≥92% of LPNs will know how to perform venipuncture and maintain an IV site.
CEUFast, Inc. is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. ANCC Provider number #P0274.
≥92% of LPNs will know how to perform venipuncture and maintain an IV site.
After completing this continuing education course, the participant will be able to meet the following objectives:
Often, a patient will need venipuncture for some reason. They may need routine labs drawn, they may be suffering from a chronic illness, or they may be acutely ill. Regardless of the reason behind venipuncture, specific content must be reviewed.
First off, the anatomy of the skin and veins must be discussed. Understanding veins, how they work, and where they lead is essential.
It is also essential to understand the types of blood tests that can be commonly performed and what each test will tell us, such as how organs are functioning.
The steps of inserting a needle and IV catheter are outlined, including the necessary equipment and techniques to ensure venipuncture and IV success. The course will also outline the assessment, maintenance, and documentation of the venipuncture and IV procedure.
Steps for adults versus pediatric IV and venipuncture are discussed as the process can differ depending on the patient's age.
First, let's discuss the skin and veins to gain a foundational understanding to increase the chances of venipuncture success.
Various blood tests can be run to diagnose and manage certain illnesses. Venipuncture is performed to acquire blood for these lab tests, so they are worth reviewing (National Heart, Lung, and Blood Institute, 2022).
Blood Chemistry Studies: This test, also called a chemistry panel, measures chemicals in the body that help to show how everything is functioning. Blood chemistry studies may look at various items, such as hormones, vitamins, proteins, minerals, fats, and electrolytes, which are crucial in keeping the body functioning adequately.
Electrolyte panels are an example of a blood chemistry test. Electrolyte panels examine specific electrolytes such as magnesium, sodium, and potassium.
Renal panels are performed to look at specific functions of the kidney.
A comprehensive metabolic panel (CMP) includes the same as a BMP, but also includes liver function tests.
Blood Lipid Profile: This test is also called a cholesterol panel, a lipid test/profile, or a coronary risk panel. The blood contains lipids or fat molecules. An increase or buildup of lipids in the arteries and vessels can increase a patient's risk of a heart attack or other cardiovascular complications.
There are five lipids measured in a blood lipid profile. They include:
Total cholesterol: Overall cholesterol levels that include HDL, VLDL, and LDL.
Triglycerides: This is from the intake of food. Intaking a lot of bad foods will cause an excess amount of triglycerides, increasing the risk of heart problems and an inflamed pancreas.
B-type Natriuretic Peptide (BNP): This test measures this specific hormone and provides information on the functioning of the heart. Higher levels may mean the heart is not pumping adequately and blood is not getting to the areas it should be. An elevated BNP could also mean the kidneys are not working as they should.
Liver Function Tests: Many liver function tests can be performed to check the enzymes in the liver for evidence of any damage or disease.
Alanine transaminase, or ALT, helps the liver use proteins for energy. When ALT levels are increased in the blood, it may indicate the liver has some damage.
Aspartate transaminase, or AST, metabolizes amino acids. Increased levels of ALT may also indicate liver damage.
Alkaline phosphatase, or ALP, assists the liver in breaking down proteins. High levels of ALP in the blood may indicate the liver is damaged or diseased.
Bilirubin is produced when red blood cells break down. If there are elevated levels of bilirubin, it could indicate liver damage or even anemia.
These are just some examples of common blood tests. There are many others out there that are used to help identify diseases and diagnose patients.
There are different colored tubes that are used with venipuncture. Each tube has a colored top, which indicates the additive, and what the tube tests for (University of North Carolina [UNC] Medical Center, 2021).
Ensure the blood is mixed with the coagulant; this is usually performed by a centrifuge for eight minutes.
Pink top: The tube with the pink top is similar to the purple top. It also contains EDTA, but it is used more with blood analyses for blood transfusions. It allows for examining blood types for comparison to other types, also called cross-matching. It also requires mixing with the added anticoagulant for eight minutes in the centrifuge.
