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WHO accuse on illustration Blood: finest Practices in Phlebotomy. Geneva: world Health Organization; 2010.


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This thing covers all the steps recommended for safe phlebotomy and reiterates the embraced principles because that blood drawing and blood collection (31). The chapter includes background info (Section 2.1), valuable guidance (Section 2.2) and also illustrations (Section 2.3) pertinent to ideal practices in phlebotomy.

The information given in this ar underpins that given in the remainder of part II for particular situations. Chapter 4 likewise provides info relevant come the procedure for illustration blood given below in ar 2.2, however focuses top top blood collection from donors.

Institutions deserve to use this guidelines to establish standard operation procedures. Such procedures should clearly state the threats to patients and also health workers, and the means to reduce those risks – discussed below in sections 2.1.4 and also 2.2.


2.1. Background information on ideal practices in phlebotomy

Best methods in phlebotomy involve the complying with factors:


planning ahead;
using an suitable location;
quality of laboratory sampling.

2.1.1. Planning ahead

This is the most important component of delivering out any procedure, and is normally done in ~ the begin of a phlebotomy session.


2.1.2. Using an proper location

The phlebotomist must work in a quiet, clean, well-lit area, even if it is working through outpatients or inpatients.


2.1.3. Top quality control

Quality assurance is crucial part of best practice in infection prevention and also control (1). In phlebotomy, it helps to minimize the opportunity of a mishap. Table 2.1 lists the main components of high quality assurance, and also explains why they space important.


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2.1.4. Quality treatment for patients and health workers

Several factors can improve safety standards and quality of treatment for both patients and health workers, and laboratory tests. This factors, discussed below, include:


Availability of appropriate supplies and also protective equipment

Procurement of provides is the straight responsibility that the governmental (management) frameworks responsible for setup up phlebotomy services. Administration should:


make available sufficient activities sample tubes to protect against dangerous techniques (e.g. Decanting blood come recycle activities tubes).

Several safety-engineered gadgets are accessible on the market; such devices reduce exposure to blood and also injuries. However, the use of such devices should it is in accompanied by other infection prevention and control practices, and also training in your use. Not all safety devices are applicable come phlebotomy. Prior to selecting a safety-engineered device, users need to thoroughly investigate available devices to determine their appropriate use, compatibility through existing phlebotomy practices, and also efficacy in protecting staff and also patients (12, 33). Annex B provides additional information on epidemic prevention and also control, safety and security equipment and best practice; Annex C gives a considerable guide come devices obtainable for illustration blood, including safety-engineered equipment.

For setups with low resources, price is a driving factor in procurement that safety-engineered devices.

Where safety-engineered tools are no available, experienced use of a needle and also syringe is acceptable.


Availability the post-exposure prophylaxis

Accidental exposure and certain information around an incident need to be taped in a register.

Support services must be advocated for those that undergo accidental exposure. PEP can help to avert HIV and hepatitis B epidemic (13, 27). Hepatitis B immunization need to be detailed to all health workers (including cleaners and waste handlers), either upon entry right into health-care services or as part of PEP (34). Annex D has details the PEP because that hepatitis B and HIV.


Avoidance that contaminated phlebotomy equipment

Tourniquets are a potential source of methicillin-resistant Staphylococcus aureus (MRSA), through up come 25% of tourniquets contaminated through absence of hand toilet on the component of the phlebotomist or reuse of contaminated tourniquets (35). In addition, reusable finger-prick devices and also related point-of-care testing tools (e.g. Glucometers) contaminated v blood have actually been implicated in outbreaks of hepatitis B (4, 5, 36).

To avoid contamination, any type of common-use items, such together glucometers, need to be visibly clean before use on a patient, and single-use items have to not it is in reused.


Training in phlebotomy

All staff should be trained in phlebotomy, to prevent unnecessary threat of exposure to blood and to mitigate adverse occasions for patients.


Supervision by competent staff and also structured cultivate is vital for all wellness workers, including physicians, who undertake blood sampling.
Patient cooperation

One the the vital markers of quality of care in phlebotomy is the involvement and also cooperation that the patient; this is mutually useful to both the health and wellness worker and also the patient.

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Clear info – either composed or linguistic – have to be obtainable to each patient that undergoes phlebotomy. Annex F offers sample text for explaining the blood-sampling procedure to a patient.


2.1.5. Quality of activities sampling

Factors that affect the result of activities results during collection and also transportation include: