Preventing Pediatric Redraws

Distraction Products Offer Ways to Avoid Costly Blood Draw Errors

The pre-venipuncture distress of a pediatric patient isn’t just a problem for phlebotomists – it can create problems downstream and at the administrative level.

Why? Having to perform a redraw due to a compromised or inadequate sample is an added expense that adds up – fast.

In an economic analysis published by Robert J. Latino, CEO, Reliability Center, Inc., a single ER at a 225-bed acute care hospital was found to have conducted 10,013 redraws annually at an average cost of $300 – totaling for an annual cost over $3 million. 1

Numerous variables can complicate the process to obtain a blood sample. Ask any phlebotomist – a routinely simple blood draw is by no means guaranteed. Certain categories of patients make venipuncture especially difficult. Critical care patients undergo more frequent testing and often complicate finding an adequate draw site. A collapsed vein is a temporary condition typically encountered during draws on elderly patients that limit sample sizes to an amount rarely adequate enough for testing.

Then there are pediatric patients.

Children, by nature, present a unique challenge for phlebotomists. Though the anticipation of pain is enough to raise the anxiety level of any patient, higher levels of pre-venipuncture distress are common in children. Seeing the needle before the procedure or even hearing other children having blood drawn in another room is enough to get a child anxious. Add in the unfamiliarity of the phlebotomist to the child and it’s easy to understand why venipuncture has been reported as being the most feared aspect of attending a hospital for a child. 2

Simple distractions can help ease the anxieties of needle-phobic children and reduce the chances of obtaining an inadequate or compromised sample. Distraction techniques should be performed with the goal of eliminating procedural and visual cues said Dennis Ernst, Executive Director of the Center for Phlebotomy Education. In a 2011 interview with CAP TODAY, Ernst explained the effectiveness of distraction techniques when drawing from pediatric patients.

“Television and movies do the best job, and that’s been confirmed in the literature. Another form of distraction that will work but is not as effective is to have a parent or assistant distract the child with a stuffed animal or some kind of toy or bubbles, or charts they can look at on the wall to pick out a sticker and get them pointed in a direction other than the line of sight of the person drawing blood,” said Ernst. 3

Having the parent present – or at least within close vicinity of their child – may not be as comforting as it would seem. Watching their son or daughter undergo a pain-inducing procedure may cause anxiety for the parent, which can easily translate to the patient and exacerbate the situation.

More and more phlebotomists are turning to products that have bright colors and recognizable figures, shapes or animals, to assist in comforting a child.

In the interview, Ernst even suggested specific products, designed with the purpose of not only taking children’s attention away from the needle, but also producing sensations that actually mask the pain of venipuncture.

This class of products – designed to aid in distraction techniques – has the potential to not only improve the quality of care given to children during blood draw procedures, but also to help phlebotomists obtain the samples they need and facilities avoid the expenses of redraw.