How to draw blood from rolling veins: 5 tips for difficult IV injections without missing the vein

Drawing blood from deep veins is a situation that many medical staff, lab technicians, and new phlebotomy students find challenging. According to many studies, the rate of failed initial venipuncture can range from 10–30%, especially in elderly, obese, dehydrated patients, or those with small and difficult-to-see veins. This not only causes more pain to the patient but also prolongs the procedure, increases the risk of bruising, and affects the quality of the blood sample.

In this article, Tiptory will guide you on how to draw blood from deep veins, how to find difficult veins, and techniques to perform venipuncture accurately on the first attempt. These practical tips will help you increase your success rate, reduce the number of needle sticks, and make the blood drawing process safer and more efficient for both the practitioner and the patient.

Effective methods for drawing blood from deep veins

Position the patient to make veins more prominent

• If encountering difficult veins, have the patient lie down or sit comfortably with back support to reduce tension and the risk of dizziness.
• Slightly elevate the patient's legs to increase blood return to the heart, which helps peripheral veins become fuller.
• Position the arm from which blood will be drawn at or below heart level. This position helps blood pool in the arm, making deep veins easier to see and access.

Apply tourniquet correctly to make veins fuller

• Apply a tourniquet firmly about 7–10 cm above the elbow before venous blood collection.
• The tourniquet should be tight enough to impede venous blood return but not so tight as to cause pain or obstruct arterial circulation.
• After applying the tourniquet, observe and palpate the arm to identify suitable difficult veins or deep veins before inserting the needle.

Warm or gently rub the blood collection area

• If veins are hard to find, apply a warm compress to the blood collection area for a few minutes. Warmth helps blood vessels dilate, increases blood flow, and makes veins more prominent.
• Gently rub or stroke the area along the vein's direction with your fingertips to stimulate circulation. Avoid forceful patting as it can cause blood vessels to constrict or discomfort the patient.
• Combining warming, gentle rubbing, and vein localization before venipuncture will increase the likelihood of successful blood collection on the first attempt, especially in patients with deep veins, elderly individuals, or dehydrated patients.

Part 1: Quickest tips to make deep veins prominent

Tip 1: Warm the blood collection area correctly

Warm compress to help veins become more prominent

• When drawing blood from deep veins or encountering difficult veins, place a warm compress or a clean towel soaked in warm water on the intended venipuncture site for about 2–3 minutes.
• Warmth helps veins dilate, increases blood flow to the area, thereby making veins more prominent and easier to locate.
• This method is particularly useful for individuals with small veins, the elderly, dehydrated individuals, or patients with difficult veins.

Disinfect the skin before venipuncture

• After warming, disinfect the blood collection area with 70% alcohol and allow the skin to dry completely before venipuncture.
• Do not insert the needle while the skin is still wet with alcohol, as it can cause a stinging sensation and compromise the sterile procedure.
• Always keep the blood collection area clean to reduce the risk of infection and ensure the quality of the blood sample.

You can warm the arm with warm water

• If a warm compress is unavailable, you can have the patient immerse their arm in warm water or gently run warm water over their forearm for a few minutes.
• Use water at a moderate temperature, avoiding overly hot water to prevent burns or skin irritation.
• After warming with water, dry the arm, disinfect it according to the proper procedure, and then proceed with venous blood collection. This method helps increase the chances of finding the correct deep vein and improves the success rate of blood collection on the first attempt.

Tip 2: Palpate for veins before drawing blood

Use your hand to locate the vein

• With deep veins or difficult veins, don't rely solely on visual observation. Use your fingertips to palpate along the forearm to locate the vein.
• Gently rub the intended blood collection area to stimulate blood circulation, helping the vein become more prominent and easier to identify.
• When you palpate a vein correctly, you will feel an elastic structure that is soft but firm enough. This is usually a sign that the vein is suitable for venipuncture.

