Overview

Phlebotomy uses large, hollow needles to remove blood specimens for lab testing or blood donation. Each step in the process carries risks - both for patients and health workers. Patients may be bruised. Health workers may receive needle-stick injuries. Both can become infected with bloodborne organisms such as hepatitis B, HIV, syphilis or malaria. Moreover, each step affects the quality of the specimen and the diagnosis. A contaminated specimen will produce a misdiagnosis. Clerical errors can prove fatal.

The new WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.

Contents

• Acknowledgements
• Acronyms
• Executive summary
• PART I. BACKGROUND
  • 1. Introduction
    • 1.1 Overview
    • 1.2 Purpose and scope
    • 1.3 Objectives
    • 1.4 Target audience
    • 1.5 Indications for blood sampling and blood collection
    • 1.6 Structure of document
• PART II. ASPECTS OF PHLEBOTOMY
  • 2. Best practices in phlebotomy
    • 2.1 Background information on best practices in phlebotomy
    • 2.2 Practical guidance on best practices in phlebotomy
    • 2.3 Illustrations for best practices in phlebotomy
  • 3. Blood-sampling systems
    • 3.1 Background information on blood-sampling systems
    • 3.2 Practical guidance on blood-sampling systems
    • 3.3 Illustrations for blood-sampling systems
  • 4. Venepuncture for blood donaton
    • 4.1 Background information on venepuncture for blood donation
    • 4.2 Practical guidance on venepuncture for blood donation
  • 5. Arterial blood sampling
    • 5.1 Background information on arterial blood sampling
    • 5.2 Practical guidance on arterial blood sampling
    • 5.3 Illustrations for arterial blood sampling
  • 6. Paediatric and neonatal blood sampling
    • 6.1 Background information on paediatric and neonatal blood sampling
    • 6.2 Practical guidance on paediatric and neonatal blood sampling
    • 6.3 Illustrations for paediatric and neonatal blood sampling
  • 7. Capillary sampling
    • 7.1 Background information on capillary sampling
    • 7.2 Practical guidance on capillary sampling
    • 7.3 Illustrations for capillary sampling
• PART III. IMPLEMENTATION, EVALUATION AND MONITORING
  • 8. Implementing best phlebotomy practices
    • 8.1 Setting policies and standard operating procedures
    • 8.2 Procurement
    • 8.3 Phlebotomy training
    • 8.4 Safe waste and sharps disposal
    • 8.5 Prevention and management of incidents and adverse events
  • 9. Monitoring and evaluation
• PART IV. REFERENCES
• PART V. ANNEXES
  • Annex A. Methods and evidence base
    • A1 Consultation with experts and scope of recommendations
    • A2 Evidence base
    • A3 Peer review and technical editing
    • A4 Implementation and evaluation plans
    • A5 Review and updating of the recommendations
    • A6 Monitoring and evaluation of the implementation
  • Annex B. Infection prevention and control, safety equipment and best practice
  • Annex C. Devices available for drawing blood
  • Annex D. Managing occupational exposure to hepatitis B, hepatitis C and HIV
    • Step 1 Provide immediate first-aid care to the exposure site
    • Step 2 Determine the risk associated with the exposure
    • Step 3 Evaluate the source of the potential exposure
    • Step 4 Manage individuals exposed to HBV and HIV
    • Step 5 Report the incident
  • Annex E. Training course content for phlebotomists
    • Course contents
  • Annex F. Explaining the procedure to a patient
    • Introduction
    • Please sit down and make yourself comfortable
  • Annex G. Disassembly of needle from syringe or other devices
    • One-hand scoop technique
    • Use of a removal device
  • Annex H. Blood spillage
  • Annex I. Modified Allen test
  • Annex J. Cochrane review
  • Annex references
• Glossary
• Chinese
• French
• Portuguese

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