Friends and Family Test
Results for June 2017
Thank you to the 2 people who completed the test during the month of June 2017
We asked you “What could we do better”
You suggested : Our response
I had a very good service and the waiting time is very good (10 minutes waiting for a blood test) and I booked an appointment with the doctor Thursday evening for Friday morning. But unfortunately I experienced a poor quality services with the phlebotomist. She didn't wash her hands prior and after taking bloods neither she cleaned my skin prior to insert the needle. She was not wearing and gloves and touched materials doors, computer palpate my vain and inserted the needle all with the same unwashed hands. This is quite dangerous and can lead to a serious spread of infections from patient to patient. And more this not follow the infections control policies at all. I would suggest to Improve quality of the procedures more than the waiting time.
We are very sorry to hear that you felt you received poor quality service from our phlebotomist and take infection control very seriously. We are committed to making improvements and have reviewed our policy on phlebotomy. This has been discussed with the phlebotomists. A copy of the policy is attached which deals specifically with the matters you raise about hand washing and cleaning the area where blood is being taken from.
How about a little music when one has to hang on for ages "in the queue" Hearing the same message over and over again gets a bit tedious and perhaps irritating. NB not complaining about hanging on - realise how busy you are.
We are constantly looking at ways to reach our patients about current issues. The telephone system is one way that we can inform and educate our patients about the services we provide and how to access healthcare. We recognise that the same message can become tedious or irritating so we have recently updated the telephone message with relevant and varied information which we will continue to do to add variety.
We really value positive comments as we use them to try to retain, where we can, what patients value most.
Please do complete the test for us in
Protocol for Blood taking for all Phlebotomist
This is also the standard operating procedure at St Georges Hospital
The phlebotomists will take blood samples from patients as they have completed the phlebotomy study day course.
The phlebotomists have been immunised against hepatitis B and have had a blood test to confirm immunity.( a copy of hepatitis B immunity to be retained by HR )
Make sure all samples from previous patients have been safely stored away and out of sight and are ready for dispatch , before new patient is called in.
Explain procedure to patient
Warn them that there may be a bruise.
Sit patient down with arm extended on pillow, apply tourniquet above elbow.
Be aware that patient may faint during or after the procedure.
If patients say that they faint then lie them down before taking the blood
Adequate hand washing is of course essential to maintain hygiene. Any broken skin on the hands of the clinician should be covered, and in these incidences glove wearing may be more pertinent
All Phlebotomist are advised and encouraged, to wash their hands frequently, and immediately if soiled, and must use Alcohol Gel to disinfect their hands after washing. Phlebotomists are also encouraged to use the hand barrier cream provided, as an added protection and to minimize the development of rashes and abrasions which can result from the wearing of disposable gloves and/or regular hand-washing.
Phlebotomists may use Alcohol Gel in between attending to patients, provided hands are visibly clean and free of any cuts, scratches, abrasions or other lesions and the patient is not a known infection risk.
Gel must be applied before attending to each patient. Hands must be washed thoroughly after every 5 patients attended to or sooner if soiled.
Prepare vacutainer / needles and blood bottles
Label the bottles and check that the blood form has been filled in.
If unsuccessful try again if possible and refer to walk in phlebotomy or rebook if necessary.
Be mindful of patients with additional needs ie patients with Dementia or learning disabilities and children who may needs Ametop cream before blood is taken.
All Phlebotomists are strongly advised and encouraged, but not compelled, to wear disposable laboratory/clinical latex free gloves provided they are using the ‘closed’ blood collection Vacutainer system and they have no cuts, scratches, abrasions or other lesions on their hands, and the patient is not a known infection risk.
However, Phlebotomists must wear gloves if they have cuts, scratches, abrasions or lesions on their hands, even if these are covered by dressings.
The purpose of wearing gloves is to protect the healthcare professional from contamination as opposed to protection of the patient. Gloves alone would not reduce or eradicate incidences of needle stick injuries, where the clinician may be placed at risk. Wearing a glove for venepuncture can make the procedure considerably more difficult, due to the reduced ability to palpate a suitable vein, and the reduction of general dexterity. It is with this in mind that some clinicians do not wear gloves for the sole procedure of venepuncture.
Phlebotomists must also wear gloves provided, when bleeding patients using ‘open’ blood collection methods such as a finger-prick using a sterile disposable lancet when a capillary blood collection is necessary. This system poses a much greater risk of contamination of the operator with blood.
Furthermore, phlebotomists must wear gloves provided when bleeding patients who are of known infection risk, irrespective of the method of blood collection.
Gloves must be changed immediately if soiled.
The Phlebotomist must change his or her gloves after each patient.
For cannulation there is a greater risk of contamination to the clinician and consequently gloves should be worn at all times.
Cleaning the area where blood is being taken from
There is some evidence to suggest that for simple venepuncture cleaning the skin with an alcohol or chlorhexidine wipe, removes bacteria that are normally present to keep pathogens at bay, and as a result therefore actually increases the risk for pathogenic bacteria to infect the area. There are occasions where cleaning the skin may be necessary e.g excessive dirt on the skin.
After taking the blood the phlebotomist should dispose of the needles/sharps of any kind into the sharp boxes which are either on the desk or by the sink.
After taking blood press with cotton wool ball over the puncture site until bleeding stops. Apply a plaster or tape.
Any policies that cover the procedure of venepuncture will indicate the necessity of glove wearing due to the risk of contamination to the clinician. However in incidences where that clinician may feel that glove wearing could be of detriment to their own safety, it is not of any risk to the patient in terms of infection if gloves are not worn. Therefore, a fully trained and experienced blood taker may choose not to wear them, at their own discretion. However; if a patient requests that gloves are worn; this request should be complied with. Adequate hand washing should remain essential if this is the case.
References: advice taken from St Georges microbiology team
MDU hand out
Updated: Sara Moloney June 5th 2017
Due review June 2019