I would like to know if evidence based practice suggests patients labs to be drawn peripherally when the patient has a PICC, CVC, or IVAD in place. What does the evidence show? Please site references if available and what is your hospital's practice?
Tracy RN CRNI VA-BC
Forum topic
Thu, 04/07/2016 - 14:54
#1
labs drawn peripherally if patient has central line
We provide education to the patient about the risks and benefits of using a central line for blood sampling and then once educated, we allow them to choose the method they prefer (unless using this method would be harmful to the patient, for example, having to stop a life sustaining infusion). Risks are a possible increase in infection due to more hub manipulation, as well as potentially shortening the life of the catheter, lining the inner lumen with fibrin, and getting erroneous lab values. INS Standards of Practice Standard 43, III, states to "carefully analyze risks versus benefits before deciding to use a VAD for obtaining blood samples." I would refer you to the whole section - too much for me to include here. There are eight references listed for this section of the standard.
Wendy Erickson RN
Eau Claire WI
Thank you for your response Wendy. I will review the references.
Thanks Wendy for referencing the 2016 INS standard on phlebotomy. That one was greatly expanded due to so much new information about this practice, yet all questions are still not completely answered. I like your approach to using a CVAD for blood sampling!! Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
thank you Lynn for your prompt response. I know it is a grey area. I was aware of the 2016 INS standard, but had not clearly reviewed the references. As I am doing so, it does seem to continue to be a grey area. Thank you for your input with your vast knowledge. I appreciate you.
Tracy