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How to Perform a Venesection, Detailing Vein Selection
and Patient Care
V3.0
05.02.13
Table of Contents
1. Introduction ................................................................................................................... 3 2. Purpose of this Policy ................................................................................................... 3 3. Scope ........................................................................................................................... 3 4. Definitions / Glossary .................................................................................................... 3 5. Ownership and Responsibilities .................................................................................... 3 5.1. Role of the Nominated Director ............................................................................. 3 5.2. Role of the Managers ............................................................................................ 3 5.7. Role of Individual Staff ........................................................................................... 3 6. Standards and Practice ................................................................................................ 4 6.2. VENESECTION PROCEDURE ............................................................................. 4 7. Dissemination and Implementation ............................................................................... 6 8. Monitoring compliance and effectiveness ..................................................................... 6 9. Updating and Review.................................................................................................... 7 10. Equality and Diversity................................................................................................ 7 10.2. Equality Impact Assessment .............................................................................. 7 Appendix 1. Governance Information .................................................................................. 8 Appendix 2.Initial Equality Impact Assessment Screening Form ....................................... 10 How to Perform a Venesection, Detailing Vein Selection and Patient Care
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1. Introduction
1.1. Venesection is a clinical procedure commonly performed in the Haematology setting.
A therapeutic venesection is the removal of a volume of blood as a treatment for certain
blood disorders.
1.2. This version supersedes any previous versions of this document.
2. Purpose of this Policy
This policy outlines the minimum standard expected from clinical staff who perform
venesection as part of their duties within Haematology. The primary purpose of this policy
is to ensure that practice is safe and based on best possible evidence.
3. Scope
This policy applies to all clinical staff regardless of grade or profession who undertake
venesection within Haematology. This includes permanent, temporary, locum and bank
health care staff working in both clinical outpatient and inpatient areas.
4. Definitions / Glossary
Therapeutic Venesection - the removal of a volume of blood as a treatment for certain
blood disorders.
5. Ownership and Responsibilities
5.1. Role of the Nominated Director
The Nominated Director is responsible for authorising final approval of the Document.
5.2. Role of the Managers
5.3. Senior Clinical staff have overall clinical responsibility over patients.
5.4. Consultants and/or The Clinical Nurse Specialist will ensure that the procedure is
performed as clinically required and a valid prescription is available.
5.5. Nurse Managers are responsible for ensuring Healthcare staff undertaking
venesection are appropriately trained and assessed.
5.6. Nurse Managers must ensure this policy is available to clinical staff performing
venesection and that appropriate equipment is available.
5.7. Role of Individual Staff
All staff members who perform venesection are responsible for ensuring that:

They are competent, within their scope of professional practice, to safely and
competently carry out the procedure.

They abide by this policy.
How to Perform a Venesection, Detailing Vein Selection and Patient Care
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6. Standards and Practice
6.1. The Policy and Procedure (See below) support proper preparation of the patient and
aim to ensure safe practice and high quality patient care.

The skill must be performed in accordance with RCHT policies and procedures,
guidelines and protocols.
Staff must have access to policies and procedures via the document library.
There is education and support in place to enable to staff to attain competency
in the skill.


