Adapted sample taking
Best infection control measures for
sampling venous
and capillary blood
WHO intermediate recommendations
February 2004
May 2007
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Best practices
•
Ensure blood is sampled safely, no exposure to
bloodborne pathogens to patients, health care
workers, environment
•
Scope of best practices restricted to infection control
•
Do not address other routine practices:
• labelling
• selecting the right equipment for the right patient
• containers
• protecting the sample from contamination
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Steps of safe blood sampling
Step 1:
select equipment, prepare area
Step 2:
prepare patient, collect blood sample
Step 3:
transfer blood sample
Step 4:
waste management
Other practice issues: type of phlebotomy equipment
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Step 1
Select equipment, prepare area
•
Provide an
collection
appropriate
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environment
R E S P O N S E
for
blood
Step 1
Select equipment, prepare area
•
Wash and/or disinfect your hands first
•
Avoid collecting blood if local infection or other skin
condition (e.g., weeping dermatitis, skin lesions)
compromises the skin integrity of your hands.
•
Cover any small cuts on your hands
(e.g., with a bandaid/plaster).
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Step 1
Select equipment, prepare area
•
Prepare a clean,
designated and if
possible, dedicated area
for collecting blood
samples.
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Step 1
Select equipment, prepare area
•
Wear a new pair of gloves for
each patient
•
Use a sterile single-use lancet or
phlebotomy set for each patient
•
Inspect packaging for breaches
in integrity
•
Do not use equipment that may
not be sterile (punctured, torn or
damaged).
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Step 2:
Prepare patient, collect blood sample
•
Wash visibly soiled/dirty skin
•
Swab
• Antiseptic - clean,
single use swab and maintain
product-specific recommended
contact time.
• Do not use cotton balls stored wet
in a multi-use container.
• Unnecessary to swab clean skin before blood sampling
Don’t touch the puncture site after skin disinfection or
before
sampling.
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•
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Step 2: Preparation of the patient
and collection of the blood sample
•
Discard in an appropriate sharps disposal container
any needle or lancet that has touched a non-sterile
surface prior to sampling.
•
When the use of a tourniquet is indicated, use a clean
device that has not been contaminated with blood or
body fluids.
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Step 2: Preparation of the patient
and collection of the blood sample
•
Anticipate and take measures such as appropriate
patient restraint to prevent sudden patient movement
during and after blood sampling.
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Step 2: Prepare the patient and
collect the blood sample
•
After sampling, minimize bleeding by applying gentle
pressure on the sampling site with a dry, clean cotton
ball or other similar material.
•
Apply clean dressing to the wound after bleeding has
stopped.
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Step 3. Transfer blood sample
•
When using a syringe and a needle to perform
phlebotomy,
• transfer the collected blood slowly and directly into the
collection tubes without removing the needle to prevent
spillage or splashing
•
Cover the tubes
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Step 3. Transfer the blood sample
•
Avoid recapping needles and other manipulations of
used needles.
•
If recapping is necessary, use one hand only to avoid
puncturing the hand holding the cap.
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Step 3. Transfer the blood sample
•
Collect used sharps at the point of use in puncture
resistant and leak-proof sharps containers.
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Step 3. Transfer the blood sample
•
Prepare blood collection tubes for storage or
transport according to recommended national and/or
international packaging requirements.
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Step 3. Transfer of the blood sample
•
Disinfect the sampling area
to eliminate the risk of
contamination of equipment
with blood or body fluids for
future use, particularly if
spillage or splashing of
blood occurred.
•
Wash hands after removing
gloves.
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Step 4. Waste management
•
Seal sharps containers before they are completely full
for transport to a secure area in preparation for
disposal.
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Step 4. Waste management
•
Manage waste in an efficient, safe and environmentfriendly way to protect people from voluntary and
accidental exposure to used equipment.
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Type of phlebotomy equipment
•
Single-use, vacuum-based phlebotomy equipment is
available to reduce the risk of environmental
contamination.
•
Safer injection devices are increasingly available to
prevent reuse of injection equipment and needle-stick
injuries.
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Module 2: Adapted sample taking
Developed by the Department of Epidemic and
Pandemic Alert and Response of the World Health
Organization with assistance from:
European Program for Intervention Epidemiology
Training
Canadian Field Epidemiology Program
Thailand Ministry of Health
Institut Pasteur
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