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1. SUSHRUSHA INSTITUTE OF NURSING SCIENCES, DAUND.
CLINICAL TEACHING
ON
BLOOD COLLECTION


SUBMITTED TO, SUBMITTED BY,
Mrs. Archana Salvi Ms. Anuradha S. Wanve
Associate Professor F.Y. M.Sc. Nursing

2. SIONS, DAUND. SIONS, DAUND.

SUBMITTED ON:-
GENERAL OBJECTIVE: -
At the end of this clinical teaching students will be able to gain in depth knowledge about blood collection and will be able to
apply the same in their clinical practices.


SPECIFIC OBJECTIVES:-
Student will be able to_
a) define blood collection.
b) state purposes of blood collection.
c) explain different sites for blood collection.
d) discuss the advantages and disadvantages of blood collection.
e) describe the scientific principles of blood collection.
f) enlist articles needed for blood collection.
g) discuss different blood containers.
h) demonstrate procedure for blood collection.
i) list down the complication for blood collection.

3. SR.
NO.
SPECIFIC
OBJECTIVE
TIME
DURATION
CONTENT TEACHER/LEARNER
ACTIVITY
AV
AIDS
EVALUATION

4. 1.







2.





3.








4.









introduction







define blood
collection.




state purposes
of blood
collection.






explain sites of
blood
collection






2 min







3 min





5 min









6 min




BLOOD COLLECTION

INTRODUCTION:-
The process of collecting a blood sample is
called phlebotomy.
This procedure is also known as venipuncture.
A person who performs phlebotomy is called a
phlebotomist, although doctors nurses, and
medical laboratory scientists.

DEFINITION:-
Blood collection involves obtaining the blood
sample by venipuncture for routine laboratory
investigation.


PURPOSES:-
1) To determine the variations if any in blood
composition.
2) Diagnosis of various diseases, infection.
3) For blood grouping and crossmatching.
4) To detect drug levels or toxicity.


SITES OF BLOOD COLLECTION :-
1.Antecubital fossa:- Major arm veins used
for phlebotomy. The median cubital vein is
the larger and more stable vein and is
preferred for venipuncture. The cephalic and
basilic veins have a greater tendency to roll



Teacher introduces the
topic blood collection.






Teacher define the topic
blood collection.




Teacher state the
purposes of blood
collection.





Teacher explain sites of
blood collection.




















White
board






Flip
card










chart









Students
understood the
introduction of
blood collection.




Students
understood the
definition of
blood collection.


Students
understood the
purposes of
blood collection.



Students
understood sites
of blood
collection of
blood collection.

5. 5.

































discuss
advantages
and
disadvantages
of blood
collection.




























5 min









and veinpuncture may be more painful from
these sites.

2.Dorsum of hand:- Distended veins on the
dorsal side of the hand. Phlebotomy is done on
the hand when veins from the antecubital
fossa are not available nor suitable.

3.Top of foot:- It is a very rare site which is
used when veins in the antecubital fossa are
not available nor suitable.

Sites should be avoided are as follows:-
1.Extremities with massive edema, burns,
injury.
2.Phlebitis or thrombosis.
3.Compromised vein due to trauma.
4.Areas that are affected by cellulitis.


ADVANTAGES :-
1. Free flowing, undiluted blood can be
achieve, which gives correct results.
2. Large quantity of blood can be obtained
which is adequate to perform many tests at a
time.
3. Ideal for all haematological tests.



DISADVANTAGES :-






















Teacher discuss the
advantages and
disadvantages of blood
collection.








































































Students
understood the
advantages and
disadvantages of
blood collection.

6. 6.

































describe the
scientific
principles of
blood
collection.



























15 min





















1. If due to faulty method, counter
puncture is performed. It may be lead to
hematoma.
2. Internal injury to tissue.
3. Bleeding.




SCIENTIFIC PRINCIPLES OF BLOOD
COLLECTION
1.ANATOMY AND PHYISIOLOGY
Blood
DEFINITION:-
Blood is a connective tissue.
It is a body fluid in humans and other animals
that delivers necessary substances such as
nutrients and oxygen to the cells and
transports metabolic waste products away
from those same cells.

