**Module 8: Blood Collection -- Finger Prick**

+----------------+-----------------------------------------------------+
| **Purpose**    | To provide the participants with necessary          |
|                | knowledge and skills to perform finger prick.       |
+----------------+-----------------------------------------------------+
| **P            | -   Module 6: Safety at the HIV Rapid Testing Site  |
| re-requisite** |                                                     |
|                | -   Module 7: Preparation for Testing -- Supplies & |
| **Modules**    |     Kits                                            |
+----------------+-----------------------------------------------------+
| **Module       | 2-2 ½ hours                                         |
| Time**         |                                                     |
+----------------+-----------------------------------------------------+
| **Learning     | At the end of this module, participants will be     |
| Objectives**   | able to:                                            |
|                |                                                     |
|                | -   Explain the preparation tasks required for      |
|                |     rapid tests                                     |
|                |                                                     |
|                | -   Put a client at ease while collecting blood     |
|                |                                                     |
|                | -   Collect blood from a finger prick accurately    |
|                |     and confidently                                 |
+----------------+-----------------------------------------------------+

**Module Overview**

+-----+-------+--------------+---------------------+-------------------+
| **  | **T   | **Activity/\ | **Content**         | **Resources\      |
| Ste | ime** | Method**     |                     | Needed**          |
| p** |       |              |                     |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 5 min | >            | Module introduction | Slides 1-3        |
| 1** |       | Presentation |                     |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 20    | > P          | Overview of initial | Slides 4-10;      |
| 2** | min   | resentation; | steps & finger      | video sections    |
|     |       | >            | prick procedures    | [Initial          |
|     |       | > Discussion |                     | S                 |
|     |       |              |                     | teps]{.underline} |
|     |       |              |                     | and [Finger       |
|     |       |              |                     | P                 |
|     |       |              |                     | rick]{.underline} |
+-----+-------+--------------+---------------------+-------------------+
| **  | 10    | > D          | Finger prick        | Slide 11          |
| 3** | min   | emonstration | procedures          |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 15    | > Role play  | Rehearsing          | Slide 12          |
| 4** | min   |              | finger-pricking a   |                   |
|     |       |              | client              |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 10    | > Practice   | Transfer pipette    | Slide 13          |
| 5** | min   |              |                     |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 60-85 | > Practice   | Finger prick        | Slide 14          |
| 6** | min   |              |                     |                   |
+-----+-------+--------------+---------------------+-------------------+
| **  | 5 min | > Q&A        | Summary             | Slide 15          |
| 7** |       |              |                     |                   |
+-----+-------+--------------+---------------------+-------------------+

**Material/Equipment Checklists**

-   PowerPoint slides or transparencies

-   Overhead projector or computer w/LCD projector

-   Prepared Flipchart -- content outline

-   Video and equipment to play the video

-   One-page job aid for finger prick

-   Assemble several packets of the materials and supplies required for
    finger prick. These packets will be used during for demonstration,
    role play, and hands-on practices.

