 Retighten tourniquet and … � � After collection tube full, grasp Vacutainer firmly and remove tube; insert additional collection tubes as needed. Comments:9. 31 0 obj <> endobj %PDF-1.5 %���� Comments:Documentation/Follow up 1. venipuncture sites by looking for veins that are relatively straight. Comments:22. However, with our pre-built web templates, things get simpler. What would be the parameters to report in an urgent fashion? %%EOF h�b```f``a �Pn�f`B/�g\��d� �@�����z��Jh�c_4k�����`����|B� 8�� � � Check for distal pulse. � If tourniquet has been on too long release it, wait 1�2 minutes and reapply. � � �x gd�D a. Vacutainer method: Attach double-ended needle to Vacutainer and have proper blood specimen tube resting inside the Vacutainer. It is to be It is to be used as a guide for the preceptor and the employee to understand the expected knowledge, skills, and attitude (KSA) that is required to safely � � Comments:26. Checked agency protocol about shaving if site is very hairy. We provide a full listing of phlebotomy schools, courses and programs in your local area. If none, tourniquet is too tight and should be reapplied. Comments: Copyright � 2007 Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved. 4. Who should you report the urgent findings to? Dilated the vein A. 6. � Thread needle along path of vein. Steps 1�5 of General Guidelines. Cleanse site with approved solution per policy using circular motion at the site and extending 2 inches beyond the site. 1 = No experience; Theory/observed only 2 = Limited competency; < 5 times per year; Needs supervision 3 = Acceptable competency; > 5 times per year 4 = Competent; Performs on a daily or weekly basis; Proficient Comments:6.

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