Venipuncture - Case Study Example

?Case study: Venipuncture Introduction The case under analysis is a situation in which a practicing nurse was unable to carry out a venipuncture procedure. She seems to lack competence in the area as seen through repeated attempts to draw blood. This is a point of concern for the practitioner as it undermines the quality of care offered to the patient. Therefore, this paper will focus on the collection of blood as a nursing procedure. Since the blood was drawn from a venous site, then key guidelines for venipuncture will be examined. The Australian Nursing and Midwifery Council (ANMC) competency standard associated with this aspect of care is standard number 9.5. It requires nurses to promote the security and safety of their patients by taking care of their physical environment as well as their other needs. The purpose of this paper is to identify the source of incompetence and give recommendations on how to improve this aspect of care. Analysis of the aspect of care This case study focuses on venipuncture. A number of aspects emanate from this nurse’s experience. First, it is a good practice to talk to a patient and offer the assurance regarding the medical procedure (Lavery & Ingram, 2007). No evidence of this is present in the situation. Additionally, nurses ought to position the patient’s arm in the most favorable position. In venipuncture, this is supposed to be a straight line. Once again, it appears that the nurse skipped this step. A limit exists on the number of attempts that a nurse can perform on a patient. If two attempts have failed, one is meant to consult a senior practitioner for assistance (Harrison et. al., 2010). However, this nurse tried to do everything on her own. Caregivers need to exercise judgment when selecting the suitable vein for blood collection. It is likely that this professional did not choose the best vein to carry out the draw. She did not wait for the vein to become visible as this hampers success of the procedure. The pressure with which she inserted the needle could also have caused the problem (Sequin et. al., 2004). As mentioned earlier, the chosen competency statement in the ANMC guideline is standard number 9.5. It talks about facilitation of patient security and safety (Nursing and Midwifery Council, 2007). Nurses must eliminate risks that stem from the environment. They must adhere to preset standards that govern the procedures they are performing. The competency statement also states that infection control must be kept at a minimum. Nurses must use ergonomics into to protect patients and themselves from injury. Safety should be top in their priority list, and this should involve adherence to legislative procedures. The caregiver ought to provide comfort to the patient by adjusting external parameters to meet these needs. This objective must be maintained throughout the therapeutic intervention. In this case, the nurse was meant to administer a procedure in a safe and secure manner, but she fell short. According to the competency statement, the nurse is supposed to adjust medical procedures in response to a patient’s comfort requirements. Clearly, this nurse did not abide by such a principle. Furthermore, she was meant to prioritize the patient’s safety. Making four attempts in venipuncture is dangerous to a patient’s safety. It could cause health complications like tendon, nerve or arterial injury (Adams & Elliot, 2006). The gentleman may have encountered some bruising. It might even lead to excessive bleeding, fainting and even spark of an allergic reaction (Walther-Wenke, 2008). Competency statement 9.5 also states that the nurse must adhere to the principles of ergonomics in order to minimize injury. These standards were compromised in the case. Several ergonomic principles could have been ignored such as the grip of the need, the angle in which the needle was administered as well as the depth to which the nurse inserted the needle (Scales, 2008). The subject in this case study is in need of a development program for venipuncture. Therefore, the key learning objective for her is to improve competence in the collection of blood. She needs to involve her supervisor or superiors in this improvement plan (Higgins & Green, 2008). The nurse ought to notify the supervisor and work with him or her to identify training opportunities. It is imperative to increase opportunities for the practice of this skill. Staff members may offer their services for this as patients would be placed at considerable risk (Norfolk et. al., 2009). The subject needs to polish up on theoretical knowledge as well. While she claims to have followed all protocols, it is likely that she is not familiar with sources of error. In order to gain a visual understanding of the method, the nurse needs to watch a number of videos that show the procedure practically. It is advisable to view this administration on patients of different, ages, races and sexes so as to note the difference (McClelland, 2007). Manikins are available for venipuncture practice sessions. The nurse needs to carry out this procedure on the dummy under the presence of a supervisor. If the opportunity is available, the nurse should visit a part of her hospital that carries out venipunctures in close succession (Ellis and Bentz, 2007). She should observe these procedures closely and learn from them. Sometimes, community centers could be the best choice for these activities. Ideally, practice should be the key goal in this learning procedure. Conclusion The paper focused on a case study in which a nurse failed to carry out a venipuncture procedure adequately. Therefore, its purpose was to identify sources of incompetence and give recommendations for a learning pathway. It was established that the nurse had violated statement 9.5 of the ANMC standards. She did not adjust external variants to ensure the safety and comfort of her patients. An analysis of the situation also revealed that principles of ergonomics were compromised. Possible technical sources of the error were identified, like poor preparation and selection of the vein, as well as inappropriate use of pressure when inserting the syringe. The nurse can improve her competence in venipuncture by liaising with her supervisor, polishing up on her theoretical knowledge, and embracing opportunities for practice. She can watch this procedure physically in a busy lab or could use videos for the same. Generally, practice will lead to better outcomes. References Adams, D & Elliot, T, 2006, ‘Skin antiseptics used prior to intravascular catheter insertion’, British Journal of Nursing, vol. 16 no. 5, pp. 278-80. Ellis, J and Bentz, P, 2007, Modules for Basic Nursing Skills, 7th edition, Lippincott Williams and Wilkins, London. Harrison, G, Speroni, K, Dugan, L, & Daniel, M 2010, ‘A comparison of the quality of blood specimens drawn in the field by EMS versus specimens obtained in the emergency department ’, Journal of Emergency Nursing, vol. 36 no. 1, pp. 16-20. Higgins, J & Green, S 2008, Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0.The Cochrane Collaboration, London. Lavery, I & Ingram, P 2007, ‘Venipuncture: best practice’, Nursing Standard, vol. 22 no. 1, pp. 44- 48. McClelland, D 2007, Handbook of Transfusion Medicine, 4th edition, TSO, London. Norfolk, D, Pirie, L, Russell, J and Taylor, C 2009, Guideline on the administration of blood components, British Committee for Standards in Haematology, London. Nursing and Midwifery Council 2007, National competency standards for the registered nurse, Nursing and Midwifery Board Publishers, Melbourne. Scales, K 2008, ‘A practical guide to venipuncture and blood sampling’, Nursing Standard, vol. 22 no. 3, pp. 29-36. Sequin, D, McEachrin, C, Murphy, T 2004, ‘Venipuncture equipment, technique, and hemolysis of laboratory blood samples obtained in the emergency department’, Journal of Emergency Nursing, vol. 30 no. 5, pp. 418. Walther-Wenke, G 2008, ‘Incidence of bacterial transmission and transfusion reactions by blood components ’, Clinical Chemistry and Laboratory Medicine, vol. 46 no. 7, pp. 919-25. Read More