PHYSICAL PROPERTIES :-
1.Denser & viscous than water and sticky.
2.Temperature is higher than normal body
temperature
3.Slightly alkaline pH i.e. 7.35 to 7.45.
4.Colour of blood varies with its oxygen
content









Teacher describe the
scientific principles of
blood collection.








































































Students
understood the
scientific
principles of
blood collection.

7. When it has a high oxygen content, it is bright
red When it has a low oxygen content, it is
dark red .
5.Blood volume is 5 to 6 litres in an average
adult male & 4 to 5 litres in an average adult
female.

























COMPONENTS OF BLOOD :-

8. Two components of blood :-

1)Blood plasma (55%): Watery liquid
extracellular matrix contains dissolved
substances.
















2)Formed elements (45%):

9. Cells & cell fragments.




FUNCTIONS:-
1. Transport medium Oxygen, nutrients &
waste material.
2. Hormones to their target glands.
3. Protective antibodies to the site of
infection.
4. Protection against infection.
5. Regulation of pH.
6. Maintenance of body temperature.
7. Clot formation.






BLOOD GROUPS :-

10. The surface of erythrocytes contain a
genetically determined collection of antigens
made up of glycoproteins and glycolipids.
The presence or absence of various antigens,
blood is categorized into different groups.
1. Blood group A:- People whose RBCs
have only antigen A have type A blood.
2. Blood group B:- People having antigen
B are type B blood.
3. Blood group AB:-People with both
antigen A and B are type AB blood.
4. Blood group O:- People who neither
antigen A nor antigen B are type O
blood.
5. Rh Blood Group:- It is due to the
presence of Rh antigen called Rh factor.

-The needle may be inserted under the top
layer of the skin, into the loose tissues ,or into
a blood vessel.
-The skin contains numerous nerves be careful
during selection of the site to avoid injury to
these areas.
-Blood can be collect from Antecubital fossa
which include median cubital vein and cephalic
and basilic veins, Dorsum of hand and rarely
top of foot.
2. MICROBIOLOGY

11. 7.
































enlist articles
needed for





























2 min


-Wash hands thoroughly before and after the
procedure to avoid cross infection.
-Articles required for IM should be sterile and it
should be sterilized By autoclaving.
-The bacteria are present on the skin, so the
skin of the patient is disinfected by means of
alcohol 70 percent.
3.PSYCHOLOGY
-Explain the procedure thoroughly to the
patient to win the confidence and get the co-
operation.
-Proper positioning will help to relax the patient
while collecting blood.
-Distracting the patient while collecting blood
will minimize the pain.
-Pain is reduced by using sharp needles.
-Maintain privacy if required.




1)Tourniquet.
2)Small mackintosh.





























Teacher enlist the articles
of blood collection.









































Objects































Students enlist
the articles

12. 8.


blood
collection.


























discuss
different blood
containers.































2 mins

3)Syringes 5 ml, 10 ml.
4)No.20 guage needles or vacucontainer
assembly.
5)Alcohol swab.
6)Disposable gloves.
7)Specimen container-test tube, bottle.
8)Laboratory requisition form.
9)Dry cotton balls.
10)adhesive tapes.



















BLOOD CONTAINER S:-





























Teacher discussed the
different blood containers.








































Pam
Phlet


needed for blood
collection.




























Students
understood the

13. 9.































demonstrate
procedure for































15 min















PROCEDURE OF BLOOD
COLLECTION:-





























Teacher demonstrate the
procedure of blood
collection.







































different blood
containers.




























Students
understood the

14. blood
collection.






























































Nursing action before procedure:-
1.Check physician’s order.
2.Identify the patient.
3.Prepration:- It include

a) Preparation of self:-
-Perform hand hygiene.
-Put on gloves.

b) Preparation of articles:-
-Arrange all the articles in clean tray.
-Take specimen bottles, needles and syringes
as required.

c) Preparation of patient:-
-Inform the patient and explain all procedure to
patient.
-Provide proper position to patient i.e. sitting or
lying position.

c) Preparation of environment:-
-Provide calm environment.
-Maintain adequate lighting in room.

Nursing action during procedure:-

4. Select and examine the vein, visualize the
vein, including the antecubital area, wrist,
dorsum of the hand and top of the foot (if
necessary). Palpate the vein.







































































procedure of
blood collection.

15. RATIONALE:- Select a vein that is visible,
palpable and fixed to the surrounding tissue so
that it does nor roll away.