Prioritize palpation with fingertips

• Use your index or middle finger to assess the direction, depth, and size of the vein before inserting the needle.
• Perform the action gently, avoiding excessive pressure as it can cause the vein to collapse or discomfort the patient.
• Combining observation and palpation will help identify difficult veins, thereby increasing the chances of successful deep vein blood collection on the first attempt.

Do not forcefully pat the arm

• Many people believe that gently patting or slapping the arm will make veins more prominent. However, this is not a recommended technique in clinical practice.
• Forceful patting can damage subcutaneous tissue, increase the risk of hematoma, cause pain, and affect the sample collection process.
• Instead, prioritize safe measures such as warming the blood collection area, applying the tourniquet correctly, and palpating to identify the vein before venipuncture. These techniques are both effective and help reduce the risk of complications during venous blood collection.

Tip 3: Increase blood flow before blood collection

Encourage the patient to do light exercise to make veins more prominent

• When encountering deep veins or difficult veins, instruct the patient to rotate their arm in circles or gently swing it for a few minutes.
• These gentle movements help increase blood flow to the arm, causing veins to dilate and become more prominent, thereby making venipuncture easier.
• Patients can also perform simple movements such as bending and extending the elbow or clenching and unclenching the hand gently to stimulate circulation without causing fatigue.

Choose appropriate exercises before blood collection

• Light exercises such as bending and extending the arm or repeatedly clenching and unclenching the hand can help veins become prominent faster.
• Avoid asking the patient to perform high-intensity exercises as this can cause fatigue or affect the sample collection process.
• Once the vein is prominent, proceed with venous blood collection according to the proper procedure to increase the success rate on the first attempt.

Avoid strenuous activity before routine blood tests

• For individuals preparing for blood tests, especially biochemical tests or those assessing body function, it is advisable to limit high-intensity exercise on the day before blood collection unless otherwise instructed by a doctor.
• Excessive physical activity can temporarily alter some blood parameters, affecting the accuracy of test results.
• To obtain reliable results, fully adhere to the healthcare facility's instructions regarding diet, rest, and activity before blood tests.

Tip 4: Help the patient relax before blood collection

Instruct deep breathing to reduce stress

• If the patient is anxious or afraid of needles, instruct them to inhale slowly through their nose, hold their breath for a few seconds, then exhale slowly through their mouth.
• Deep breathing helps the body relax, reduces the stress response, and supports vein dilation, thereby facilitating deep vein blood collection.
• At the same time, maintaining a calm state of mind also helps limit vasoconstriction, reduces pain, and increases the chance of successful venipuncture on the first attempt.

Create a comfortable atmosphere for the patient

• Gentle conversation or directing the patient's focus to another topic instead of the needle can help reduce nervousness.
• If conditions permit, playing soft music can also help patients relax before venous blood collection.
• The calm demeanor and positive communication of healthcare professionals contribute to increased patient cooperation and a quicker blood collection process.

Lay the patient down if there is a risk of fainting

• If the patient has a history of fainting during blood collection, feels dizzy, or shows signs of sweating or paleness, have them lie down before performing the procedure.
• Lying down helps increase blood flow to the brain, reducing the risk of fainting during blood tests.
• Proactively laying the patient down also helps prevent falls and injuries if fainting occurs, and creates conditions for a safer venous blood collection process.

Tip 5: Drink enough water before blood collection

Encourage the patient to drink water before blood collection

• If the test does not require fasting or fluid restriction, encourage the patient to drink enough water before coming to the medical facility.
• A well-hydrated body will help veins become fuller, blood flow remain stable, and facilitate deep vein blood collection or difficult vein blood collection.
• Patients should drink plain water in sips for several hours before blood tests, avoiding drinking too much right before the blood collection to prevent discomfort.

Confirm the requirements of each test type

• Before instructing the patient on eating and drinking, check whether the test requires fasting or fluid restriction.
• Some tests still allow plain water, while others may have specific instructions. Patients should adhere strictly to the doctor's or lab's instructions to ensure accurate results.
• If unsure, ask a healthcare professional before preparing for venipuncture.

