KMB 001

HIGH SCHOOL OF HEALTH SCIENCE (STIKES)

Hospital BAPTIS KEDIRI

Type of Skill : Venous Blood Collection

No. Revision :2
Student Name : Yosi Eka Damayanti ________________
Study Program / NIM : Bachelor Degree___/ 01.2.17.00631_____
Level / Semester : III (Three)________/ VI (Six)__________
Date / Time : April, 1 2020_____/ 08:00____________
Place of Practice : Emergency room___________________

* Scale
NO COMPONENT
(0,1,2,3)
I Tools preparation :
1 Vacuntainer and needle
2 Examination tube
3 Alcohol swab
4 Dry Gauze
5 Clean hand shirts
6 Tray
7 Bending / safety box
8 Torniquet
II Pre-interaction stage:
1 Order verification
2 Nurse's self preparation
3 Prepare a tool
4 Prepare the environment: Keep client privacy closed
III Orientation phase:
1 Bring tools and identify patients (call names, ask names, read TT cards, read patient bracelets)
2 Give a therapeutic greeting
3 Clarification of contracts when awarding positions
4 Explain the purpose and procedure of positioning
5 Give clients the opportunity to ask questions
6 Prepare tools near the client
IV Work stage:
1 Check doctor's orders / instructions on the type of laboratory tests needed and prepare laboratory
requests.
2 Washing hands
3 Prepare equipment
4 Adjust the patient's position
5 Wear clean t-shirts.
6 Place the base on the area of the hand where the blood sample will be taken.
7 Select the distal side of the vein used.
8 Place the patient's arm in a comfortable position so that the officer is free when performing the
action.
9 Place the tourniquet 5-15 cm above the venous puncture site
10 Choose veins that are well dilated, encourage the patient to grasp.
11 Disinfection of venous veins with alcohol from the inside outward approximately 5 cm in
diameter.
12 Remove the needle cap from the syringe or vacuntainer and inform the patient that the patient will
feel pain.
13 Place the thumb or index finger of the non-dominant hand 2.5 cm below the insertion place and
pull the skin towards the officer.
14 Hold the syringe / needle at an angle of 15-30 degrees from the patient's arm with the base /
pinhole facing up.
15 Gently insert the needle into the vein.
16 Mount the specimen tube into the needle holder.
17 Pay attention to the flow of blood into the syringe / tube.
18 Take blood samples according to the expected amount
19 Release the torniquet
 * Scale
NO COMPONENT
(0,1,2,3)
20 Remove the needle from the vein and place the dry gauze over the side of the venous puncture
without applying pressure using the other hand, pulling the needle by striking straight back from
the side of the venous puncture.
21 Apply pressure by using dry gauze at the insertion place ± 1 minute.
22 Discard the needle in the safety box
23 Take off your shirt
24 Cover the former location of the plaster
25 Attach the patient's identity label to each tube and confirm to the patient to make sure the blood
sample taken is in accordance with the patient's identity.
26 Tell the patient that the procedure is finished
27 Tidy up the equipment
28 Washing hands
29 Send blood samples to the laboratory.
V Termination stage:
1 Evaluate client responses
2 Summarize the results of the activity
3 Giving an impression
4 Contract time, place, topic / next activity
VI Document:
1 Blood test
2 Clinical condition
3 Client response
VII Attitude:
1 Therapeutic communication
2 Maintain working principles
3 Work carefully and carefully
4 Work systematically
VIII Cognitive:
1 The purpose of taking venous blood
2 Indication of changes in patient position
3 Vigilance of nurses

1. Rating table
Sub value Final score
Step Step (Weight x Total value x 100
Weight Score
Score) Maximum Score (30)

I Preparation of tools and

1
environments
II Pre-reaction Stage 1
III Orientation Stage 1
IV Work Stage 3
V Termination Phase 1
VI Documentation 1
VII Attitude 1
VIII Cognitive 1
Total value

2. Value Conversion
A : > 80
AB : 75-79,9
B : 70-74,9
BC : 65-69,9
C : 55-64,9
Results: Pass / Not pass
*cross the unnecessary ones
Guidance note:

Kediri, April 1 2020

Advisor / Examiner:

( ________________________)