5.Instruct the patient to extend his arm. Hold
the arm straight at elbow with fist clenched.
RATIONALE:-Proper positioning reduces the
risk of injury.

6.Apply the torniquet 5-15 cm above the
selected site with just sufficient pressure to
obstruct the venous flow.
RATIONALE:- A torniquet when applied
increases venous pressure and makes the
veins more prominent and easier to enter.

7.Cleanse the with alcohol swab in a circular
motion; center to periphery. Allow it to dry.
RATIONALE:-It reduces the number of micro-
organism.

8.Fix chosen vein with thumb and draw the
skin taut immediately below the site before
inserting needle to stabilize the vein.
RATIONALE:- The vein may roll away so it is
important to taut and stabilize vein.

9.Hold the syringe between the thumb and last
three fingers with the bevel up and directly in
line with the course of the vein.
Insert the needle quickly and smoothly under
the skin and into the vein.

16. 10. Obtain blood sample by gently pulling back
on the plunger.
RATIONALE:- Use minimal suction to prevent
hemolysis of blood and collapse of vein.

11. Release the torniquet as soon as possible
as the specimen is obtained and the patient to
open the fist.

12. Apply sterile cotton balls on the puncture
site without applying pressure and withdraw
needle slowly along the line of the vein.
RATIONALE:- Slow withdrew of needle is less
painful and reduces trauma.

13. Request the patient to apply gentle but firm
pressure on the puncture site for 2-4 mins.
RATIONALE:- To prevent leakage of blood.

14. Remove the needle from syringe as soon
as possible after withdrawing blood and gently
eject blood sample into the appropriate
container without forming bubbles in the test
tube or bottles.
RATIONALE:- Gentle ejection may prevent
hemolysis.

15. Invert the tube gently several times to mix
the blood with the anticoagulant where
applicable. For some test blood allowed to
coagulate in the test tube.

17. 10.
































list down the
complication






























5 min

RATIONALE:- Gentle handling may prevent
risk of hemolysis.

16. Apply band aid/adhesive tape on the
puncture site.

17.Label the specimen correctly and send it to
laboratory immediately with completed
requisition forms.
RATIONALE:- Specimen should reach the
laboratory with the minimum delay for optimum
reliability.

18.Dispose the needle and syringe in
appropriate containers.
RATIONALE:- To avoid spread of possible
blood borne diseases.

19.Clean all spills with 10% bleach (sodium
hypochlorite) solution. Remove gloves and
wash hand.
RATIONALE:- To avoid spread of possible
blood borne diseases.

20.Record in the patient’s chart the procedure
and the test for which the sample was sent to
the laboratory.

21.Replace the tray with the reusable articles
in proper place.































Teacher list down the
complication of blood
collection.



































Hand
out































Students
understood the

18. for blood
collection.
















COMPLICATIONS:-
1. Pain
2. Bleeding
3. Fainting
4. Bruising
5. Infection
6. Hematoma

ASSIGNMENT:-

Role of nurse in blood collection.

SUMMERY:-
In this CT, we have seen_
a) Definition of blood collection.
b) Purposes of blood collection.
c) Sites for blood collection.
d) Advantages and disadvantages of blood
collection.
e) Scientific principles of blood collection.
f) Articles needed for blood collection.
g) Procedure for blood collection.
h) Different blood container.
i) Complications for blood collection.

























complications of
blood collection.

19. CONCLUSION:-
This topic helps student to improve
their practical skill as well as knowledge
regarding blood collection and helps to avoid
life threatening complications in patients.
BIBLIOGRAPHY:-
1.Sr. Nancy
Principles and practice of nursing
6
th
edition
Page no:- 204-205.
2. Annamma Jacob,
clinical nursing procedures the art of nursing
practice,
2
nd
edition,
Page no:- 143-144.
3.Ross and Wilson (2003)
“Anatomy and Physiology”
9
th
edition
Published by Churchill living stone
Philadelphia
Page No:-

20. REFERENCES:-

1. https://pathlabs.ufl.edu/client-
services/specimen-shipping/blood-collection-
process-venipuncture/

2. https://www.msdmanuals.com/en-
in/professional/critical-care-medicine/how-to-
do-peripheral-vascular-procedures/how-to-do-
venous-blood-sampling