6.2. VENESECTION PROCEDURE
Equipment
1. Valid prescription with the patient’s name, date of birth, hospital number, amount to
venesected and doctor’s signature
2. Non-sterile low protein powder free latex gloves
3. Apron
4. Local anaesthetic spray or local anaesthetic cream if required.
5. Tourniquet
6. Cotton wool balls
7. Venesection pack with integral needle and no anticoagulant in bag
8. Tape
9. 10cm cling bandage
10. Intravenous fluid giving set, cannula and replacement fluid, if required.
11. Spring balance to weigh the bag of blood
12. Chloraprep
Procedure
ACTION
RATIONAL
E
1.
Explain the procedure to the patient
So that the patient understands
what will happen and informed
verbal consent can be obtained
2.
Lie the patient on a bed or couch and
make them comfortable
This is in case the patient’s
blood pressure drops during the
procedure
3.
Take the patient’s blood pressure and
record it on a TPR sheet and the
patient’s nursing notes, clearly,
accurately and legibly.
This is to establish a base line
blood pressure pre-procedure.
The doctor should be told of any
abnormal readings before the
procedure begins. It is also so
that the information is available
for future reference.
4.
Apply tourniquet and ensure arterial
flow is not compromised
5.
Select a large palpable vein, avoiding
any well used areas if at all possible.
Negotiate with the patient a mutually
acceptable site. Remove the tourniquet
To get the best flow of blood
possible, avoiding areas of scar
tissue. Patients who have
repeated procedures often know
How to Perform a Venesection, Detailing Vein Selection and Patient Care
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until just prior to venepuncture
which veins are the best to use.
To promote comfort for the
patient.
IF THERE DOES NOT APPEAR TO BE A SUITABLE VEIN, PLEASE SEE THE NOTE AT THE
END OF THE PROCEDURE
6.
Local anaesthetic cream may be
prescribed and applied prior to
venesection to give anaesthesia.
To ensure the patient’s comfort
at the time of the procedure
If the patient has regular venesections
this could be applied while they are
waiting to see the doctor
7.
If any replacement fluid has been
prescribed if should be started now,
slowly through a cannula in the
opposite arm.
To minimise any drop in blood
pressure or reaction to lowered
blood volume in the patient
8.
Apply tourniquet. Clean the site
according to RCHT Asceptic
Technique Guidelines.
To avoid introducing infection
with the needle puncture
9.
The integral needle is used to puncture
the vein and secured with tape. A flow
is established by positioning the bag on
the scales. The higher the bag is, the
slower the flow. The bag must never be
placed higher than the needle
To establish a flow of blood from
the vein into the collection bag
while the patient remains
comfortable
If the blood is flowing too quickly release
The tourniquet, if it is flowing too slowly
Increase the pressure to obtain a faster
flow, making sure this does not cause the
patient discomfort or impede the radial
pulse. The flow may also be helped if
the patient opens and closes their fist.
10.
When the specified amount of blood has
been venesected, release tourniquet.
The needle is removed while the
puncture site is covered with a cotton
wool ball and pressed firmly until the
bleeding stops, before being bandaged
firmly. When the replacement fluid has
been completed, the cannula should be
removed according to Trust policy
To terminate the venesection
safely and prevent further
haemorrhaging
11.
When the procedure has been
completed the patient rests to
recover for 20 minutes or until they
feel able to go. A drink should be
given to them during this time
To allow the body to recover
from the change in blood
volume
12
After checking the patient’s blood
pressure on the opposite arm to the
To check that there has not been
a drop in the patient’s blood
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venesection puncture, the patient is
helped off the bed or couch, and if there
are no apparent problems they may
leave. Any abnormalities should be
reported to a doctor immediately
and the patient should be seen by
the doctor.
pressure. To prevent
haemorrhage from the needle
puncture site
To minimise any potential
complications
The blood pressure reading is
Recorded clearly, accurately and legibly
in the patient’s nursing notes and on the
TPR chart
13.
When the patient leaves they should be
advised to contact the unit if they are
worried or have any problems following
this procedure
To give the patient a point of
contact should they experience
any problems following this
procedure
NB:
Some patients have veins which are too small for the needle attached to the donor bag. In this a
case a butterfly needle (19g or 21g) may be used with syringes to draw off the required amount.
Any small amounts of replacement fluid prescribed may also be given slowly this way, amounts
over 50ml should be given via the IV infusion. Other parts of the procedure should be carried out
as stated above.
The amount of venesected blood should be weighed for accuracy. 100mls of blood weighs
109gms.
7. Dissemination and Implementation
7.1. This policy will be available on the document library when it has been ratified.
7.2. All staff have access to this document.
7.3. The nurse in charge of the clinical area will be responsible for ensuring the
practitioner has been suitably trained before delegating this task.
8. Monitoring compliance and effectiveness
Element to be
monitored
Lead
Tool
Frequency
Reporting
arrangements
Acting on
recommendations
and Lead(s)
Change in
practice and
lessons to be
shared
Compliance with procedure
Headland managers and Haematology CNS
Staff training records and documentation
Compliance should be audited annually.
Report will be used to identify gaps in staff training and the results fed
back to staff to reinforce good practice.
The Headland managers and Haematology CNS will be responsible
for implementing any actions or changes recommended to improve the
service.
The Headland managers and Haematology CNS will be responsible
for implementing any actions or changes recommended to improve the
service.
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9. Updating and Review
9.1. This document will be reviewed every three years
9.2. Revisions can be made ahead of the review date is necessary
10. Equality and Diversity
10.1. This document complies with the Royal Cornwall Hospitals NHS Trust service
Equality and Diversity statement.
10.2. Equality Impact Assessment
10.3. The Initial Equality Impact Assessment Screening Form is at Appendix 2.
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Appendix 1. Governance Information
Document Title
How to perform a venesection, detailing vein
selection and patient care.
Date Issued/Approved:
February 2013
Date Valid From:
February 2013
Date for Review:
February 2016
Directorate / Department responsible
(author/owner):
Sarah Caskey Headland Manager
Caroline Edwards Haematology CNS
Contact details:
01872 258095 / 253239
Brief summary of contents
Defines safe practice with regard to
performing venesection.
Suggested Keywords:
Venesection
RCHT

