Blood collection poses significant risks, including infection and exposure to bloodborne pathogens. This concern extends particularly to laboratory staff and the individuals directly involved in sample collection.
Needlestick Injuries
A needlestick injury, or percutaneous sharps injury, occurs when a needle or other sharp object accidentally punctures the skin. These injuries can result in physical harm and significantly increase the risk of transmitting bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). In addition to physical injuries, needlestick incidents can also cause psychological stress among healthcare workers due to the fear of potential infections.
It is estimated that approximately 385,000 needlestick and other sharps-related injuries occur among hospital-based healthcare personnel each year¹. The most commonly reported causes of needlestick injuries are the unsafe disposal of needles and issues with the safety features of the needles.
For laboratory staff and others involved in sample processing, it is crucial to identify high-risk patients, particularly those known to carry bloodborne viruses like HIV and hepatitis. Appropriate precautions should be taken at the laboratory level to manage these cases safely.
It is also essential to promptly dispose of sharps, even those with hinged caps, to prevent accidental injuries. Knowing the whereabouts of sharps at all times is critical in reducing injury risks.
Using procedure trays to organise and safely handle equipment is highly beneficial. These trays keep necessary tools readily available and secure, thereby enhancing the overall safety of the blood collection process.
Reducing Risks to the Patient
When considering the patient’s risk during the blood collection procedure, various complications must be considered. These include:
- Haematoma: Risk of significant blood loss under the skin.
- Nerve damage: Potential for injury to surrounding nerves.
- Pain: Discomfort during and after the procedure.
- Infection: Risk of infection at the puncture site.
- Dizziness and lightheadedness: Due to nervousness or other factors.
- Overt bleeding: Excessive bleeding post-collection.
- Thrombosis: Potential for blood clot formation.
Risks to the Patient
For bleeding and thrombus formation, insert the needle at an angle parallel to the vein, ideally less than 30 degrees, to reduce the risk of puncturing through the vein and causing blood loss into the surrounding tissue. Following needle removal, applying pressure to the site is essential to minimise bleeding.
Stringent hand hygiene practices are necessary to prevent infection, including using disposable gloves to prevent cross-contamination. Thorough skin disinfection with an alcohol swab or similar device is crucial to sterilise the skin before needle insertion.
For syncope, reassure the patient and create a comfortable environment. Ensuring the operator is confident and proficient in performing the procedure is also key. The patient should also be well-hydrated and seated during the procedure to reduce the risk of fainting.
To address excessive bleeding, using a smaller diameter needle can help minimize the risk. Applying additional pressure at the puncture site post-collection is especially important for patients on anticoagulants or antiplatelet agents.