The blue top tube requires filling to its limit; it may not be useful if not filled fully.
Yellow top: The tube with the yellow top is often used for blood chemistry tests looking at hormones. Any test that depends on the separation of the serum of the blood is performed with a yellow top tube. The silica particles in this tube separate the red blood cells from the plasma. The blood serum is separated in a centrifuge, and the top portion or layer will become yellow.
Gray top: The tube with the gray top is not used very often because the yellow top tube also includes the same tests plus more—the gray top tube just tests for lactate and blood sugar. The gray top tube contains sodium fluoride, ensuring there is no sugar breakdown in the sample. It also contains potassium oxalate, which acts as an anticoagulant.
Red top: The tube with the red top is also not commonly used. When it is used, it tests for hormones and toxicology screens. However, the yellow top tube can also test for all of this and more.
Light green top: The tube with the light green top is used in biochemistry tests as it contains lithium heparin to collect heparinized plasma.
At times, the collection of blood cultures must occur. Blood cultures help determine if there are pathogens of bacteria in the blood that is supposed to be sterile and free of infection.
The blood culture bottles are similar to vacuum tubes but are shaped differently. A special media in the blood culture bottles preserves aerobic or anaerobic microorganisms, and each is tested. The aerobic bottle is filled first, and the anaerobic bottle is filled second. However, the anaerobic bottle should be filled first if a syringe is used. However, most blood culture bottles have been designed so that collection via a syringe is unnecessary. The bottles have longer necks that fit into the tube holders commonly used for regular blood draws (Ombelet et al., 2019).
Collecting the right amount of blood is necessary to test for microorganisms. Around 10 mL of blood is common. However, it depends on the facility protocols, the manufacturer, and the collection method. Around 5 mL may be required for pediatric patients. If insufficient blood is collected, microorganisms may not grow properly, and a diagnosis may be missed. The same may occur if too much blood is collected.
Now that we have discussed venipuncture tests, let's proceed to the insertion process.
Alert: Aseptic technique should be used on all venipunctures, tubing, and dressing changes.
When selecting a vein to perform venipuncture, consider the following factors:
Veins for Venipuncture
|Back of Hand |
|Inner wrist |
|Inner Elbow |
|Ankles and Feet|
Central lines will be discussed in another course in this series.
|Catheter||Purpose||Max flow rate||Volume|
|250-300 mL/min||Extra large|
Use only catheters with a safety protection feature to guard against needlesticks (Nettina, 2019).
Depending on the insertion being performed, the equipment can differ.
If using safety needles, a 22G or less will be needed. If using butterfly needles, a 21G or less will be needed.
Syringes, a transfer device, a vacutainer tube holder, and blood collection tubes will also be necessary. Vacuum tubes withdraw a specific amount of blood that is predetermined.
Other equipment includes a tourniquet, alcohol wipes, gauze, a sharps disposal container, and bandages/tape (Nettina, 2019).
The shallower the veins, the sallower the insertion angle must be.
IV insertions into the hand should be done at 10-20°. The deeper the vein, the steeper the approach could be. A deep vein should be done with at least a 20-30° angle.
Shallow attempts can be painful for the patient, often resulting in a second stick and tissue damage.
Hand veins can be quite shallow. If necessary, start at 20-30° to break the skin, then change the angle to 10-20° to follow the vein.
Arm and leg veins have more tissue, and insertion should begin at a 20-30° angle.
The antecubital fossa vein is much deeper. It is possible to start at 20-30° to break the skin and then change the angle to 40-45° (Beecham & Tackling, 2022).
There are other techniques that can be used.
To reduce pain during venipuncture, penetrate these layers quickly.
The anesthetic decreases pain but may cause the vein to collapse (disappear) or cause an allergic reaction. A warm compress may decrease the vasoconstrictive effect of the local anesthetics.