Limit caffeinated beverages before the test

• If possible, patients should avoid coffee, strong tea, energy drinks, and other caffeinated beverages for about 24 hours before blood collection, especially if recommended by a healthcare professional.
• Caffeine can increase fluid excretion in some people, leading to dehydration and making veins harder to find.
• Instead, prioritize drinking plain water to maintain adequate hydration, which helps the venipuncture process go smoothly and increases the chance of successful blood collection on the first attempt.

Part 2: How to safely collect blood from the forearm

Step 1: Preparation before blood collection

Verify patient information before blood collection

• Before venipuncture, verify the patient's information against the test requisition form.
• Double-check the patient's full name, medical record number or patient ID, date of birth, and the purpose of the blood test.
• Also, confirm the requested test type, ensuring the requisition, blood collection tubes, and labels all match the correct information to minimize the risk of sample mix-ups.

Identify factors that may affect the blood collection process

• Ask the patient about any history of allergies to alcohol wipes, adhesive tape, latex gloves, or other medical supplies.
• Find out if the patient has a fear of needles, has ever fainted during blood draws, or had unusual reactions during previous venipuncture procedures.
• This information helps in choosing the appropriate position, preparing for potential complications, and ensuring a safer blood collection process.

Prepare all necessary equipment and adhere to infection control

• Gather all necessary blood collection needles, tourniquets, gauze, alcohol swabs, test tubes, bandages, and other supplies before starting.
• Wash hands properly and wear appropriate Personal Protective Equipment (PPE) according to healthcare facility regulations to reduce the risk of infection.
• Thorough preparation from the start helps the deep vein blood collection process go smoothly, minimizes errors, and improves the quality of the test sample.

Step 2: Apply the tourniquet correctly during blood collection

Apply a tourniquet to make veins more prominent

• Before deep vein blood collection, apply a tourniquet approximately 7.5–10 cm proximal to the anticipated venipuncture site.
• The tourniquet slows venous blood flow back to the heart, causing veins to become engorged and more prominent, thus making it easier to locate the venipuncture site.
• This is a crucial step to increase the success rate of blood collection, especially in individuals with small veins or difficult-to-access veins.

Adjust tourniquet pressure and duration

• Apply the tourniquet tight enough to make veins prominent but not so tight as to cause pain or impede arterial circulation.
• Do not keep the tourniquet on for more than 2 minutes continuously, as this can alter some blood parameters and affect test results.
• If prolonged time is needed, release the tourniquet briefly and then reapply it according to the correct procedure before continuing with venipuncture.

Check the vein after applying the tourniquet

• After applying the tourniquet, gently palpate with fingertips to assess the position and elasticity of the vein.
• A suitable vein for blood collection typically feels soft, elastic, and slightly bouncy when pressed.
• Correctly identifying the site before needle insertion helps prevent vein rolling, reduces the number of punctures, and improves the effectiveness of deep vein blood collection.

Can be replaced by a blood pressure cuff in some cases

• When a tourniquet is difficult to use or better pressure control is needed, a blood pressure cuff inflated to approximately 40–60 mmHg can be used to help make veins prominent.
• This method is often useful for individuals with difficult veins, elderly patients, or those with easily movable veins.
• Whether using a tourniquet or blood pressure cuff, monitor the patient's comfort and strictly follow infection control procedures to ensure safety during blood collection.

Step 3: Locate the median cubital vein

Prioritize the median cubital vein for blood collection

• In most venipuncture cases, the median cubital vein is preferred due to its typically large size, stability, and accessibility.
• This vein is located on the inner side of the elbow, running between muscle masses, and can sometimes be visible under the skin with a light blue hue.
• Because it is stabilized by surrounding tissue, the vein is less likely to move when punctured, making deep vein blood collection or venipuncture easier and less painful.

Palpate to locate the vein if difficult to observe

• If the median cubital vein is not clearly visible, use fingertips to gently rub and palpate along the inner elbow area to locate it.
• Do not rely solely on skin color; instead, combine observation with feeling the vein's elasticity.
• When the correct position is identified, the likelihood of successful venipuncture on the first attempt will be higher.

