WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy

Annex A: Methods and evidence base
A1 Consultation with experts and scope of recommendations
In April 2008, the <strong>WHO</strong> Injection Safety programme – which is part of the Department
of Essential Health Technologies (EHT) at <strong>WHO</strong> Headquarters in Geneva – convened a
consultation on best practices for phlebotomy and blood collection. The consultation included
special categories such as arterial blood sampling, capillary blood sampling and paediatric blood
collection.
A working group was convened, comprising international experts and colleagues from <strong>WHO</strong>
departments involved in infection control and safety of health-care practices.
The specific objectives of the consultation were to:
• review the first draft of this document, which had been developed in response to clinical
questions and a suggested scope developed by SIGN in consultation with other <strong>WHO</strong>
experts and the Centres for Disease Control and Prevention;
• identify critical steps in phlebotomy procedure as a basis for making recommendations.
The focus of the consultation was primarily on the needs of developing and transitional
countries, in which injection safety programmes are not yet well developed or in which quality
systems are lacking. The consultation identified the need for guidelines on best phlebotomy
practices in policy and organizational issues, and in technical and scientific aspects of blood
collection.
Recommendations of the working group
Content of guidelines
<strong>Guidelines</strong> should include information on the importance of:
• safe practices in phlebotomy;
• an uninterrupted supply of single-use devices in situations where safetyengineered
devices are unaffordable;
• training in phlebotomy, to avoid adverse effects to the patient and the
health worker, and blood samples of poor quality.
Evidence base
Recommendations should be evidence based.
Consistency and flexibility
Recommendations should be designed to:
• promote a consistent approach to ensuring phlebotomy safety and
quality of blood drawn;
• be sufficiently flexible to allow for variations in device selection and
training curricula.
Annex A: Methods and evidence base 65