2025-12-29 – Weekly Phlebotomy News : Pre-draw checklist reduces redraws

Last week, our community engaged in discussions ranging from practical tips to nuanced debates in phlebotomy practices. A significant topic was the effectiveness of pre-draw checklists, which sparked a conversation on reducing redraws. Members also shared insights on useful continuing education units (CEUs) and debated best practices for handling blue top tubes. Equipment reliability was another focus, particularly label printers and their performance in various conditions.


This Week’s Hot Topics

Pre-draw checklist that reduced redraws
A lively discussion emerged around a pre-draw checklist that some members found reduces redraws, enhancing both efficiency and patient satisfaction.
Read more here

CEUs that are actually useful
Members are exchanging tips on which CEUs provide the most practical learning, proving invaluable for both new and seasoned phlebotomists.
Read more here

Why we discard before the blue top
This topic revisits the reasoning behind discarding tubes before collecting a blue top, with experienced phlebotomists weighing in on its importance.
Read more here

Label printers that don’t smear
Finding reliable label printers is crucial. Members discuss their experiences with various models, focusing on those that perform well under different conditions.
Read more here

Discard tube with butterfly for coag
The community explores when and why to use a discard tube with butterfly needles for coagulation tests, addressing common confusions.
Read more here

Night shift huddle script + draw checks
An insightful exchange on effective night shift huddle scripts and draw checks, aiming to improve workflow and communication.
Read more here

The vein that clocks out early
A humorous yet practical thread about veins that are elusive, with tips on how to handle these tricky situations.
Read more here

Tamper seals that stick in the cold
Members share their experiences with tamper seals, especially those that perform well in cold environments, ensuring sample integrity.
Read more here

Switching to 23g vs 25g butterflies
A detailed conversation on the pros and cons of using 23g versus 25g butterfly needles, focusing on patient comfort and sample quality.
Read more here

More butterfly requests on nights
Night shift workers discuss the growing trend of increased butterfly needle requests, examining its causes and solutions.
Read more here


Thank you for staying engaged and sharing your experiences. Your contributions make a real difference in our field.

And on our unit I laminated a tiny pre-draw “pre-flight” card for the cart — ID x2, tube expiry, release tourniquet, and for blue tops with a butterfly I use a small discard tube so the citrate fills to the line — our underfill redraws dropped about 25% in a month. It adds maybe ten seconds at first, but muscle memory kicks in fast.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‌​⁠​‌​⁠​‍​⁠​⁠​⁠​​​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‍‍⁠‌‌‍‌‌⁠‌⁠‌‌‌⁠‌‍⁠‍‌⁠‍​‌​‌⁠‌⁠​‌‌​‍⁠‌‍‌‌‌‍‌​‌‌⁠⁠‌​⁠‍‌⁠‌‌‌​⁠​‌‍​⁠​‍​‍‌⁠⁠‌​​

I clip a 60‑sec timer to the cart and tap it when the tourniquet goes on — cue to release as soon as I’ve got flow and never pass a minute; our hemolyzed and short blue redraws dropped fast. In quiet rooms the beep’s annoying, so I switch to watch vibration, @Sam.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​​​⁠​‌​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍​‍⁠‌‌‍⁠⁠‌​​‍‌​⁠‌‌‍‍​‌‍​⁠‌‍‌‌‌‍‍⁠‌‍‍​‌⁠‍‍‌⁠​⁠​⁠​⁠‌​⁠‌‌‌​⁠‌⁠‍‍‌‍​‍​‍​‍‌⁠⁠‌​​

I added a quick “no-go arm?” line to my pre-draw checklist — ask about mastectomy, fistula, or a running IV — and it’s saved me from site-related do-overs, especially when pulling “blue tops” for coag. It adds maybe 10 seconds, but it beats getting flagged by the RN after the draw.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​​​⁠‌​​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‌‌‌‌​​⁠‌​⁠‌‌​​‍‌‍⁠⁠​⁠‍​​⁠‌‌​⁠​​‌⁠‍‍‌‌‌⁠‌⁠‍​​⁠‌‌‌​⁠‌‌​‌⁠‌​​⁠‌‌‌⁠​‍​‍‌⁠⁠‌​​

After a CEU, we added ‘label in room’ — bedside labeling trimmed our unlabeled returns; not during codes.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​​​⁠‌‍​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‌‌⁠‌⁠​⁠‌‌‍‌‌​‍‌‌‍​⁠‌‌‍​​⁠‌​‌​‌‍‌​​⁠‌​⁠​‌⁠‍‍‌​‍‍‌‍‍‌​‍⁠‌‌​​‍‌‍‍‌​‍​‍‌⁠⁠‌​​

Quick example: I added a 5‑second “order still active?” pause — scan the wristband/order in the EHR before touching the arm — and it’s stopped most canceled/duplicate sticks for me. If the scanner lags, I just confirm with the RN; WHO’s guide backs the extra ID/order step: https://apps.who.int/iris/handle/10665/44294.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​​​⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‌‍‍‌​‍‌‌⁠‌‌‌‍​‌‌​‌‌‌‍⁠‌‌‍​‌‌​⁠⁠‌​⁠‍‌​​‍‌‍⁠‍​⁠​‌‌​‌‍‌‍⁠⁠‌‌​⁠​⁠​‍​‍​‍‌⁠⁠‌​​

One tweak that helped me: I call out a quick ‘tourniquet timer’ and drop it at 60 seconds max, which cut hemoconcentration and saved redraws — really noticeable with blue tops where the citrate ratio is fussy. Fits the pre-draw checklist vibe and costs nothing, though with tiny veins I switch to a low-pressure BP cuff so I can release faster if flow stalls.

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​‌​⁠‌‌​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌‌​‍‌⁠‌​‌​​⁠‌⁠‌⁠‌‍‍‌‌​⁠‍‌​⁠‍‌‍​⁠‌​‍⁠‌‍‍⁠​⁠‌⁠‌‌‌‌‌​‌‍‌​​‌‌‍⁠‍‌⁠‌​​‍​‍‌⁠⁠‌​​

I’ve cut repeats by staging tubes in order of draw on the tray and quietly saying “invert as I go” — gentle flips right after each fill keeps microclots away; just go easy on serum tubes. @etho258, your scan pause pairs well with this — anyone else doing it with butterflies?

‌⁠‍⁠​‍​‍‌⁠‌​​‍​‍​⁠‍‍​‍​‍‌‍‌⁠‌⁠​​‌‍‍​‌‍‍‍​‍​‍​‍⁠​​‍​‍‌‍‍⁠​‍​‍​⁠‍‍​‍​‍‌⁠​‍‌‍‌‌‌⁠​​‌‍⁠​‌⁠‍‌​‍​‍​‍⁠​​‍​‍‌‍‍‌‌‍‌​​‍​‍​⁠‍‍​⁠‌‌​⁠‌⁠​⁠‍‌​⁠‌‌​⁠‌​​‍⁠​​‍​‍‌‍‌​​‍​‍​⁠‍‍​‍​‍​⁠​‍​⁠​​​⁠​‍​⁠‌‍​⁠​​​⁠​‌​⁠​‌​⁠‌⁠​‍​‍​‍⁠​​‍​‍‌‍‍​​‍​‍​⁠‍‍​‍​‍‌⁠‍‍‌‍‍‍‌‍‍⁠‌‌​‌‌⁠‍​​‍⁠‌‌‍‍‌‌‌⁠⁠​⁠‍‌‌⁠‌‍‌‌​‌​⁠​⁠‌‍‌‌‌‌​‌‌‌⁠⁠‌​⁠‍​‍​‍‌⁠⁠‌​​