Avoid venipuncture at branching sites

• Avoid selecting a site where the vein branches or converges for blood collection.
• These areas carry a higher risk of hematoma, blood leakage under the skin, and can make sample collection more difficult.
• Prioritize a straight, sufficiently long, and stable segment of the vein to ensure safe blood test collection, reduce complications, and obtain a high-quality blood sample.

Step 4: Properly disinfect the blood collection area

Clean the venipuncture site with 70% alcohol

• Before venipuncture, disinfect the puncture site with 70% alcohol for at least 30 seconds.
• Wipe from the center of the anticipated puncture site in a circular motion or one direction outwards, ensuring the cleaned area has a minimum diameter of about 2 cm.
• Performing proper disinfection techniques helps reduce the risk of infection and ensures safety during the venipuncture process.

Allow the skin to dry completely before venipuncture

• After disinfection, wait approximately 30 seconds for the alcohol to evaporate and the skin to air-dry naturally before inserting the needle into the vein.
• Do not insert the needle while the skin is still wet, as this can cause a stinging sensation, increase patient discomfort, and affect the effectiveness of disinfection.
• This is a crucial step in the blood testing process, helping to reduce the risk of infection at the puncture site.

Prioritize 70% alcohol for disinfection

• 70% alcohol is a commonly used disinfectant before deep vein blood collection and many other medical procedures.
• In some cases where an iodine-containing solution is professionally indicated, it is recommended to wipe again with 70% alcohol before blood collection to minimize the risk of affecting some test results.
• Choosing the appropriate disinfectant helps ensure the quality of the blood sample and the accuracy of the test.

Do not recontaminate the disinfected area

• After cleaning the skin, do not blow, fan with hands, or directly touch the disinfected area.
• If the anticipated puncture site is accidentally touched, it must be disinfected again from the beginning before continuing with venipuncture.
• Strict adherence to aseptic technique helps reduce the risk of infection and improves the quality of the blood test sample.

Step 5: Proper needle insertion for blood collection

Stabilize the vein before needle insertion

• Before deep vein blood collection, hold the patient's forearm with one hand, while gently pulling the skin below the vein to stabilize the blood vessel, preventing it from moving when the needle is inserted.
• The patient can be instructed to gently clench their hand to make the vein more prominent. Avoid asking them to clench or unclench their hand continuously, as this can affect some test parameters.
• Good stabilization helps with accurate venipuncture and reduces the number of needle sticks.

Insert the needle at the correct angle and collect sufficient blood volume

• Insert the needle into the vein decisively at an angle of approximately 15–30 degrees, then hold the needle steady throughout the venipuncture process.
• Collect blood into test tubes or syringes in the correct order and required volume to ensure the quality of the test sample.
• Avoid moving the needle within the vein, as this can cause pain, damage the vessel wall, or lead to hematoma.

Remove the tourniquet at the right time

• After blood has started to flow and before withdrawing the needle, the tourniquet should be released within approximately 1 minute from the time it was applied.
• The tourniquet should not be left on for too long, as this can alter the concentration of some blood components, affecting the accuracy of test results.
• Releasing the tourniquet at the right time also helps blood flow normally, facilitating the final steps of the procedure.

Safely withdraw the needle after releasing the tourniquet

• Only withdraw the needle after the tourniquet has been released to make the patient more comfortable and reduce the risk of pain or subcutaneous bleeding.
• Immediately after needle withdrawal, apply clean gauze directly to the puncture site for a few minutes or as instructed by the healthcare facility to stop bleeding.
• Following the entire procedure correctly will ensure safe blood testing, reduce the risk of hematoma, minimize complications, and improve the quality of the blood sample.

Step 6: Proper post-venipuncture hemostasis

Apply gentle pressure to the puncture site immediately after needle withdrawal

• After completing venipuncture, place a clean gauze pad over the puncture site and apply gentle, continuous pressure to stop the bleeding.
• Maintain moderate pressure for about 5 minutes, or longer if the patient is on anticoagulants or has a bleeding disorder.
• Proper pressure helps stop bleeding quickly, reduces the risk of prolonged bleeding, and limits hematoma formation after blood draw.