-   Small containers of water to practice use of transfer pipette

**Teaching Guide**

+-----------------+-----------------------------------------------------+
| **Slide         | **Teaching Points**                                 |
| Number**        |                                                     |
+=================+=====================================================+
| **1**           | **[Module 8: Blood Collection - Finger              |
|                 | Prick]{.underline}**                                |
|                 |                                                     |
|                 | DISPLAY this slide before you begin the module.     |
|                 | Make sure participants are aware of the transition  |
|                 | into a new module.                                  |
+-----------------+-----------------------------------------------------+
| **2**           | **[Learning Objectives]{.underline}**               |
|                 |                                                     |
|                 | STATE the objectives on the slide.                  |
+-----------------+-----------------------------------------------------+
| **3**           | **[Content Overview]{.underline}**                  |
|                 |                                                     |
|                 | EXPLAIN the topics that will be covered in this     |
|                 | module.                                             |
+-----------------+-----------------------------------------------------+
| **F             | WRITE the content outline on a flipchart prior to   |
| lipchart**![](m | training.                                           |
| edia/image1.wmf |                                                     |
| ){width="0.8423 | REFER to it frequently to orient participants to    |
| 611111111111in" | where they are in the module.                       |
| height="0.84236 |                                                     |
| 11111111111in"} |                                                     |
+-----------------+-----------------------------------------------------+
| ![](m           | If the participants are [lab and health             |
| edia/image2.gif | workers]{.underline}, they may already be familiar  |
| ){width="0.4479 | with finger prick. In that case, acknowledge their  |
| 166666666667in" | skills, but emphasize that it is important for them |
| height="0.54166 | to learn and follow the accurate procedures for HIV |
| 66666666666in"} | rapid testing. Adapt the module according to their  |
| ***TIPS***      | skill level while making sure to teach the right    |
|                 | procedure. Ask them to comment on the new things    |
|                 | they have learned at the end of the module.         |
+-----------------+-----------------------------------------------------+
| ![](m           | CUE the videotape to the right place using the      |
| edia/image2.gif | counter readings below.                             |
| ){width="0.4479 |                                                     |
| 166666666667in" |   ----------------------------- ------------------  |
| height="0.54166 |   **Videotape Section**         **Counter           |
| 66666666666in"} |                                 Reading**           |
| ***TIPS***      |                                                     |
|                 |   Initial Steps                 05:50               |
|                 |                                                     |
|                 |   Finger Prick                  11:35               |
|                 |   ----------------------------- ------------------  |
|                 |                                                     |
|                 | If using the DVD format, select the desired section |
|                 | from the menu.                                      |
|                 |                                                     |
|                 | DISPLAY relevant slide both ***before*** and        |
|                 | ***after*** the video. It serves the following      |
|                 | purposes.                                           |
|                 |                                                     |
|                 | -   Before the video, it directs participants'      |
|                 |     attention to the key messages in the video.     |
|                 |                                                     |
|                 | -   After the video, you can use the questions on   |
|                 |     the slide to review key learning points.        |
+-----------------+-----------------------------------------------------+
| **4**           | **[Video: Initial Steps (Duration                   |
|                 | 5:45)]{.underline}**                                |
| ![](m           |                                                     |
| edia/image3.wmf | FOLLOW the procedure below:                         |
| ){width="0.5534 |                                                     |
| 722222222223in" | > INFORM participants that they are going to watch  |
| height="0.32638 | > a video about initial steps prior to performing   |
| 88888888889in"} | > any HIV rapid tests.                              |
|                 | >                                                   |
| ***Video***     | > READ the questions on the slide, which you expect |
|                 | > them to answer at the end of the video segment.   |
|                 | >                                                   |
|                 | > ENCOURAGE participants to take notes while        |
|                 | > watching the video.                               |
|                 | >                                                   |
|                 | > PLAY the video.                                   |
|                 | >                                                   |
|                 | > ANSWER any questions participants have.           |
|                 | >                                                   |
|                 | > DEBRIEF by asking participants to answer the      |
|                 | > questions on the slide.                           |
+-----------------+-----------------------------------------------------+
| **5**           | **[Video: Finger Prick (Duration                    |
|                 | 3:00)]{.underline}**                                |
| ![](m           |                                                     |
| edia/image3.wmf | FOLLOW the procedure below:                         |
| ){width="0.5534 |                                                     |
| 722222222223in" | > INFORM participants that they are going to watch  |
| height="0.32638 | > a video about the finger prick procedure.         |
| 88888888889in"} | >                                                   |
|                 | > READ the questions on the slide, which you expect |
| ***Video***     | > them to answer at the end of the video segment.   |
