1. Remove all hand and wrist jewelry, including rings.

2. Wet your hands with warm water.

3. Apply soap to your hands.

4. Rub your hands together vigorously, working up a lather.

5. Scrub palms, between fingers, under nails, and the back of hands for at least 15 seconds.

6. Rinse in a downward position.

7. Dry your hands thoroughly with paper towels.

8. Turn off the faucet with paper towels.

9. Discard paper towels.

1. Wash your hands.

2. Put on a lab coat or gown and fasten buttons or ties appropriately.

3. Apply goggles, face mask, or face shield. If applying a mask, tie the mask at the top and then at the bottom.

4. Apply gloves over the cuffs of the lab coat or gown.

1. Untie and remove gown.

2. Remove gloves as you finish peeling off gown

3. Dispose of the gloves and gown in a biohazard waste container.

4. Remove the face mask, goggles, or face shield. If wearing a mask, untie the top ties and then the bottom ties, and discard the mask in a biohazard waste container.

5. Wash your hands.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Introduce yourself and explain the procedure to the patient.

3. Verify the lab tests ordered against the requisition.

4. Position and prepare the patient.

5. Wash your hands and don personal protective equipment.

6. Apply the tourniquet.

7. Select vein by palpating the vein.

8. Cleanse the site with an alcohol wipe and allow to air dry. Remove the tourniquet.

9. Assemble the equipment.

10. Reapply the tourniquet (if necessary).

11. Examine the safety needle.

12. Anchor the vein.

13. Insert the needle into the vein at the appropriate angle.

14. Advance and change tubes in the appropriate order of draw.

15. Remove the tourniquet.

16. Mix anticoagulated tubes as they are removed from the adapter.

17. Remove the last tube from the adapter before removing the needle. Activate the safety device.

18. Remove the needle and discard it in a sharps container.

19. Apply pressure to the site with gauze.

20. Label tubes with appropriate information.

21. Check the site and apply a bandage.

22. Thank the patient.

23. Dispose of used supplies and materials.

24. Remove personal protective equipment and wash your hands.

25. Deliver specimens to appropriate departments.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Introduce yourself and explain the procedure to the patient.

3. Verify the lab tests ordered against the requisition.

4. Position and prepare the patient.

5. Wash your hands and don personal protective equipment.

6. Apply the tourniquet.

7. Palpate the vein.

8. Cleanse the site with an alcohol wipe and allow to air dry. Remove the tourniquet.

9. Assemble the equipment.

10. Reapply the tourniquet.

11. Check the syringe plunger to verify free movement.

12. Examine the safety needle.

13. Anchor the vein.

14. Insert the needle into the vein at the appropriate angle.

15. Pull back the plunger evenly to withdraw blood.

16. Remove the tourniquet.

17. Remove the needle and activate the safety device.

18. Apply pressure to the site with gauze.

19. Transfer blood to evacuated tubes in the correct order of draw using the syringe transfer device.

20. Mix any anticoagulated tubes as needed.

21. Discard the syringe and needle in a sharps container.

22. Label tubes with appropriate information.

23. Check the site and apply a bandage.

24. Thank the patient.

25. Dispose of used supplies and materials.

26. Remove personal protective equipment and wash your hands.

27. Deliver specimens to the appropriate departments.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Introduce yourself and explain the procedure.

3. Verify the lab tests ordered against the requisition.

4. Wash your hands and don personal protective equipment.

5. Assemble the equipment.

6. Select the puncture site (and warm if necessary). Cleanse with alcohol and allow to air dry.

7. Position and hold the finger and make the puncture in the appropriate area and position.

8. Wipe away the first drop of blood.

9. Collect the specimen in the appropriate containers, without air bubbles.

10. Seal the specimen containers.

11. Mix specimens with anticoagulant to prevent clot formation.

12. Apply pressure to the puncture site with gauze.

13. Bandage the puncture site appropriately based on the patient’s age.

14. Label the specimens.

15. Thank the patient.

16. Dispose of used supplies and materials appropriately.

17.Remove personal protective equipment and wash your hands.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Identify yourself and explain the procedure.

3. Verify the lab tests ordered against the requisition.

4. Wash your hands and don personal protective equipment.

5. Assemble the equipment.

6. Position the patient’s arm on a flat, steady surface.

7. Select and cleanse the incision site with alcohol and allow to air dry.

8. Apply the blood pressure cuff on the arm and inflate to 40 mm Hg.

9. Position the incision device.

10. Make the incision and start the timer.

11. Wick blood onto the filter paper every 30 seconds after the timer starts.

12. Stop the timer when blood is no longer absorbed by the filter paper and record the time.

13. Deflate and remove the blood pressure cuff.

14. Cleanse the puncture site and apply a butterfly bandage.

15. Instruct the patient on puncture site and bandage care.

16. Correctly dispose of used supplies and materials.

17. Thank the patient.

18. Remove personal protective equipment and wash your hands.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Introduce yourself and explain the procedure to the patient.

