Which of the following criteria is acceptable in determining the quality of a peripheral blood smear?

Choice A reason:
An alcohol-based hand rub is generally used for hand hygiene when the hands are not visibly soiled. It is effective against many types of microbes but is not the best option for hands that are visibly dirty or contaminated with proteinaceous materials, such as blood or body fluids. The CDC recommends washing hands with soap and water in these situations.

Choice B reason:
Sterile water rinse alone is not sufficient for cleaning hands that are visibly soiled. While sterile water can be used to rinse off debris, it does not have the cleaning or antimicrobial properties necessary to properly decontaminate the hands.

Choice C reason:
Soap and water are the recommended decontamination agents when hands are visibly soiled with blood or body fluids. The physical action of handwashing, combined with the detergent properties of soap, effectively removes soil and transient microorganisms. The CDC guidelines specifically state that hands should be washed with soap and water when they are visibly dirty or contaminated with proteinaceous materia.

Choice D reason:
An alcohol rinse, similar to an alcohol-based hand rub, is not adequate for cleaning visibly soiled hands. Alcohol is a disinfectant that is effective against many germs when used on clean hands but does not remove visible dirt or organic material well.

Choice A Reason:
Wrapping the site with a heel warmer for 30 minutes is a preparatory step before the heel stick procedure. It is used to increase blood flow to the area to make the collection easier. However, it is not the action to take after the blood has been collected. The heel warmer should be removed before performing the heel stick.

Choice B Reason:
Wiping away the first drop of blood is the correct procedure. The initial drop may be contaminated with tissue fluids or alcohol if the site was cleaned prior to the stick, which can affect the accuracy of the test results. Therefore, the first drop should be wiped away, and subsequent blood should be used for the PKU test.

Choice C Reason:
Keeping a pressure dressing on the site for the entire day is not necessary and is not part of the standard heel stick procedure. After the blood is collected, a small bandage is typically applied to stop any bleeding. The site should be monitored for a short time for any signs of continued bleeding or bruising, but a pressure dressing for the day is excessive.

Choice D Reason:
Targeting the central arch area of the foot for the heel stick is incorrect and can be harmful. The recommended area for a heel stick is the lateral portions of the heel to minimize discomfort and avoid injury to the bone or nerves. The central arch area should be avoided to prevent potential harm.