9. A separate order of draw is required for syringe collections. Although one lone textbook continues to perpetuate this annoying myth, the need for a separate order of draw for syringes has no basis in the literature. This falsehood has never appeared in the CLSI standards. In fact, the standards have clearly stated a separate order of draw is unnecessary.
10. If an outpatient responds to her name being called, you know you have the correct patient. Operating under this false pretense can have devastating consequences to the patient. Many names sound alike. Call for Mr. Snyder and Mr. Schneider steps forward. Ask for Mrs. Brown and Mrs. Braun comes your way. Beckon Robert and Roger takes a seat in the outpatient chair. Speaking a name and expecting the right patient to respond is setting up a trap both you and the patient can fall into. While you may summon a patient from a full waiting room this way, you simply must give the patient who responded an opportunity to verbalize her name. If the patient is hard of hearing or cognitively impaired, or if there's a language barrier, have a family member or caregiver verbalize the patient's name for her, and document the individual's name.
11. ED blood draws during IV insertion are more efficient because they save the patient a stick. While this may be true for some patients, studies show that up to 25 percent of draws during an IV start will be hemolyzed. Depending on the size and composition of the catheter, it could go up to 55 percent. When that happens, you've just added an hour delay to the physician getting the results. How efficient is that? By the time the sample is centrifuged and hemolysis detected, at least 2 minutes have passed. Add another 25 minutes to dispatch a phlebotomist, perform a venipuncture, return to the lab and centrifuge the sample, and the attempt to save the patient a stick has done him a disservice instead. While 75 percent of draws during an IV start may be acceptable, Murphy's Law tells us those whose blood ends up hemolyzed will be the patients whose physician needs results the fastest.
12. Wearing gloves won't reduce your risk of an accidental needlestick. Actually, it will. A recently published report indicates healthcare workers who wear gloves are 66 percent less likely to sustain an accidental needlestick than those who don't. And that's not all. Should you sustain a needlestick while wearing gloves, the glove material wipes off up to 86 percent of the blood that would otherwise go into your tissue if you weren't wearing gloves at the time. That means your risk of acquiring HIV, hepatitis or any of the other 18 pathogens that have been known to be transmitted by a blood exposure is drastically reduced. Need another reason? No, you don't.
13. It's OK to palpate a site prepped for a blood culture collection as long as I cleanse the tip of my gloved finger first. Not so. Gloves used during phlebotomy procedures aren't usually sterile. And even if you were to cleanse with the same antiseptic used to cleanse the site, most people aren't going to wait the 30 seconds it takes for the antiseptic to be effective. Instead, palpate above and below the intended puncture site, but not directly on it.
Lisa O. Balance is the director of Online Education at the Center for Phlebotomy Education. A medical technologist, laboratory manager and certified laboratory consultant, she is the managing editor of the Phlebotomy Today family of e-newsletters and develops online continuing education programs for healthcare professionals who perform phlebotomy procedures.