Pediatrics is an intricate sector of healthcare that requires significant care for children as the most vulnerable group globally. Accordingly, challenges in pediatric care are experienced in phlebotomy, a medical connotation for drawing blood specimens from patients (Thompso, 2018). Piazza et al. (2019) provided that invasive procedures could induce psychological or physical pain, causing avoidance or non-compliance to healthcare. Children and their parents or guardians express needles as a predominant source of fear and concern in such procedures (Piazza et al., 2019). Therefore, it is essential in medical care that comfort management and effective phlebotomy practices are employed to reduce the potential risk of pain or complications. Medical personnel must possess the necessary skills of reciprocity, intersubjectivity, and multidisciplinary integration to manage such situations for effective patient care. Using the phlebotomy of a 6-year-old, Micah from the Nalder family provides a video of the procedure (The Nalder Family, 2017). The video formed a basis for a case analysis and presentation of essential features of the process.
Patient comfort in phlebotomy is vital in patient care, especially for a child. Consequently, medical professionals employ comfort techniques under medical procedures for success (Piazza et al., 2019). Accordingly, the phlebotomist conducted a set of actions that created a sense of control for the boy throughout the procedure. The phlebotomist reassured the boy that nothing would be done without him knowing it, as she would inform him at every step (The Nalder Family, 2017). She then exposed the items used to draw blood, handing the boy the rubber strip tied around the boy’s arm. As seen in the procedure, the boy actively interacted with the band, which may reassure them it was harmless. Moreover, control was elicited by offering choices, asking for preferred choices between a band-aid or tape, and later asking for consent to use the silver band-aid from a set of different choices (The Nalder Family, 2017). These attributes present a psychological state of calming the patient as a primary function.
Establishing comfort is both physical and psychological, offering higher chances of phlebotomy success. According to McCall (2020), the appropriate positioning of the patient’s arm is an effective requirement in phlebotomy, enhancing comfort. Therefore, during the procedure, the phlebotomist was keen to evaluate the patient’s comfort, positioned the boy’s arm, and asked him to sit toward the edge of the seat for comfort (The Nalder Family, 2017). She employed questions that ascertain the patient’s knowledge of the tools she would use, which can offer an essential awareness of the child’s perception of them, whether distressed or not. She reiterated that the rubber band should not pinch the boy and should be snug, and the patient highlighted discomfort. The physical comfort was managed by questioning and subsequent adjustments until the boy was satisfied (The Nalder Family, 2017). The techniques were employed with ease and contributed to successful phlebotomy.
Furthermore, the phlebotomist consistently communicated throughout the procedure, explaining what she would do at every step and giving her reasons. Asking for consent was a vital tool to elicit comfort from patients, ensuring the patient was aware of what was happening (Thompson, 2018). Before the invasive action, she demonstrates the effect of tying the rubber around the arm to expose the veins. Moreover, a countdown was used as an interactive mechanism to help the boy and debunked fear by informing him that the needle was harmless, even used on babies (The Nalder Family, 2017). The contrast helped the boy create a positive environment without worrying if babies use similar needles.
Aside from comfort, patient safety is also crucial in pediatric processes to avoid complications such as contamination of patients and the medical practitioner. Blood-borne disease transmission is a potential risk under phlebotomy and would require a practitioner to exercise caution (Titare et al., 2022). Right from the start, she began the procedure by disinfecting her hand and wearing a pair of gloves, and further decontaminating the finger that will be in contact with the child’s skin during the phlebotomy (The Nalder Family, 2017). According to Titare et al. (2022), the approach is necessary as the phlebotomist may have touched surfaces with pathogens. The facts were explained to the boy, who was instructed not to touch the drawing area when cleaned.
Furthermore, the boy was instructed on the consequences of jerking their arm, highlighting that the action may affect both of them. However, an essential part at that point was that the phlebotomist did not recuse the potential of the patient being nervous; instead, the boy was informed that they could push their elbow down. Finally, a fundamental approach was praise when the boy completed the task, a mechanism employed by both the parent and the phlebotomist (The Nalder Family, 2017). Its application may be perceived as a potential tool to reinforce the child’s comfort. According to Thompson (2018), praise is an effective mechanism to focus on the positive outcomes of a medical procedure that helps manage the perception of both the patient and the parent. Progressively, praise enhances a child’s willingness to participate in medical practices in the future.
Conclusively, the aggregation of the phlebotomist’s control of the procedure presented a benchmark for effective medical care that enhances continued trust in healthcare. The central takeaway should be establishing a calm, relaxed environment in which the child is constantly interactive and aware of each step, backed with reasons. Thus, pediatric care is presented as a simple procedure but requires concise approaches integral to successful outcomes. Emphasis is required on professionals’ possession of skills in the multidimensional approaches to child care, employing skills that manage anxieties, misconceptions, and potential fears from children and their parents or guardians.
References
McCall, R. (2020, July 7). Phlebotomy Essentials, Enhanced Edition (7th ed.). Jones & Bartlett Learning.
Piazza, J., Merkel, S., Neusius, H., Murphy, S., Gargaro, J., Rothberg, B., & Kullgren, K. A. (2019). It’s Not Just a Needlestick: Exploring Phlebotomists’ Knowledge, Training, and Use of Comfort Measures in Pediatric Care to Improve the Patient Experience. The Journal of Applied Laboratory Medicine, 3(5), 847–856. Web.
The Nalder Family. (2017). Micah gets his blood drawn by the best phlebotomist ever! Video]. YouTube. Web.
Thompson, R. H. (2018). The Handbook of Child Life: A Guide for Pediatric Psychosocial Care (1st ed.). Charles C Thomas Pub Ltd.
Titare, U. R., Sharma, R. A., Ghanwate, N., & Saurkar, P. (2022, April 19). Early Detection of Blood Borne Pathogens and its Antibiotic Susceptibility. International Journal of Health Sciences and Research, 12(4), 246–257. Web.