The IV catheter and tubing should be secured to prevent dislodging and irritation at the catheter site. The facility usually determines the IV site dressing and stabilization device. A transparent semipermeable dressing and tape are often used. More reliable devices are made but may not be used by your facility. Be sure to tape the tubing to the skin several inches above the insertion site to prevent dislodging when manipulating the fluid bags or pumps (Bond et al., 2016).
Hydration is critical when performing venipuncture. The veins are more likely to dilate when the body is hydrated. If the venipuncture can be planned, ensure the patient hydrates beforehand.
Nurses should assist with ensuring the patient is relaxed. Tension and stress can constrict the veins, limiting the potential of successful venipuncture or infusion.
Sometimes, a blood return does not occur. Instead of immediately discontinuing the insertion, some techniques can be tried to create a flashback or ensure the catheter is patent.
A slow and gentle approach should be used to get a flashback. Pulling too quickly or with too much force can damage the vein.
It is possible the syringe could be the problem. A smaller syringe, 5 mL compared to 10 mL, will generate less force and may produce a flashback.
Position changes may cause a flashback; the catheter may have been against the vein wall.
If it is a peripheral IV, try placing the tourniquet on the same arm above the catheter, then try to aspirate again.
If none of these tips work, likely, the catheter is not functioning correctly, possibly due to it being in an incorrect position. Assess the site for redness, swelling, or fluid leakage.
The catheter should be flushed with normal saline (NS). If it meets resistance during this flushing, there is a problem. The area near the insertion site should be palpated before and during the flushing. If the patient complains of pain, the process should be stopped. If the flush cannot be felt going through the vein or the fluid stays at the tip of the catheter, it is malfunctioning or incorrectly placed.
The patient will feel all of this that is going on. They are a key resource to let you know if something is going awry with the venipuncture. Complaints of pain in other areas of the body, especially when flushing a central venous catheter, could indicate a location or catheter issue.
Use an aseptic technique when changing tubing and bags or bottles. The system can be set up in the medication room or at the patient's bedside. Most medication rooms have enough room to lay out the equipment and control the sterile ends of the bags, bottles, and tubes.
Use only bags or bottles that are sealed and within the expiration date. If the contents of the bag or bottle of IV fluid are cloudy or not the color it is supposed to be, do not use it. The addition of medication or parenteral nutrition may change the color. These additions should be noted on the bag by the pharmacy or by the nurse who added the substance.
Filters are usually built-in lines used for blood or parenteral nutrition. Some filters can be added between the tubing and the IV bag. Most facilities standardize to avoid problems. If you need a special filter for blood infusion, the blood bank will provide that add-in filter or special tubing with a built-in filter.
Most infusion pumps require special tubing. The facility will standardize this tubing as well. Secondary administration tubing is used to piggyback IV medication bags to infusion tubing. The medication bag should always be hung higher than the IV-liter bag (Nettina, 2019).
There is specially coated tubing that prevents the leaching of polyvinyl chlorine from the tubing. The coated tubing should infuse nitroglycerin, paclitaxel, and cyclosporine.
Minimize tubing manipulation and multiple components in the tubing to reduce the chances of contamination.
The frequency of changing the IV administration sets is specific to facilities.
The tubing system must be labeled when it is hung with the date, the time it was opened, and the person's initials applying the tubing. The labeling allows everyone to identify when the tubing needs to be changed (Nettina, 2019).
Spiking and priming the tubing are two processes that nurses should be familiar with. As discussed above, tubing delivers solutions such as fluids or medications to the bloodstream. Often, a pump can be used to assist with this process.
To spike an IV bag means to penetrate it with the spikey end of the tubing. There is a spiking port on the IV bag.
To spike an IV bag:
All safety precautions, including standard ones, should be followed for safety reasons. Always wear personal protective equipment. Hand hygiene is essential, even if gloves are worn, and should be performed during all venipunctures. The skin can be palpated without gloves if it is not punctured or broken. However, hand hygiene must occur after, and gloves should then be worn (Doyle & McCutcheon, 2015).