3. Verify the lab tests ordered against the requisition.

4. Wash your hands and don personal protective equipment.

5. Position the patient’s hand and apply the tourniquet around the wrist.

6. Choose the puncture site and palpate the vein.

7. Cleanse the site with an alcohol wipe and allow it to air dry. Release the tourniquet.

8. Assemble the equipment.

9. Reapply the tourniquet (if necessary).

10. Anchor the vein.

11. Holding the butterfly wings, insert the needle into the vein at the appropriate angle.

12. Advance the needle and hold it in place by one wing with the thumb of the opposite hand.

13. Collect the sample in accordance with the method being used (evacuated tubes or syringe).

14. Release the tourniquet, remove the needle, and activate the safety device.

15. Apply pressure to the site with gauze.

16. Mix anticoagulated tubes if applicable.

17. If using a syringe, transfer blood to evacuated tubes. Use a syringe transfer device.

18. Discard the needle and tubing in a sharps container.

19. Label tubes with appropriate information.

20. Check the site and apply a bandage.

21. Thank the patient.

22. Dispose of used supplies and materials.

23. Remove personal protective equipment and wash your hands.

24. Deliver specimens to appropriate departments.

1. Extend the patient’s wrist over a towel and position the hand palm up.

2. Locate the radial and ulnar pulse sites by palpating with the appropriate fingers.

3. Ask the patient to make a fist.

4. Compress both arteries.

5. Ask the patient to open and close the fist until the palm blanches.

6. Release pressure on the ulnar artery and observe the color of the patient’s palm.

7. State and record a positive or negative result.

8. Explain the significance and appropriate action to take for the test result.

1. Assemble the equipment.

2. Greet the patient, introduce yourself, and explain the procedure. Ask the patient to state his or her name. Use two identifiers to verify patient identity. Introduce yourself and explain the procedure.

3. Verify that the patient is in a respiratory steady state.

4. Verify the lab tests ordered against the requisition.

5. Wash your hands and don personal protective equipment.

6. Perform the modified Allen test to assess collateral circulation in the hand.

7. Locate the radial artery.

8. Cleanse the puncture site with 70% isopropyl alcohol and allow to air dry.

9. Cleanse the puncture site with povidone-iodine tincture and allow to air dry.

10. Administer local anesthetic and wait 1 to 2 minutes.

11. Cleanse your index finger with alcohol and place it above the area where the needle should enter the artery.

12. Hold the syringe like a dart, bevel up, and insert the needle at a 45- to 60-degree angle distal to your finger until blood appears in the needle hub.

13. Allow arterial pressure to fill the syringe.

14. Remove the needle and apply direct pressure to the puncture site with folded gauze for at least 5 minutes.

15. While applying pressure, expel air from the syringe, activate the safety device, and plant the needle into the rubber block.

16. Mix the specimen with heparin.

17. Place the specimen in ice chips.

18. Check the site and remove the povidone-iodine with an alcohol wipe.

19. Apply a pressure bandage of gauze.

20. Check for a pulse distal to the puncture site.

21. Remove and discard the needle in a sharps container.

22. Place the Luer cap on the syringe, label the specimen, and return it to the ice chips.

23. Thank the patient.

24. Dispose of used supplies and materials; remove personal protective equipment and wash your hands.

25. Deliver the specimen immediately to the lab.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Identify yourself and explain the procedure.

3. Verify the lab tests ordered against the requisition.

4. Wash your hands and don personal protective equipment.

5. Apply the tourniquet, identify the puncture site, and remove the tourniquet.

6. Vigorously scrub the site with alcohol and allow to air dry.

7. Vigorously scrub the site with povidone-iodine and allow to air dry.

8. Assemble the equipment.

9. Cleanse the tops of the blood culture bottles.

10. Reapply the tourniquet without contaminating the site.

11. Perform the venipuncture.

12. Inoculate each bottle in the correct order and mix the samples.

13. Release the tourniquet, remove the needle, activate the safety device, and apply pressure to the site with gauze.

14. Label the blood culture bottles correctly.

15. Remove povidone-iodine from the patient’s arm and apply a bandage.

16. Discard used materials and supplies appropriately.

17. Thank the patient.

18. Remove personal protective equipment and wash your hands.

1. Wash your hands and put on gloves.

2. Apply a small drop of blood to the correct area of the slide.

3. Place the spreader at the correct angle in front of the blood drop.

4. Pull the spreader back to contact the blood drop.

5. Move the spreader forward in a continuous motion.

6. Repeat steps 2 through 5 to prepare a second slide.

7. Allow the smears to dry.

8. Properly label the smears.

9. Examine the blood smears for quality and acceptability.

10. Remove gloves and wash your hands.

1. Greet and identify the patient. Ask the patient to state his or her name. Use two identifiers to verify patient identity.

2. Introduce yourself.

3. Verify the lab tests ordered against the requisition.

4. Explain the procedure to the patient.

5. Wash your hands and don personal protective equipment.

6. Assemble the equipment.

7. Position the patient.

8. Depress the patient’s tongue with a tongue depressor and inspect the back of the throat with the flashlight to locate inflamed areas.

9. Quickly touch the tip of the swab to the tonsils and any other inflamed areas.

10. Return the swab to the holder.

11. Crush the ampule at the bottom of the holder containing the transport media.

12. Thank the patient.

13. Dispose of used supplies and materials.

14. Remove personal protective equipment and wash your hands.

15. Deliver the specimen to the appropriate department.