The newly revised venipuncture standard released by the Clinical and Laboratory Standards Institute in April, 2017 is the most comprehensive revision in the document's history. With over 140 new mandates, facilities have a lot of changes to implement. This series discusses one or more substantive changes each month.

Before drawing every patient, there have always been mandatory questions to ask. "Can you tell me your full name?" for example.  "What is your birth date?" is another one. Asking patients "Do you have a latex allergy?" has also been required since 2003.

With the publication of the revised venipuncture standard last year, there are three new questions every patient must be asked. Additional questions now required by the standards include:

Can you spell your first and last name, please?---Requiring patients to spell any part of their name has never been a standards requirement until now, and for good reason. Too many patients have similar sounding names. Only by asking them to spell their first name can Helen Snyder escape being misidentified as Ellen Schneider, and thousands of others who share a phonetically similar names. The answer to this question must be stated by the patient or the patient's caregiver or family member if the patient is unable to provide it him/herself.

Can you state your birth date?---Whereas this question was optional in the past, it is now a mandatory request. 

Have you ever had problems getting your blood drawn?---This has always been a wise question to ask, but now it's required. The intent of this mandate is to encourage patients to reveal complications or special considerations the phlebotomist should be aware of. Complications of past draws that would be helpful to know might include nerve injury or involvement, tendency to bruise excessively and fainting. The standard now requires patients with a history of losing consciousness during a blood draw to be reclined during the procedure.

Special considerations that could come to light when asked this question might include mastectomy, needle phobia, difficult-to-locate veins, and the presence of fistulas or grafts that preclude sites for consideration.

Editor's note: Readers are urged to obtain their own copy of the standard as soon as possible and begin implementing all new provisions immediately. The document, Collection of Diagnostic Venous Blood Specimens (GP41-A7), is the standard to which all facilities will be held if a patient is injured during the procedure or suffers from the consequences of an improperly performed venipuncture. It can be obtained from CLSI or the Center for Phlebotomy Education, Inc.

Read an interview by CLP Magazine with Dennis J. Ernst MT(ASCP), NCPT(NCCT) about the revised standard.