Gloves should be discarded in the appropriate areas.
Contaminated surfaces must be cleansed with proper cleaning items, such as a 10% bleach solution.
To prevent potential patient harm, ask for two identifiers to verify the patient's identity.
Explain the process to the patient, ensuring that all details and reasons are provided. The order should be verified (Doyle & McCutcheon, 2015).
The provider (doctor, physician assistant, or nurse practitioner) orders the flow rate.
The nurse should notify the provider if the patient's rate does not seem correct. Considerations include age, patient condition, patient tolerance of the infusion, and the prescribed infusions.
The very young and elderly can easily experience fluid overload. The flow rate should be slower, or the patient must be carefully monitored.
The patient's condition will often determine the flow rate. Someone in hypovolemic shock requires a large amount of fluid. Someone with heart or renal failure requires restricted fluids.
Some medications cause vascular irritation (potassium chloride, Phenergan) or have the potential for an allergic response (antibiotics). These medications should be more diluted or infused slowly.
Some medications' efficacy is based on the administration time and infusion speed (antibiotics). Some medications must be titrated based on the patient's response (dopamine, nitroprusside, heparin).
An infusion pump controls the flow rate more efficiently and accurately; therefore, using a pump is considered the best practice. However, pumps are expensive; therefore, they may be a limited resource. Infusions not on a pump require more frequent monitoring of the flow rate. Flow control dials or clamps and occlusive clamps can slip or be dislodged. Another potential flow problem is the stretching and distorting of the tubing due to patient movement. Cold or viscous solutions can also cause flow fluctuations (Nettina, 2019).
An infusion pump measures the flow rate in mL/hours. To find the rate in mL/hour for an infusion pump, divide the total number of mL by the total number of hours (Nettina, 2019).
1000mL/8 hr = 125mL/hr (rate for an infusion pump)
When you regulate an IV flow rate with a clamp or dial controller, the rate will usually be measured in drips/minute. IV administration sets deliver a specific number of drops per mL. The number is on the package label. Standard drip sets deliver 10-20 drops/mL. Microdrip sets deliver 60 drops/mL, and blood sets usually deliver 10 drops /mL. Dial controllers may not be accurate if the IV catheter is less than a 20G.
A suggested formula for drips/minute (clamp or dial controller):
Total number of mL to infuse x drip factor (drops/mL) = flow rate (drops/minute).
Total number of minutes to infuse.
Example: Administer 1000mL of D5W over 8 hours using an infusion set that delivers 10 drops/mL.
1000 mL x 10 drops/mL = ? drops/min
8 hours x 60 minutes
1000 mL x 10 drops/mL = ? drops/min
2.08 mL/minute x 10 drops/mL= ? drops/min
20.8 drops/mL (21 drops/mL, round to nearest whole number)
Both short-term and long-term IVs require maintenance.
Heparin is no longer routinely used to flush and maintain catheters. However, you may still hear the term heparin lock or hep-lock. Hep-lock refers to a catheter with a short tube that is connected to the IV but not to a fluid bag or bottle. The hep-lock allows the patient freedom when the IV infusions are intermittent (Nettina, 2019).
An aseptic technique is used to access a hep-lock or IV tubing. Clean the hub of the hep-lock or tubing with alcohol. Do not contaminate the cleaned hub. Remove the protective cover from the injection device or tubing and connect it to the hub. Most systems have needless connecting injection devices and tubing. If not, tubing connected by a metal needle should be taped to the tubing to prevent accidental removal.
The infusion pump has pressure limit defaults to prevent adverse effects. However, the upper limits may be manually increased based on the following:
Medications and solutions administered may be diluted, added to a burette, administered with an infusion pump, used in a syringe, or administered directly as a push or a bolus. The proper method of administration depends on the patient's circumstances and the type of catheter used.
The medication must be diluted into a smaller volume when using a burette. The fluid/medication should be hung, and the roller clamp should be slowly opened to allow some of the contents into the burette. An additive port can be used to inject the drug.
