Dear Center for Phlebotomy Education:

Some of my phlebotomy staff are placing a strip of tape on top of their glove so that hey can immediately put gauze and tape on the site after the draw. I checked your book, The Lab Draw Answer Book, but it doesn't mention anything about tape placement. Can you tell me what the most common practice is when it comes to using tape? Should I have them place on the tray, in their pocket, or on the back of their gloved hand? What should we do?

My response:

I've been answering phlebotomy questions for over twenty years, and this one has never been asked. But it's a good one. 

There isn't anything in the standards (or my book) about where to place the tape. But it makes sense to be concerned about the bacteria the tape is transferring to the patient's skin. If it's put on the phlebotomy tray, it's probably loaded. If it's put on the nitrile glove, it's probably one of the cleaner places they can put it.

One note of caution, though. If they need to have it that close, make sure the reason isn't that they want to expedite the post-venipuncture care step. According to the standards, they MUST be applying pressure (or have cooperative patients applying it, but not by bending the arm up), and they MUST remove the gauze and watch the site for at least 5-10 seconds before bandaging to make sure bleeding has stopped both superficially and subcutaneously. If they're rushing this step and not even observing the site (as a phlebotomist did on my blood draw last week), it can lead to hematoma and even a permanent nerve injury from the hematoma. (Rest assured I provided proper post-venipuncture care myself to prevent all that.) 

So make sure your staff knows post-venipuncture care cannot be rushed. For that reason, they don't really need to have the tape right there on their glove. It can be kept in the tray without even exposing the adhesive to anything.

I hope this helps.

Phlebotomy Supervisor

I would check with your institutions Infection Prevention specialists. My guess is that they would say placing the gauze on the glove is not acceptable practice. This is our policy where I work.

Karen Nelson, 05/03/2021 08:38:05