Keep the arm straight during hemostasis

• Instruct the patient to keep their arm extended straight while pressing the gauze on the blood draw site.
• Do not bend the elbow to stop bleeding, as this action can increase pressure on the vessel wall, causing blood to leak into the subcutaneous tissue and form bruises or hematomas.
• If movement is necessary, the patient should still keep the gauze fixed and the arm straight.

Check the blood draw site before concluding

• After hemostasis, recheck if the puncture site has completely stopped bleeding.
• If bleeding is still present, continue to press the gauze for a few more minutes before bandaging or allowing the patient to leave the blood draw area.
• Following the correct post-venipuncture care steps will help reduce pain, limit bruising, and protect the blood draw site during recovery.

Step 7: Instrument disposal after blood draw

Dispose of needles and sharps according to regulations

• Immediately after completing venipuncture, activate the needle's safety mechanism (if available) to reduce the risk of needle-stick injuries to healthcare personnel.
• Dispose of used needles, syringes, and sharp instruments in a specialized puncture-resistant sharps container.
• Do not bend, detach, or recap needles by hand after use, as this can increase the risk of occupational accidents.

Proper classification of medical waste

• Materials contaminated with blood or bodily fluids, such as gauze, cotton, blood collection tubes, and other soiled materials, must be collected in infectious medical waste containers according to regulations.
• Sorting waste at the point of generation helps limit cross-contamination and protect the work environment.
• Always adhere to the infection control procedures of the healthcare facility throughout the venipuncture process.

Dispose of general waste according to regulations

• Items not containing blood or bodily fluids and that do not release blood when squeezed, such as clean gloves after proper removal, can be disposed of as general waste if consistent with facility and local regulations.
• In cases where different waste classification regulations apply, prioritize following the guidelines of the hospital or regulatory agency.
• Proper disposal after blood collection for testing not only protects healthcare workers but also helps reduce the risk of spreading pathogens in the healthcare environment.

Step 8: Check blood sample labels

Re-verify information on the blood tube

• Before sending samples to the laboratory, recheck all information on the blood collection tube and requisition form.
• Accurately match the patient's full name, medical record number or patient ID, date of birth, type of test, and other identification information according to facility regulations.
• This is a crucial step to ensure the blood sample for testing is accurately identified from the outset.

Detect and correct errors before sample transfer

• If a label is found to be incorrect, missing information, or does not match the patient's record, it must be handled according to the facility's procedures before sending the sample.
• Do not transfer blood samples if any information has not been verified, as this may affect the analysis process and results reporting.
• Thorough checking after venipuncture helps limit errors throughout the entire testing process.

Reduce confusion and ensure accurate results

• Incorrect labeling or mismatching can lead to delayed sample processing, re-drawing blood, or results being assigned to the wrong patient.
• Performing a final check before sample transport is an important measure to ensure testing quality and help physicians make accurate diagnostic and treatment decisions.
• Maintaining strict checking procedures after each venipuncture will contribute to improving patient safety and reducing preventable errors.

Part 3: How to handle unsuccessful blood draws

Method 1: Find an alternative vein when needed

Choose another vein if the median cubital vein is not found

• If the median cubital vein cannot be located in either arm, continue to search for a suitable vein for blood collection in the forearm.
• The patient can be asked to lower their arm below heart level and clench their hand lightly to make the veins more prominent, facilitating blood collection from deep veins.
• Always combine observation and palpation to assess the size, elasticity, and direction of the vein before needle insertion.

Prioritize the cephalic vein in the forearm

• The cephalic vein is located on the lateral side of the forearm (thumb side) and is the preferred choice after the median cubital vein.
• This vein is often easily visible, less mobile, and favorable for venipuncture, increasing the likelihood of successful blood collection on the first attempt.
• In many cases of difficult venipuncture, this is a commonly chosen alternative site.

Consider drawing blood from the basilic vein

• The basilic vein is located on the medial side of the forearm (little finger side) and can be used when preferred sites are not suitable.
• However, this vein is often more mobile, making it prone to rolling during needle insertion, requiring the operator to stabilize the vein carefully.
• Additionally, it is important to note that this area has many important neural and vascular structures nearby, so exercise caution to reduce the risk of complications.

Use dorsal hand veins when no other suitable options are available

• If forearm veins are inaccessible, dorsal hand veins can be considered for venipuncture.
• Veins in this location are usually easily visible and can be identified by palpation.
• However, it is not recommended to prioritize blood collection in elderly individuals due to thin skin and poor venous support tissue, making veins prone to rolling, increasing the risk of pain, hematoma, and failure during deep venipuncture.

Method 2: Avoid high-risk blood draw sites

Do not draw blood from areas with signs of infection

• Avoid venipuncture in areas of skin that are swollen, red, warm, painful, or show signs of infection.
• Drawing blood from these sites can increase the risk of spreading infection, cause more pain, and affect the quality of the test sample.
• Prioritize choosing healthy, clean skin areas with easily accessible veins.

Do not choose areas with healed scars or burns

• Areas with large scars or burn scars often have altered tissue structure, making veins difficult to access for blood draw and challenging to pinpoint the exact puncture site.
• Scar tissue can also reduce blood flow or make veins less stable, increasing the risk of failed blood draws.
• If possible, choose another site with soft tissue and more prominent veins.

Avoid arms with special medical interventions

• Do not perform venipuncture on the same arm as a mastectomy or an arteriovenous fistula for hemodialysis, unless specifically instructed by a physician.
• Also, avoid drawing blood from an arm with an intravenous cannula, vascular graft, or shunt, as this can increase the risk of complications and interfere with treatment.
• Choosing the correct site helps protect the vascular system and ensures patient safety.

Do not draw blood from bruised areas or above an IV line

• Avoid inserting the needle into a bruised area, as the blood in this area may be affected, and the patient will experience more pain.
• Do not draw blood from a site above an intravenous (IV) line, as the infusion fluid can alter the blood sample's composition, leading to inaccurate test results.
• In these cases, find an alternative vein in a more suitable location to ensure sample quality and increase the success rate of deep vein blood collection.

Method 3: Adjusting the needle during blood draw

Recognizing signs of improper needle placement

• During venipuncture, the needle may sometimes go through the vein, too deep into the tissue, or be inserted at an unsuitable angle.
• In other cases, the needle's bevel may be pressed against the vein wall, obstructing blood flow into the collection tube.
• When these situations occur, blood may flow very slowly, intermittently, or not at all, even if the correct deep vein location has been identified.

Gently adjust the needle before withdrawing it

• If it is suspected that the needle is not properly within the vein, it can be retracted a very small distance without completely removing it from the skin.
• Then, gently adjust the needle's angle to reposition its tip correctly within the vein, and continue to observe blood flow.
• All manipulations must be performed slowly, accurately, and with minimal needle movement to reduce damage to the vessel wall.

Avoid forceful maneuvers that could damage the vein

• Do not forcefully push or rotate the needle under the skin, as this can tear the vein wall, causing pain and increasing the risk of hematoma.
• If the technique has been correctly adjusted but blood still cannot be drawn, the procedure should be stopped, and another puncture site should be chosen according to professional protocol, instead of attempting multiple manipulations at the same site.
• Proper needle adjustment technique will increase the success rate of venipuncture blood collection, while reducing discomfort and complications for the patient.

Method 4: Ask for assistance when blood collection is difficult

Limit the number of needle sticks

• If venipuncture blood collection has been attempted twice but the vein cannot be accessed or no blood sample is obtained, do not continue to try on the same patient.
• Repeated needle sticks can increase the risk of pain, hematoma, vein damage, and make the patient more anxious.
• Adhering to the healthcare facility's protocol helps ensure safety and improve the quality of patient care.