If a secondary infusion is necessary, it can occur through a bag or syringe, depending on the medication.
For patients receiving intermittent transfusions, the disconnected IV lines should be discarded.
Before administration of fluids and medications, the cannula should be flushed. For patients who are not actively receiving fluid or medications through their IV line, it should be flushed at least once per shift. Sterile 0.9% sodium chloride should be used for flushing. A 10 mL syringe should be used for flushing as it prevents excess pressure and potential catheter rupture. If any resistance is felt when flushing, the patency should be reassessed.
As dressings are pertinent for protecting against complications such as infection and dislodgement, they must be kept clean, dry, and secure. Any excess fluid or blood leakage indicates the need for a dressing change. If possible, a transparent film should be used unless the patient is allergic.
The old one should be removed carefully when changing the dressing, ensuring the cannula stays in place. The edges of the tape should be loosened slowly, staying close to the skin's surface. While changing the dressing, assess the insertion site. A 2% chlorhexidine and 70% alcohol swab should be used for cleansing the area as needed. The skin should completely air dry before applying the dressing.
A cotton ball or small piece of gauze can be placed under the catheter's hub to reduce pressure. An IV board or splint can help stabilize the extremity when activity and movement are expected. Ensure that the extremity is positioned and strapped in a neutral position to reduce the chance of injury. The splint should be assessed daily and if soaked with blood or drainage. Overall, everything should be secure, the site visible if possible, the tape should not be too restrictive, and the patient should be free from harm.
Document all care provided, especially when performing venipuncture and IV maintenance. Documentation should include information on the needle, the site, and each time it is assessed or care is provided, such as a dressing change.
As a note, extension sets should be changed when the insertion site is changed or if contamination and/or injury has occurred (Nettina, 2019).
Assess the IV catheter at least daily for signs of infiltration, infection, phlebitis, or other complications. Also, remove if there are any signs of complications.
The insertion site should be assessed for signs of infection, including pain, swelling, and redness. The position of the catheter and the patency of the catheter should be assessed. The site should also be checked for any signs of extravasation, which can cause tissue damage and necrosis.
When assessing the dressing, ensure it is secure, intact, dry, and free of soaking blood. The bandages or dressings should not be so tight that it cuts off circulation, but also should not be too loose that it falls off, increasing the chances of catheter damage. The insertion site should always remain visible for assessment; transparent dressings can increase visibility.
If the patient has fluids or medications running through an IV, the fluid or medication, the infusion rate, and the equipment to infuse it should be assessed.
The catheter should be removed as soon as the patient no longer requires it; this prevents any further or unnecessary consequences (Nettina, 2019).
There are complications following venipuncture and IV insertion that should be discussed (Nettina, 2019).
Extravasation is the infiltration of vesicant solutions into the surrounding tissue.
|Catheter-associated bloodstream infection|
|Occlusion or sluggish flow|
Venipuncture is a scary and stressful experience for a child. Even though it is a routine procedure, needles can be scary. Ensuring the approach is calm may help to ease the stress and anxiety of routine venipuncture.
There are ways to ease the stress for children. First off is a distraction; this may be a good method that can be performed by the nurse or by the parents/caregivers. Positioning may decrease anxiety. However, if a child cannot see what is happening, it may increase anxiety. The use of music has been researched and shows it helps to ease stress. Family involvement in the process is crucial as they provide great comfort. If the child is fearful of pain, topical analgesics can be used.
Research has also shown that oral sucrose can be used in patients younger than six months old.
Education is just as important for children as it is for adults. Assure the child that the blood loss will not be harmful to them. In fact, a Band-Aid with cool designs may reassure the child that they will not bleed too much. However, bandages must be used cautiously in children who may remove them and try to swallow them.
