The Principles of Infection Prevention and Control — NOCN Vocationally-Related Qualification Nursing & Healthcare Revision
This subtopic covers the core principles of infection prevention and control essential for safe phlebotomy practice. It addresses roles and responsibilitie
Topic Synopsis
This subtopic covers the core principles of infection prevention and control essential for safe phlebotomy practice. It addresses roles and responsibilities under legislation such as the Health and Safety at Work Act, the application of standard precautions, risk assessment for blood collection procedures, and the correct use of PPE and hand hygiene to minimise the transmission of healthcare-associated infections.
Key Concepts & Core Principles
- Venepuncture technique: The correct angle of insertion (15-30 degrees), bevel-up position, and anchoring of the vein to prevent rolling.
- Order of draw: The sequence in which blood collection tubes are filled to avoid cross-contamination of additives (e.g., blood culture first, then citrate, serum, heparin, EDTA, fluoride).
- Anatomy of arm veins: The median cubital, cephalic, and basilic veins are preferred sites; avoid areas with scarring, haematoma, or intravenous lines.
- Infection control: Hand hygiene, use of gloves, skin disinfection with 70% alcohol wipes, and proper disposal of sharps into a UN-approved sharps bin.
- Patient identification: Use at least three identifiers (name, date of birth, NHS number) and check against the request form to prevent mislabelling.
Exam Tips & Revision Strategies
- In written responses, always link theory to practical phlebotomy examples. For instance, when discussing the chain of infection, mention how a tourniquet can act as a vehicle for cross-contamination.
- During practical assessments, verbalise your actions as you perform them, especially when demonstrating hand hygiene steps, glove usage, and waste disposal, to prove your underpinning knowledge.
- When answering questions on procedures, use the phrase ‘in accordance with local policies’ to show awareness that procedures may vary, but always refer back to national legislation and evidence-based guidelines such as NICE or the HSE.
- For risk assessment questions, structure your answer using the five steps: identify hazards, decide who might be harmed and how, evaluate risks and precautions, record findings, and review.
- In written assessments, always reference specific legislation or national guidelines by name (e.g., 'The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections') to demonstrate depth of knowledge.
- When answering scenario-based questions, systematically address: risk assessment, choice of controls (hierarchy), PPE rationale, hygiene measures, safe sharps management, and waste disposal.
- For observed practical assessments, verbalise your actions as you perform them, explaining infection control decisions such as hand hygiene moments or glove change to show underpinning knowledge.
- Link theory to practice by citing examples from your own workplace experience, ensuring you maintain confidentiality.
Common Misconceptions & Mistakes to Avoid
- Confusing the disposal routes for different types of waste: placing non-contaminated items in orange clinical waste bags or sharps in general waste.
- Applying hand gel immediately before an invasive procedure without performing a hand wash, failing to recognise that gel is not sufficient in some situations (e.g., when hands are visibly soiled).
- Reciting legislation without linking it specifically to phlebotomy practice, such as failing to mention how COSHH relates to the use of disinfectants.
- Overlooking the importance of pre-procedure skin decontamination, assuming that glove use alone is sufficient to prevent infection at the puncture site.
- Not recognising that risk assessments are dynamic; forgetting to reassess after a spillage or if the patient’s condition changes during the procedure.
- Assuming that wearing gloves replaces the need for hand hygiene; many fail to perform hand hygiene before donning gloves or after removal.
Examiner Marking Points
- Award credit for clearly outlining the learner’s own responsibilities and those of others (e.g., employer, colleagues) in infection prevention, referencing specific phlebotomy scenarios.
- Credit must be given when the learner accurately identifies and explains key legislation and policies, such as COSHH, RIDDOR, and local infection control policies, and their relevance to phlebotomy.
- Learner evidence must demonstrate understanding of the chain of infection and the systems/procedures (e.g., sharps management, waste segregation, decontamination) used to break it, with specific application to venipuncture.
- In risk assessment tasks, award credit for identifying hazards in phlebotomy (e.g., needlestick injury, blood spillage) and evaluating control measures using a recognised risk assessment model.
- Practical evidence must show correct selection and use of PPE appropriate to the task (e.g., gloves, apron) and the learner must explain the rationale for each item.
- Credit for personal hygiene must include demonstration of effective hand washing technique, knowledge of when to perform hand hygiene (e.g., WHO '5 Moments'), and the importance of maintaining neat attire and short nails.
- Award credit for clearly explaining the phlebotomist's specific responsibilities under the Health and Safety at Work Act 1974 and the Control of Substances Hazardous to Health (COSHH) Regulations when managing blood and sharps.
- Expect candidates to demonstrate the ability to conduct a dynamic risk assessment prior to venepuncture, identifying hazards such as patient condition, environmental contamination, and availability of safety devices.