What influence does experience play in heel prick blood sampling?

The objective of this study was to investigate the role of ‘experience’ in performing the heel prick test. Babies (n = 340) were randomly allocated to be tested with either the Tenderfoot or Genie Lancet heel prick device. Testing was conducted by nine midwives (n = 4, experienced, more than 20 years qualified) who performed the heel prick procedure routinely and rotational midwives (n = 5, less experienced, 4–8 years qualified) who only performed the heel prick procedure when working in the community. Test technique outcomes investigated included (1) cleaning of heel, (2) babies position, (3) feeding at test, (4) use of soothing words. Other test outcomes (1) quality of the blood sample, (2) number of heel pricks required to take sample, (3) blood flow, (4) presence of bruising (5) time taken to collect sample, (6) time squeezing the heel and (7) time baby cried were also studied. The experienced midwives were more likely to hold the baby during testing but less likely to clean the infants heel prior to the incision. The experienced midwives collected a better quality sample, in less time and required fewer heel pricks than the less experienced midwifery group.