Skin preparation is often performed in different ways. Chlorhexidine, isopropyl alcohol, and povidone-iodine have all been used. Though they each have benefits, disadvantages do exist. Follow policy protocol for skin preparation (Elsevier, 2022).
Education should be provided based on the age of the patient and the circumstances. Ensure the patient is capable of understanding the information they will be told. Use terms and words they can comprehend, depending on their age and education level.
Documentation should include the following:
There are some general tips to follow if venipuncture or blood samples are unsuccessful.
The patient or the needle may need to be repositioned.
The collection tube may not be up against the back of the needle/the hub.
The vacuum seal in the tube could be defective, and another tube should be tried.
The tourniquet may be too tight.
Probing can be damaging to the vein and harmful or painful to the patient. Depending on the patient and the circumstance, they should not be stuck more than twice by the same person (Nettina, 2019).
General documentation of IV therapy should include the following:
Patient education should include the following:
Jessie is a phlebotomist who works in the laboratory department, often assisting with blood draws for patients in the emergency department.
Jessie has received a call about Ethel, a 72-year-old female in the emergency department with complaints of nausea, vomiting, diarrhea, and intermittent stomach pain for three days.
The emergency department sees Ethel within thirty minutes of her arrival. A nurse examines the patient and decides that the patient will need blood work and scans. Because the patient's hydration has been affected by nausea and vomiting, she will likely need fluids replaced. Instead of sticking her twice, once for blood and once for an IV, the plan is to place an IV and draw labs simultaneously.
The nurse is having difficulty finding veins. She has tried a tourniquet, fist-pumping, and the use of gravity. The lack of hydration probably contributes to the difficulty in finding veins. The nurse tries to stick a 20G into the left antecubital area, but there is no flashback. The nurse tried a different syringe and also tried repositioning the arm. Still, there was no blood return. She tried to flush the catheter but was met with resistance.
The nurse decides to withdraw the needle and try again elsewhere. She spots a vein in the left hand that she thinks may work. She starts at a 40-45° angle with a 20G needle and pushes when she feels she is in the vein; she receives a small drop of blood return, but no more. The patient begins complaining of pain and burning, and the skin is visibly bruising. It is likely that she has gone through the vein wall on both sides, blowing the vein. The nurse withdraws the needle and decides to call Jesse.
Jesse makes his way to the emergency department and examines the veins on Ethel's arms. He has Ethel lay in bed and dangle her right arm off of the bed. While doing so, he also has her slowly pump her fist. He can palpate a vein in the right antecubital area. Jesse starts at a 20° angle as it is a deeper vein. He gets flashback and can withdraw blood and finish starting the IV, easily flushing NS through the vein.
What could the nurse have done differently? Was it just the luck of the draw? It is very possible that if the nurse's angles were changed, she would have gotten blood return and not blown the vein.
Venipuncture is a procedure that is commonly performed in many different settings. Because venipuncture can be complex, certain information must be reviewed. First, background information must be given about the skin and veins. Because our skin is the barrier against protection, any time it is broken, the risk of infection increases, including with venipuncture- this is why it is essential to try and obtain successful venipuncture in one attempt. Because the arterial system is also very complex, nurses should ensure adequate knowledge of arteries, veins, and capillaries.
It is also important to understand the types of tests that can be performed with blood. For example, blood chemistry panels can be run to determine electrolyte levels and minerals. Blood lipid profiles can be performed to monitor good and bad cholesterol. Liver function tests can be performed to determine the level of functioning of the kidney. These are just a few examples of the information that our blood can tell us.
How blood tests are taken and how the results are configured are also important. There are many different tubes with various colored tops. Each top represents additives and the types of tests that can be run. Blue top tubes are for hematology tests, yellow tops look at hormones, tumor markers, and blood toxicology levels, and tubes with dark green tops look at insulin and renin. These are just a few examples of color indicators with blood tubes.
Another important aspect of venipuncture is the collection of blood cultures, which are essential in identifying bacteria in the blood. The collection of blood cultures must be performed in an aseptic and proper manner. Collecting the right amount of blood is necessary to determine the type and growth of bacteria.
