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Clinical governance

Venepuncture is one of the most commonly performed invasive procedures in the NHS and is now routinely undertaken by nurses. In order to perform venepuncture safely, the nurse must have basic knowledge of the following:
  • the relevant anatomy and physiology
  • the criteria for choosing both the vein and the device to use
  • the problems that may be encountered, how to prevent them and necessary interventions
  • the health and safety and the risk management of the procedure, as well as the correct disposal of equipment (RCN 2017b).
Certain principles, such as adherence to an aseptic technique, must be applied throughout (see Chapter c04: Infection prevention and control). The circulation is a closed, sterile system and a venepuncture, however quickly completed, is a breach of this system, providing a means of entry for bacteria.
Nurses must be aware of the physical and psychological comfort of the patient (Hoeltke [88]). They must appreciate the value of adequate explanation and simple measures to prevent the complications of venepuncture, such as haematoma formation, when it is neither a natural nor acceptable consequence of the procedure (Hoeltke [88]).

Risk management

The number of litigation cases within the healthcare environment has increased in recent years (Garza and Becan‐McBride [66]). It is therefore vital that nurses receive accredited and appropriate training, supervision and assessment by an experienced member of staff (RCN 2017a). The nurse is then accountable and responsible for ensuring that skills and competence are maintained and knowledge is kept up to date, in order to fulfil the criteria set out in The Code (NMC [165]).
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