Do you and your staff suffer from an anxiety deficiency? Do you wish you had more to worry about? Are you tired of being safe all the time? Of course not, but a few careless mistakes in the way your employees draw blood from patients and they could be among the hundreds of thousands of healthcare professionals who sustain an accidental needlestick every year.

What follows is a list of what not to do when drawing blood. Share this with your team and post it in a very visible location in your lab.

1. Recap a needle. Historically, this man­euver is responsible for more needle­sticks than any other behavior. OSHA prohibits recapping, but many individuals feel this only pertains to "the careless." They also may not realize that some patients have hepatitis, HIV or any of the other 18 diseases that can be transmitted by exposure to contaminated blood.

2. Don't wear gloves. Many say gloves make their hands sweaty, itchy and deaden the finger's sensitivity when it's time to find a vein. They also argue that gloves aren't going to stop a needle. Don't accept these excuses.

3. Use syringes as much as possible. The National Institute of Occupational Safety and Health (NIOSH) associates syringe use with the highest rate of accidental needlesticks; the Clinical and Laboratory Standards Institute (CLSI) says syringes should be avoided for safety reasons. The International Healthcare Worker Safety Center agrees with both organizations.

4. Use butterfly sets indiscriminately. The more you use a winged collection set, the more likely you are to be exposed to a contaminated needle. In fact, before safety features became prevalent, they were responsible for 32% of all accidental needlesticks to phlebotomists.

5. Place sharps containers out of reach. In reality, they should be close to the collection site and not pose a hazard to anyone.

6. Use non-safety needles. Some question the need to change if they've never had a needlestick. After all, they've worked hard to perfect their technique to a point where they've engineered away the risk completely. The CDC has shown that needles with safety features reduce accidental needlesticks by up to 76%, even by the most careful and aware phlebotomists.

7. Let sharps containers overfill. Most people are conscious about recycling, reusing and getting the most out of things to save money, and their efforts are commendable. Sharps containers, however, should not be on this list. Don't feel it's better to stuff them before discarding.

8. Pause before activating the needle's safety feature. Sixty-two percent of accidental sticks occur within moments of when the needle is removed from the patient; activate the needle's safety features promptly.

9. Remove the needle. After all, a tube holder is a terrible thing to waste, right? Wrong. Keeping the needle in the holder must be exercised and taken seriously.

10. Anchor the vein above the puncture site. Using the "two-finger-stretch" to anchor veins from above and below the intended puncture site to assure the vein won't roll is not advised. Doing so is severely compromising your safety.

11. Don't use safety transfer devices. When a syringe is used to draw blood, some people have reported piercing the stopper with the same needle used to stick the patient. The time spent to activate the needle's safety feature and replace it with a safety transfer device is well worth it.

12. Disassemble safety features. Believe it or not, some also have reported tearing off safety features, claiming they get in the way. These features are there for a reason, however, and should be maintained.

Clearly, some of these practices are outlandish and unbelievable. The cost to your employees' health and the amount to treat the potential disease or incident that results is not worth the risk.

Dennis J. Ernst is the director of the Center for Phlebotomy Education Inc. in Corydon, IN. For more information on studies referred to here, visit his Web site at www.phlebotomy.com.