Vein Puncture – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Vein Puncture
Definition of Vein Puncture:
In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of intravenous therapy or for blood sampling of venous blood. In healthcare, this procedure is performed by medical laboratory scientists, medical practitioners,
Purposes of Vein Puncture:
1. To administer fluids intravenously.
2. To administer bolus medication for investigations or treatment.
3. To draw blood specimen.
4. To administer total parenteral nutrition.
5. To administer blood and blood products.
General Rules of Vein Puncture Technique:
- No vein puncture performed in close proximity to an infected wound.
- Veins over an area of joint flexing are not practical and should be avoided.
- Vein in an injured extremity or where there is a cast, tight dressing or bandages must not be used.
- Veins located in sensitive areas such as the inner wrist are only used as a last resort.
- Veins of the lower extremities are not used in adult patient because of the higher risk of deep vein thrombosis.
- The location should be allowing as much freedom as possible to the patient.
- Remember always to use the most distal part of the vein, which accepts the chosen catheter of IV therapy.
- This will preserve the more proximal sites for subsequent vein puncture.
Procedure of Vein Puncture Process:
A. Articles need for vein puncture:
1. Sterile needle / angiocath/butterfly needle of appropriate size.
2. Sterile cotton swabs in a bowl with antiseptic/alcohol pads.
3. Tourniquet.
4. Tapes for fixing catheter /needle.
5. Syringe of required size for blood draws (optional).
6. Specimen bottle (optional).
7. Syringe loaded with medicine (optional).
8. Infusion made ready for administration.
9. Towel/mackintosh for protecting linen.
10. Gloves.
11. IV pole.
12. K tray /paper bag.
B. Procedure:
1. Make sure all necessary equipment is easily accessible check/label all injection / infusion to be given.
2. Prepare / assemble equipment, flash IV tubing to remove air (priming).
3. Explain is sample terms the procedure to the patient and make patient comfortable.
Position patient extremity for comfort and visibility of veins.
4. Be we at ease and appear confident. If we fail, it is recommended not to perform more than two failed attempts of venous puncture, it happens to everybody now and then, and more important that we ask for help.
5. Choose the vein according to the needs.
6. Trim hair over proposed site with scissors.
7. Wash hands thoroughly wear productive gloves. Remember the gloves will not protect
us against needle stick injuries, only our technique will do that.
8. Cleanse site with antiseptic solution using friction, in circular motion from center to periphery. Allow drying.
9. Be careful not to contaminate site again, disinfect finger / gloves, if palpation is felt necessary, after skin preparation is done.
10. Apply tourniquet or blood pressure cuff, check if pulse present. Perform vein puncture. Enter the skin gently with a needle in dominant hand, bevel side up at 20 to 30 degree angle and when the needle is through the skin lower needle until it is nearly parallel to the skin.
Figure: shows some steps of Venipuncture process
11. Look for blood return through the tubing of butterfly needle or flash back chamber.
12. Quickly remove protective cap from the tubing and apply pressure distally to prevent blood from flowing out and attach tubing to the catheter or needle.
13. Start the flow of solution promptly by releasing the clamp on the tubing.
14. Loop the tubing near the site of entry and anchor with tape to prevent pull.
15. Write data, time of placement of IV line, size of the needle and nurse initial, near insertion site/ nurses record.
16. Record in nurses’ notes, type of fluid, insertion sites, flow rate, size and type of catheter or needle and time infusion have begun. Note response of IV fluid amount infused according to agency policy.
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