specimen collection blood collection using capillary tube

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Republic of the Philippines
NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY
General Tinio, Cabanatuan City, Nueva Ecija
Clinical Learning Skills Laboratory
HEALTH ASSESSMENT (NCM 101)
CHECKLIST:
Collecting Blood using Capillary Tube
Name: ______________________________________________________________ Score:
Block: ________________________ Date:____________________________
PROCEDURE
Performed Comments
YES NO
ASSESSMENT
1. Assess:
• The frequency and type of testing
• The client’s understanding of the procedure
• The client’s response to previous testing
• The client’s skin at the puncture site, to determine if it
is intact and if the circulation is compromised
2. Determine:
• Assistive devices that will be required
• The client’s record for medications that may prolong
bleeding, such as anticoagulants
• Assistance required from other health care personnel
PLANNING
1. Assemble equipment and supplies:
• Capillary Tube
• Paper towel
• Antiseptic swab
• Disposable gloves
• Sterile lancet, or #19 or #21-gauge needle
• Lancet injector (optional)
IMPLEMENTATION
1. Explain to the client what you are going to do, why it is
necessary, and how he can cooperate.
2. Wash hands and observe other appropriate infection
control procedures.
3. Provide for client privacy.
4. Prepare the equipment.
Obtain a capillary tube and the lancet from the container and
place it on a clean, dry paper towel.

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Remarks:
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Rating Scale:
Excellent : 96 – 100%
Very Satisfactory : 90 – 95%
Very Good : 85 – 89%
Good : 80 – 84%
Fair : 75 – 79%
Poor : 74 and below
__________________________________________________
Student’s Printed Name and Signature
__________________________________________________
Skills Laboratory Instructor
Printed Name and Signature
5. Select and prepare the vascular puncture site.
Choose a vascular puncture site.
Clean the site with the antiseptic swab and allow to dry
completely.
6. Obtain in the blood specimen.
Put on gloves.
Place the injector, if used against the site, and release the
needle, thus permitting it to pierce the skin.
Or:
Prick the site with a lancet or needle, using a darting motion.
Wipe away the first drop of blood with a cotton ball.
Gently squeeze (but do not touch) the puncture site until a
large drop of blood forms.
Hold the capillary tube under the puncture site until enough
blood covers the tube.
Ask the client to apply pressure to the skin puncture site with
a cotton ball.
Dispose of the syringe and needle as a unit into an
appropriate sharps container.
Replace equipment and disinfects materials if needed
EVALUATION AND DOCUMENTATION
7. Send the specimen to the laboratory immediately along with
the laboratory order form
8. Put off gloves and perform hand hygiene
9. Document the procedure in the designated place and mark it
off on the Kardex
TOTA
L: