LTC blood draws

old rural nurse, RN · Jun 21, 2004

In our facility, we do all our own veinipunctures, we include the training during our nurse orientation. However, if no one in your facility has experience drawing that can train the others, I would insist that the lab provide hands-on training for your staff. (I wouldn't want to be the guinea pig for the nurse's first stick without it) It is similar to starting an IV but you need practice changing tubes etc to avoid loosing the vein, hurting the resident or ruining the tube. Hope this helps! :)

purplemania, BSN, RN · Jun 21, 2004

you also need to know the proper order in which to draw blood so that the chemicals in one tube do not ruin the specimen in the next tube. Some things (Ca) have to be on ice. There are several items to be covered. I think the video would be helpful, but would make it an accessory to the teaching, not the whole thing. You need hands on teaching. Maybe a nurse or lab tech from another facility can come teach???

Destinystar · Jun 21, 2004

like dont ltc nurses have enough to do??? why the sudden change?? is this a way to cut costs???? :crying2: (that is how i would take the news)

the lab our facility contracts with has decided that the nurses will now be doing most of the blood draws. this encompasses both rn's and lpn's. most of us have been "certified" in venipuncture procedures. we will be learning how to do blood draws by "watching a video". no real-human-teaching involved. this makes me a bit unconfortable. what do you think about this...and what does your facility do?

armyrn · Jun 21, 2004

during school i worked as a tech and all i did was drive to different LTC facilities and draw blood. i was way overpaid and the work was really easy. the different additives in the tubes are the hardest thing to learn, and you can ref that if you need to. most nurses should be able to do this anyway. is the change driven by your workplace, or the lab? the lab i used to work for no longer employs its own road techs (too expensive).

kids · Jun 21, 2004

The LTCs in my area started having the nurses do the blood draws not long after OBRA came into affect (97?-98?). The reason being that Medicare pays for very few things over the daily rate and having someone come out and draw the blood is not one of them.

At the last facility I worked at (in 1997) the lab employed Phlebotomist came to the facility early (almost every M-F) morning to do the draws and was there about 2 hours, it cost the facility $1000. If we needed an draw done at a time other than the scheduled M-F draws it cost $200 if it was 9-5, outside of those hours it was $350 to have the lab send a Phlebotomist to draw it.

That is a LOT of money to not be reimbursable.

armyrn · Jun 21, 2004

The LTCs in my area started having the nurses do the blood draws not long after OBRA came into affect (97?-98?). The reason being that Medicare pays for very few things over the daily rate and having someone come out and draw the blood is not one of them.
At the last facility I worked at (in 1997) the lab employed Phlebotomist came to the facility early (almost every M-F) morning to do the draws and was there about 2 hours, it cost the facility $1000. If we needed an draw done at a time other than the scheduled M-F draws it cost $200 if it was 9-5, outside of those hours it was $350 to have the lab send a Phlebotomist to draw it.
That is a LOT of money to not be reimbursable.

i left my position in 98, when i graduated. those amounts sound about right. for after hours i got about 50 bucks just to do the draw, not bad for a little drive and 10 minutes of work.

donmomofnine · Jun 21, 2004

We have a lab that comes in Tues. and Thurs. to skilled nursing and for any time stats as well. They are on our campus on Wednesdays in independent living so we can always catch them on Weds. too. We pay for it! My nurses have enough to do.

gomernurse · Jun 22, 2004

Thanks to all for your input. Certainly makes sense to ME to have a bit of human instruction instead of a one time video. Guess I'll have to start a little rabble-rousing.