Emerging nursing techniques: venipuncture

Venipuncture is a medical function delegated to professional nurses in some states. Each nurse must ascertain if the state in which she practices considers this a legal nursing function, and if the institution in which she is employed permits nurses to perform venipunctures. Adequate instruction and supervised practice in the technique is mandatory before a nurse performs the procedure on a patient. Psychological and physical preparation of the patient is necessary prior to a venipuncture as it is usually attended by some degree of anxiety and some restriction of activity if an infusion is ordered. Knowledge of the location, structure, and characteristics of arteries and veins is essential for patient safety. Aberrant arteries increase the hazard of venipunctures. Recognition of pathologic conditions that would preclude the use of a vein or extremity for needle insertion is imperative. The best site for a venipuncture if an infusion is to be administered is in the forearm; the least desirable site is the foot and ankle. Thrombophlebitis invariably develops to some degree whenever a needle remains in a vein for many hours, but its severity increases when a foot or ankle vein is used. The patient receiving an infusion requires nursing care determined by his particular condition, his reaction to the therapy, and the degree of immobility effected by the presence of the needle in his vein. Frequent observation of the patient and the infusion setup is essential. Many hours of practice are needed before one feels confident in performing a venipuncture. Success is contingent upon the triad of skill, knowledge, and a sensitivity to the patient who is to receive the venipuncture.