It's Not Just a Needlestick: Exploring Phlebotomists' Knowledge, Training, and Use of Comfort Measures in Pediatric Care to Improve the Patient Experience

Abstract

Background Blood draws are a routine element of the pediatric patient experience. They are also associated with the greatest fear and pain for a child. Because of the limited literature regarding phlebotomists' knowledge, experience, training, or stress related to their use of comfort techniques during pediatric blood draws, this study explored current practices and training methods. Phlebotomist training tends to focus on clinical technique rather than pediatric or patient comfort support. The study includes aims to develop a measurement for phlebotomists' use of comfort techniques for pediatric blood draws. Method Focus groups of parent advocates (n = 24) and pediatric phlebotomists (n = 11) reviewed the survey questionnaire, and it was revised before being e-mailed to hospital system phlebotomists (n = 128). Results Almost half of the sample group lacked training in child development. The most frequently used comfort measures were words of explanation and reassurance, positioning of the child, and distraction. Requesting child life specialist support and using pain management devices or topical anesthetics were used less often. Primary challenges to performing pediatric blood draws were anxious patients and parents. Conclusion Phlebotomists' use of available comfort measures occurs infrequently. Including child development and comfort techniques in training programs is essential to providing pediatric patients with a more satisfactory experience.

Effects of Virtual Reality Education on Procedural Pain and Anxiety During Venipuncture in Children: A Randomized Clinical Trial

“…Appropriate pain management is considered the most critical factor for parental satisfaction ( 30 ). Furthermore, venipuncture in children is a fairly challenging and stressful task for phlebotomists ( 31 , 32 ). When performing needle-related procedures with anxious children (or parents), they report experiencing a high level of stress ( 31 ).…”

Nurses’ Experiences of Blood Sample Collection from Children: A Qualitative Study from Swedish Paediatric Hospital Care

“…Our results also highlighted challenges in coping with parents, children with special needs and the nurses' own self-con dence during the procedure. An American study investigating phlebotomist experiences (33) described anxious patients and parents as a primary problem in relation to several aspects of blood sampling in children. Parents can often unwittingly transfer their own fears and anxiety to their children, something nurses must often be well-prepared to manage.…”

Integrating anthropometric and cardiometabolic health methods in stress, early experiences, and development (SEED) science

“…It is especially helpful to work with phlebotomists who have experience with pediatric populations both for the comfort of the child and for the ease of the blood draw. A recent study found that almost half of phlebotomists surveyed lacked training in child development (Piazza et al, 2018), which can make it difficult to obtain a sample successfully. That same study found that the primary challenge to pediatric blood draws was anxiety in children and their parents (Piazza et al, 2018).…”

“…A recent study found that almost half of phlebotomists surveyed lacked training in child development (Piazza et al, 2018), which can make it difficult to obtain a sample successfully. That same study found that the primary challenge to pediatric blood draws was anxiety in children and their parents (Piazza et al, 2018). When conducting blood draws, it is best to schedule them in the morning as they often require fasting (e.g., 8 hr, water only).…”