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Heel Stick Blood Sampling

  1. Perform hand hygiene and apply clean gloves.
  2. Verify the patient's identity using two patient identifiers in accordance with institutional policy.
  3. May warm the heel with a disposable heel warmer or moist warm cloth for 5 to 10 minutes prior to the procedure.
  4. Position the infant for comfort and administer sucrose per unit policy or other analgesics as ordered for pain.
  5. Clean the heel site with alcohol and allow to air dry.
  6. Restrain the infant's foot with nondominant hand.
  7. With dominant hand, place a spring-loaded automatic puncture device against the site with the blade slot securely against the heel. Make the puncture at a 90° angle or parallel to the length of the infant's foot.
  8. Completely depress the trigger on the puncture device with index finger using firm pressure.
  9. Remove the lancet and discard it in the sharps container.
  10. Wipe away the first drop of blood using dry sterile gauze or a cotton ball.
  11. Apply gentle pressure to the heel intermittently, using the thumb of the nondominant hand.
  12. Allow blood to flow into a pipette or microtainer tube while holding it at a 30° to 45° angle or onto a newborn screening form. Do not allow the collection device to scrape the puncture site.
  13. Mix the specimens in the tubes per manufacturer's recommendations.
  14. Apply pressure to puncture site with dry gauze or a cotton ball while positioning the foot above the infant's body.
  15. Apply a small adhesive bandage to the puncture site if needed.
  16. Label the specimens per institutional policy and prepare them for transport to the lab.
  17. Remove gloves and discard with supplies in proper trash receptacles. Perform hand hygiene.
  18. Complete the lab forms per institutional policy.
Document the procedure in the patient's record.