Blood Withdrawal from Intravenous Catheters by ED Nurses: Comparison of Two Practices

ABSTRACT PROBLEM: Laboratory tests are essential to diagnosis and treatment in the emergency department, but they can result in prolonged waiting times for patients, multiple needle pricks, and complaints about pain and discomfort. The goal of this project is to assess if a change in the blood collection process will lead to any improvement and benefit in care delivered with regard to time, patient comfort, and cost.

A feasibility study was conducted to evaluate the change in practice from cost, time, and applicability perspectives. Using an observational approach, data were collected about the management of a possible change in practice in the emergency department at American University of Beirut Medical Center. Trials of 2 proposed changes to practice were conducted and compared with the current practice. The nurses were trained in the proper use of blood withdrawal using a Vacutainer Luer adaptor.

It was shown that intravenous line insertion and blood collection processes using the Vacutainer Luer adaptor were conducted in 46.2 seconds, which is less time spent than the current process but requires a small investment.

Allowing registered nurses to withdraw blood with the start of a peripheral intravenous line will significantly reduce length of stay and costs and enhance patient experience in the emergency department at American University of Beirut Medical Center.