For those of you that have phlebotomy staff collecting your laboratory specimens:

Do you have a limit on the number of attempts each phlebotomist may make to collect a specimen?  If yes, what is the limit? 

Do you have a limit to the number of phlebotomists that may attempt to collect a specimen?  If yes, how many phlebs may try?

If you have limits and they are reached, what happens then?  Order from the physician to continue? Make it a nurse draw?  Make the physician put in a line?

Thanks for your help.

Our phlebs are limited to 2 tries. A second person also has 2 tries, but they are not supposed to attempt unless they think there is a reasonable chance they can get it - no blind poking in hopes they get lucky. If #2 strikes out, a third person can evaluate the situation and attempt. How many attempts is kind of determined at this point by how badly the specimen is needed. If the patient is in bad shape and its a test that is really important, the phleb or tech may try more than twice if they think they have a chance of getting it or the specimen may be collected arterially with physician consent. Other than that, it's a case by case decision. Sometimes we get cancellation orders, sometimes the patient needs hydrated before we try again, some patients get a line but that's not generally done just for lab draws. Thankfully we have some very experienced phlebs with exceptional skills so we don't have to deal with this very often.

2 tries followed by 2 tries . . . then it is up to the MD.  Used to be we had paramedics that would be called but they are no longer on the premises . . .

I don't remember any hard and fast rules but I know I always had a self imposed rule of 2 and done. If I missed twice (didn't happen often and usually not on the patients I would have predicted it) then I went for help. It seemed that was also the standard every where I worked even though I actually supervised phlebotomy at one location. They drew my donors as we'll.