Understanding both sides of the blood draw: The experience of the pediatric patient and the phlebotomist

Julie R. Piazza, Michigan Medicine, University of Michigan Health SystemFollow
Sandra Merkel, Michigan Medicine University of Michigan Health System, RetiredFollow
Brooke Rothberg, Michigan Medicine, University of Michigan Health SystemFollow
Joan Gargaro, Michigan Medicine, University of Michigan Health SystemFollow
Kristin Kullgren, Michigan Medicine, C.S. Mott Children's Hospital, University of Michigan Health SystemFollow

Abstract

A phlebotomist’s words and actions play a crucial role in success of a blood draw and in providing a supportive patient experience. This study examined use of comfort measures during a pediatric blood draw. The phlebotomist’s use of soft words, positioning, distraction, coaching/support were observed with sixty children between 3-14 years of age during a blood draw. The level of fear /anxiety before and during the blood draw was recorded by an RA. The child’s level of fear/anxiety was observed and reported by the parent/caregiver after the procedure. Comfort measures provided by phlebotomists, the parent/caregiver’s report of their child’s usual response, and the parent’s level of fear with needles were compared. Comfort measures were offered inconsistently across age groups. Distraction was the most frequent measure (85%), followed by coaching/support (72%). Positioning was used more often with younger children (42%) than with older children (7%). Despite the high use of comfort measures, many children (56%) had levels of 2-4 fear/anxiety. The parent/caregiver often predicted their child’s level of fear/anxiety. Phlebotomists can benefit from interdisciplinary collaboration opportunities and developmentally appropriate education, including comfort measures, to mitigate patients’ pain and fear. Given the importance of creating a positive patient-family centered environment, introductions, and interactions to build a trusting rapport are crucial. Additionally, this research highlighted the importance of self-advocacy by pediatric patients and families. When providers ask and listen, and children are brave enough to share their voice...the human experience will improve on all sides.

Experience Framework

This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

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Recommended Citation

Piazza JR, Merkel S, Rothberg B, Gargaro J, Kullgren K. Understanding both sides of the blood draw: The experience of the pediatric patient and the phlebotomist. Patient Experience Journal. 2022; 9(1):35-45. doi: 10.35680/2372-0247.1601.