title: Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety.
abstract: BACKGROUND
  Complications resulting from venipuncture include vein and nerve damage, hematoma, and neuropathic pain. Although the basic procedures are understood, few analyses of actual data exist. It is important to improve the safety standards of this technique during venipuncture. This study aimed to obtain data on actual needle movement during vacuum venipuncture in order to develop appropriate educational procedures.
  
  
  METHODS
  Six experienced nurses were recruited to collect blood samples from 64 subjects. These procedures were recorded using a digital camera. Software was then used to track and analyze motion without the use of a marker in order to maintain the sterility of the needle. Movement along the X- and Y-axes during blood sampling was examined.
  
  
  RESULTS
  Approximately 2.5 cm of the needle was inserted into the body, of which 6 mm resulted from advancing or moving the needle following puncture. The mean calculated puncture angle was 15.2°. Given the hazards posed by attaching and removing the blood collection tube, as well as by manipulating the needle to fix its position, the needle became unstable whether it was fixed or not fixed.
  
  
  CONCLUSIONS
  This study examined venipuncture procedures and showed that the method was influenced by increased needle movement. Focusing on skills for puncturing the skin, inserting the needle into the vein, and changing hands while being conscious of needle-tip stability may be essential for improving the safety of venipuncture.
authors.affiliation: Faculty of Nursing and Medical Care, Keio University, Kanagawa, Japan. chieko@sfc.keio.ac.jp
authors.forename: Chieko
authors.initials: C
authors.lastname: Fujii
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009339:Needles; D016602:Needlestick Injuries / Q000209:etiology; D059348:Peripheral Nerve Injuries / Q000209:etiology; D018962:Phlebotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012307:Risk Factors; D012984:Software; D013647:Task Performance and Analysis; D014618:Vacuum; D057772:Vascular System Injuries / Q000209:etiology; D014680:Veins / Q000293:injuries; D014741:Video Recording
keywords: blood collection; clinical education; motion analysis; nerve damage; patient safety; puncture angle
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