Nursing strategies to minimize blood loss associated with phlebotomy.

Blood loss associated with phlebotomy is significant in critically ill adults. Iatrogenic anemia may result and impose unnecessary stress on the cardiovascular and respiratory systems and may require allogeneic blood transfusions. Many strategies exist under nursing's direct control to decrease blood loss associated with phlebotomy. In the past, nursing effectively implemented many of these strategies in patients at high risk of anemia, such as pediatric, neonatal, transplant, or chronic renal failure patients, as well as patients who are Jehovah's Witnesses. Implementation of these strategies are needed for all critically ill patients because allogeneic blood transfusions carry infectious risk and because complications and chronic critical illness cannot be predicted reliably. Incorporation of these strategies into daily practice as well as the development of blood conservation programs represent imminent challenges for nursing.