Proactively ask experienced colleagues for assistance

• After two unsuccessful blood collection attempts, ask a more experienced colleague or healthcare professional to assess and perform the procedure.
• Experienced personnel can select alternative veins, apply techniques appropriate for hidden veins, or use assistive methods to increase the success rate of blood collection.
• Timely coordination helps reduce procedural time and limits the patient from undergoing unnecessary multiple needle sticks.

Prioritize patient safety

• The goal of venous blood collection is not only to obtain a test sample but also to reduce pain, limit complications, and provide a positive experience for the patient.
• When encountering a difficult vein for blood collection, knowing when to stop and hand it over to appropriate personnel is a sound professional decision, not a failure.
• Always adhere to hospital or healthcare facility regulations regarding the maximum number of needle sticks to ensure the safety and quality of blood collection for testing.

Safety notes for blood collection

Prioritize experienced personnel for pediatric blood collection

• Young children are often anxious, afraid, or uncooperative during venous blood collection, making identification and venipuncture more difficult.
• When possible, experienced healthcare professionals trained in pediatric care or pediatric blood collection should perform the procedure.
• A gentle approach, appropriate for a child's psychology, will help reduce stress, limit sudden movements, and increase the success rate of blood collection.

Proper disposal of medical waste

• All instruments and materials contaminated with blood, such as needles, syringes, gauze, or blood collection tubes, must be sorted and disposed of according to regulations for infectious medical waste.
• Needles and other sharps must be immediately placed in a puncture-resistant sharps container after use to reduce the risk of occupational accidents.
• Adhering to proper waste disposal procedures helps protect healthcare workers, patients, and the environment.

Do not reuse single-use materials

• Blood collection needles and other single-use materials must never be reused under any circumstances.
• For each blood collection for testing, a new sterile kit must be used to prevent cross-contamination and ensure patient safety.
• Adhering to this principle is a basic requirement in infection control and contributes to improving the quality of the hidden vein blood collection process as well as all other medical procedures.

References

1. Clinical and Laboratory Standards Institute (CLSI). Collection of Diagnostic Venous Blood Specimens. CLSI Standard GP41. Wayne, PA: Clinical and Laboratory Standards Institute.
2. World Health Organization. WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy. Geneva: World Health Organization.
3. World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. Geneva: World Health Organization.
4. Centers for Disease Control and Prevention. Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Atlanta, GA: Centers for Disease Control and Prevention.
5. Centers for Disease Control and Prevention. Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program. Atlanta, GA: Centers for Disease Control and Prevention.
6. Infusion Nurses Society. Infusion Therapy Standards of Practice. Journal of Infusion Nursing.
7. Lippincott Williams & Wilkins. Lippincott Procedures: Venipuncture and Specimen Collection. Philadelphia, PA: Lippincott Williams & Wilkins.
8. McCall, R. E., & Tankersley, C. M. Phlebotomy Essentials. Philadelphia, PA: Wolters Kluwer.
9. Garza, D., & Becan-McBride, K. Phlebotomy Handbook: Blood Specimen Collection from Basic to Advanced. Pearson Education.
10. Ernst, D. J. Applied Phlebotomy. Center for Phlebotomy Education.
11. Ernst, D. J. Blood Specimen Collection FAQs. Center for Phlebotomy Education.
12. The Joint Commission. National Patient Safety Goals for Hospitals. Oakbrook Terrace, IL: The Joint Commission.
13. British Committee for Standards in Haematology (BCSH). Guidelines on Venepuncture and Blood Sample Collection. British Journal of Haematology.
14. American Society for Clinical Pathology (ASCP). Phlebotomy Technician Study Guide and Procedure Manual. Chicago, IL: American Society for Clinical Pathology.
15. Agency for Healthcare Research and Quality (AHRQ). Patient Safety Network: Blood Specimen Collection and Patient Identification. Rockville, MD: Agency for Healthcare Research and Quality.

Content edited by: Rene Lee Nguyen.

Information consulted and verified by expert: Michael Anderson.