Supervised practice: 1 2 3 Date: Performance Criteria Professional A/NA A/NA A/NA Comments – responsibilities Obtains medical order for blood tests ( if required) Maintains confidentiality Obtains consent Performance Criteria Knowledge A/NA A/NA A/NA Comments – Identifies and manages risk to self, patient and the environment Verbalises an understanding of the anatomy & physiology of the circulation and veins Verbalises the indications and contraindications for venepuncture Verbalises the complications of venepuncture Demonstration of ANTT principles for venepuncture Performance Criteria Preparation A/NA A/NA A/NA Comments – Patient reassurance, education and information given Acknowledges request form if required Check the patient’s ID Chooses a suitable vein Performance Criteria Technique A/NA A/NA A/NA Comments – Prepares self (PPE) and patient Complies with ANTT Identifies the appropriate method of collection Demonstrates correct venepuncture technique Collects blood in correct order of draw Observes for potential side effects during venepuncture Successful venepuncture Supervision outcomes A/NA A/NA A/NA Comments Supervisor rating of the venepuncture: Supervisor’s name: Designation: Supervisor’s signature: *A = achieved, NA = Not achieved
Supervised practice: 1 2 3 Date: Performance Criteria – Professional responsibilities A/NA A/NA A/NA Comments Obtains medical order for blood tests ( if required) Maintains confidentiality Obtains consent Performance Criteria – Knowledge A/NA A/NA A/NA Comments Identifies and manages risk to self, patient and the environment Verbalises an understanding of the anatomy & physiology of the circulation and veins Verbalises the indications and contraindications for venepuncture Verbalises the complications of venepuncture Demonstration of ANTT principles for venepuncture Performance Criteria – Preparation A/NA A/NA A/NA Comments Patient reassurance, education and information given Acknowledges request form if required Check the patient’s ID Chooses a suitable vein Performance Criteria – Technique A/NA A/NA A/NA Comments Prepares self (PPE) and patient Complies with ANTT Identifies the appropriate method of collection Demonstrates correct venepuncture technique Collects blood in correct order of draw Observes for potential side effects during venepuncture Successful venepuncture Supervision outcomes A/NA A/NA A/NA Comments Supervisor rating of the venepuncture: Supervisor’s name: Designation: Supervisor’s signature: *A = achieved, NA = Not achieved
100f-2b%20Venepuncture_Part_B.docx