The insertion of an IV needle and catheter must require a proper technique to reduce the risk of complications. Several factors should be reviewed before insertion. The catheter size, the type of solution, the vein and its condition, the duration of therapy, the age and status of the patient, and the patient's preference and activity should all be considered before the insertion procedure. There are advantages and disadvantages to each insertion site. For example, the inner wrist is excellent for butterfly needles. However, it usually results in a painful insertion for the patient. The antecubital veins allow for rapid infusions because of the size of the vein. However, they restrict the patient's motion. The advantages and disadvantages and risks and benefits must be reviewed with the patient.
After an insertion site has been decided, it is time to prepare the equipment. Depending on the site and circumstances, additional equipment may be needed. However, basic equipment includes safety needles, syringes, tape, bandages, a tourniquet, and gauze. The site should also be prepped, thoroughly cleaned, and allowed to air dry.
Depending on the location of the site, different angles of insertion should be used. For example, the deeper the vein, the steeper the approach could be. A deep vein should be done with at least a 20-30° angle.
It is possible that vein finding can be tricky, but there are methods to find or distend a vein, such as ultrasound, gravity, or hydration.
If no flashback is received, tips and tricks, such as positioning, may allow a flashback. However, if the tips do not work and continual resistance is met, the needle is not in the right place, and the catheter is not patent.
After placing a catheter, the site can be used for venipuncture, infusion, or as needed. When infusions are ordered, the tubing should be correctly used. Tubing should be primed, and bags may need to be spiked. Follow facility protocol with these procedures.
Flow rates and infusion rates must be calculated correctly to prevent patient harm. Infusion rates are usually ordered as volume (mL) per hour. An infusion pump measures the flow rate in mL/hours. To find the rate in mL/hour for an infusion pump, divide the total number of mL by the total number of hours. If the rate seems incorrect, have someone else double-check and confer with the provider.
For patients who will have insertions long-term, regular maintenance should occur. Maintenance includes ensuring the catheter stays patent with flushing. Assessment of the catheter includes looking for infection and infiltration. Complications include infiltration and extravasation, phlebitis, circulatory overload, and air embolism.
Venipuncture in children requires a different approach. Steps should be taken to ensure that the pediatric patient is educated about the procedure and that their anxiety/stress is calmed. The family should be involved in the procedure as much as possible; this can decrease anxiety for the child. Precautions should be taken when performing venipuncture or an insertion in infants, as they can easily and accidentally pull out the catheter.
A lot of information on venipuncture and maintenance has been provided. It is important to review facility protocols and policies to follow their guidelines and regulations. Protocols should outline hand hygiene and an aseptic technique for certain procedures, which is always a critical component of care. No matter the procedure, ensure patient understanding and patient comfort. Always explain the steps of any procedure to maximize the patient's understanding while minimizing their anxiety.
CEUFast, Inc. is committed to furthering diversity, equity, and inclusion (DEI). While reflecting on this course content, CEUFast, Inc. would like you to consider your individual perspective and question your own biases. Remember, implicit bias is a form of bias that impacts our practice as healthcare professionals. Implicit bias occurs when we have automatic prejudices, judgments, and/or a general attitude towards a person or a group of people based on associated stereotypes we have formed over time. These automatic thoughts occur without our conscious knowledge and without our intentional desire to discriminate. The concern with implicit bias is that this can impact our actions and decisions with our workplace leadership, colleagues, and even our patients. While it is our universal goal to treat everyone equally, our implicit biases can influence our interactions, assessments, communication, prioritization, and decision-making concerning patients, which can ultimately adversely impact health outcomes. It is important to keep this in mind in order to intentionally work to self-identify our own risk areas where our implicit biases might influence our behaviors. Together, we can cease perpetuating stereotypes and remind each other to remain mindful to help avoid reacting according to biases that are contrary to our conscious beliefs and values.