Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

SKILL 18-10

Obtaining a Venous Blood Specimen for

Culture and Sensitivity (Continued)

Comments

11.Release the tourniquet. Check that the vein has

decompressed (Lavery & Ingram, 2005).

12. Attach the butterfly needle extension tubing to the
    Vacutainer device.


13. Move collection bottles to a location close to arm, with
    bottles sitting upright on tabletop.


14. Clean the patient’s skin at the selected puncture site with
    the antimicrobial swab, according to facility policy. If
    using chlorhexidine, use a back-and-forth motion, applying
    friction for 30 seconds to the site, or use the procedure
    recommended by the manufacturer. Allow the site to dry.


15. Using a new antimicrobial swab, clean the stoppers of the
    culture bottles with the appropriate antimicrobial, per
    facility policy. Cover bottle top with sterile gauze square,
    based on facility policy.


16. Reapply the tourniquet approximately 3 to 4 inches above
    the identified puncture site. Apply sufficient pressure to
    impede venous circulation, but not arterial blood flow.
    After disinfection, do not palpate the venipuncture site
    unless sterile gloves are worn.


17. Hold the patient’s arm in a downward position with your
    nondominant hand. Align the butterfly needle with the
    chosen vein, holding the needle in your dominant hand.
    Use the thumb or first finger of your nondominant hand to
    apply pressure and traction to the skin just below the iden-
    tified puncture site. Do not touch the insertion site.
    18.Inform the patient that he or she is going to feel a pinch.
    With the bevel of the needle up, insert the needle into the
    vein at a 15-degree angle to the skin (Fischbach & Dunning,
    2006). You should see a flash of blood in the extension tub-
    ing close to the needle when the vein is entered.


18. Grasp the butterfly needle securely to stabilize it in the vein
    with your nondominant hand, and push the Vacutainer
    onto the first collection bottle (anaerobic bottle), until the
    rubber stopper on the collection bottle is punctured. You
    will feel the bottle push into place on the puncture device.
    Blood will flow into the bottle automatically.
    20.Remove the tourniquet as soon as blood flows adequately
    into the bottle.

ExcellentSatisfactoryNeeds Practice

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