Performing Venipuncture or Capillary Puncture — Practice Checklist

Step-by-Step Procedure (7 steps)

1. 1.

   Verify the patient's identity using two identifiers (name and date of birth) and confirm the test order matches the patient.

2. 2.

   Select the appropriate equipment: evacuated tube system for venipuncture, or a lancet and microcollection tubes for a capillary/fingerstick draw.

3. 3.

   Apply the tourniquet no more than 1 minute before the draw, select a vein by palpation, and cleanse the site with the appropriate antiseptic.

4. 4.

   Perform the venipuncture at the correct angle (15-30 degrees for most veins), and fill tubes in the correct order of draw to avoid cross-contamination between additives.

5. 5.

   For a capillary draw, warm the site if needed, puncture the correct area (e.g., lateral fingertip, not the central pad), and wipe away the first drop before collecting.

6. 6.

   Release the tourniquet before withdrawing the needle (or as soon as blood flow is established), apply pressure to the site, and bandage once bleeding stops.

7. 7.

   Invert additive tubes the number of times specified for that tube type, and label every tube immediately at the patient's side — never pre-label or label after walking away from the patient.

Quality Checkpoints (4)

Confirm each of these before considering the task complete.

• Patient identity is confirmed with two identifiers before any specimen is collected.

• Order of draw is followed correctly when filling multiple tubes.

• Tubes are labeled at the bedside/chairside immediately after collection, never before or after leaving the patient.

• Tourniquet time stays under 1 minute to avoid hemoconcentration affecting results.

Avoid These Mistakes

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  Pre-labeling tubes before the draw — if the wrong patient's tube gets used, this creates a serious misidentification risk.

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  Leaving the tourniquet on too long, which can falsely elevate certain lab values.

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  Drawing tubes out of order, allowing an additive from one tube to contaminate the next.

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  Massaging or squeezing a fingerstick site aggressively, which dilutes the sample with tissue fluid and skews results.