Target Audience
PCT
CFT
Executive Director responsible for
Policy:
Director for Nursing
Date revised:
February 2013
This document replaces (exact title of
previous version):
How to perform a venesection, detailing vein
selection and patient care.
Renewal of existing document. No
consultation required as no changes to
existing policy.
Approval route (names of
committees)/consultation:
Divisional Manager confirming
approval processes
Diagnostics Therapeutics and Cancer
Name and Post Title of additional
signatories
Not Required
Signature of Executive Director giving
approval
Publication Location (refer to Policy
on Policies – Approvals and
Ratification):
{Original Copy Signed}
Internet & Intranet
 Intranet Only
Document Library Folder/Sub Folder
Clinical / Nursing Generic
Links to key external standards
None
Related Documents:
None
Training Need Identified?
No
Version Control Table
How to Perform a Venesection, Detailing Vein Selection and Patient Care
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Date
Versio
n No
Summary of Changes
Changes Made by
(Name and Job Title)
Oct 2000
1
Initial Issue
?
June
2010
2
Updated to comply with trust documentation
policy
Sarah Caskey
Caz edwards
Feb 2013
3
Format updated to comply with Trust
documentation policy
Sarah Caskey
Caz edwards
All or part of this document can be released under the Freedom of Information
Act 2000
This document is to be retained for 10 years from the date of expiry.
This document is only valid on the day of printing
Controlled Document
This document has been created following the Royal Cornwall Hospitals NHS Trust
Policy on Document Production. It should not be altered in any way without the
express permission of the author or their Line Manager.
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Appendix 2.Initial Equality Impact Assessment Screening Form
Name of service, strategy, policy or project (hereafter referred to as policy) to be
assessed: How to Perform a Venesection, Detailing Vein Selection and Patient Care
Directorate and service area:
Is this a new or existing Procedure?
Diagnostics Therapeutics and Cancer
Existing
Name of individual completing
Telephone: 01872 253239
assessment: Caroline Edwards
1. Policy Aim*
To ensure patient safety and best practice when performing
venesection.
2. Policy Objectives*
To ensure patient safety and best practice when performing
venesection.
3. Policy – intended
Outcomes*
Staff are competent to perform venesection and patients are
not put at risk.
4. How will you measure
the outcome?
By auditing practice.
5. Who is intended to
benefit from the Policy?
Patients and staff involved with venesection.
6a. Is consultation
required with the
workforce, equality
groups, local interest
groups etc. around this
policy?
No
b. If yes, have these
groups been consulted?
c. Please list any groups
who have been consulted
about this procedure.
*Please see Glossary
7. The Impact
Please complete the following table using ticks. You should refer to the EA guidance notes
for areas of possible impact and also the Glossary if needed.



Where you think that the policy could have a positive impact on any of the equality
group(s) like promoting equality and equal opportunities or improving relations
within equality groups, tick the ‘Positive impact’ box.
Where you think that the policy could have a negative impact on any of the equality
group(s) i.e. it could disadvantage them, tick the ‘Negative impact’ box.
Where you think that the policy has no impact on any of the equality group(s) listed
below i.e. it has no effect currently on equality groups, tick the ‘No impact’ box.
How to Perform a Venesection, Detailing Vein Selection and Patient Care
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Equality
Group
Age
Positive
Impact
Negative
Impact
No
Impact
x
Disability
x
Religion or
belief
x
Gender
x
Transgender
x
Pregnancy/
Maternity
Race
x
Sexual
Orientation
x
Marriage / Civil
Partnership
x
Reasons for decision
Procedure will be performed if
clinically indicated.
x
You will need to continue to a full Equality Impact Assessment if the following have
been highlighted:
 A negative impact and
 No consultation (this excludes any policies which have been identified as not
requiring consultation).
8. If there is no evidence that the policy
promotes equality, equal opportunities
or improved relations - could it be
adapted so that it does? How?
Full statement of commitment to policy of
equal opportunities is included in the policy
Please sign and date this form.
Keep one copy and send a copy to Matron, Equality, Diversity and Human Rights,
c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Chyvean
House, Penventinnie Lane, Truro, Cornwall, TR1 3LJ
A summary of the results will be published on the Trust’s web site.
Signed ____Caroline Edwards____________________________________
Date _________________________________________
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