|                 | >                                                   |
|                 | > ENCOURAGE participants to take notes while        |
|                 | > watching the video.                               |
|                 | >                                                   |
|                 | > PLAY the video.                                   |
|                 | >                                                   |
|                 | > ANSWER any questions participants have.           |
|                 | >                                                   |
|                 | > DEBRIEF by asking participants to answer the      |
|                 | > questions on the slide.                           |
+-----------------+-----------------------------------------------------+
| **6**           | **[Pre-collection Safety Precautions]{.underline}** |
|                 |                                                     |
|                 | REMIND the participants to always follow universal  |
|                 | safety precautions to protect the client and the    |
|                 | tester, even though this step is not mentioned in   |
|                 | the video or the one-page job aid.                  |
|                 |                                                     |
|                 | -   Wash hands before and after testing each client |
|                 |                                                     |
|                 | -   Put on gloves before collecting blood           |
|                 |                                                     |
|                 | -   If blood is spilled, mop it up and disinfect    |
|                 |     the area immediately.                           |
+-----------------+-----------------------------------------------------+
| **Transition**  | REFER participants to the one-page finger prick job |
|                 | aid in their manual.                                |
|                 |                                                     |
|                 | INFORM participants that you are going to review    |
|                 | the finger prick procedure step by step before      |
|                 | demonstration.                                      |
+-----------------+-----------------------------------------------------+
| **7**           | **[Finger Prick -- Getting Started]{.underline}**   |
|                 |                                                     |
|                 | ARRANGE all supplies for finger prick on a front    |
|                 | table.                                              |
|                 |                                                     |
|                 | SHOW each item one by one.                          |
|                 |                                                     |
|                 | ASK participants to:                                |
|                 |                                                     |
|                 | -   Identify each item                              |
|                 |                                                     |
|                 | -   Explain what it is used for                     |
+-----------------+-----------------------------------------------------+
| **8**           | **[Finger Prick -- Finger                           |
|                 | Preparation]{.underline}**                          |
|                 |                                                     |
|                 | PROVIDE additional tips: before finger prick, the   |
|                 | tester should...                                    |
|                 |                                                     |
|                 | -   Explain to the client what you are going to do. |
|                 |     Tell them it will hurt slightly, just like a    |
|                 |     pin-prick.                                      |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Ask the client to rub his/her hands together to |
|                 |     improve blood circulation.                      |
|                 |                                                     |
|                 | -   Ask client to rest the hand on the table.       |
|                 |                                                     |
|                 | -   The pricker should hold the clients finger      |
|                 |     firmly to prevent client from pulling away      |
|                 |     during the prick                                |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
+-----------------+-----------------------------------------------------+
| **9**           | **[Finger Prick -- Collecting Blood]{.underline}**  |
|                 |                                                     |
|                 | EXPLAIN the steps on the slide as you build the     |
|                 | slide one step at a time.                           |
|                 |                                                     |
|                 | EMPHASIZE the importance of getting the first       |
|                 | finger prick right.                                 |
|                 |                                                     |
|                 | -   It is important to perform this procedure       |
|                 |     correctly to get sufficient blood; otherwise a  |
|                 |     failed prick will result in additional finger   |
|                 |     pricks.                                         |
|                 |                                                     |
|                 |     -   Applying pressure to the finger before the  |
|                 |         prick will result in better blood flow.     |
|                 |                                                     |
|                 |     -   The tester must not be afraid of hurting    |
|                 |         the client.                                 |
|                 |                                                     |
|                 | -   The more you have to repeat the finger prick,   |
|                 |     the more disturbing it is for the client.       |
|                 |                                                     |
|                 | -   PRICK WITH CONFIDENCE!!                         |
+-----------------+-----------------------------------------------------+
| **10**          | **[Finger Prick - Proper Disposal]{.underline}**    |
|                 |                                                     |
|                 | REMIND participants of the importance of using      |
|                 | proper containers to dispose of used lancets and    |
|                 | materials.                                          |
+-----------------+-----------------------------------------------------+
| **11**          | **[Instructor-led Demonstration]{.underline}**      |
|                 |                                                     |
| **              | DEMONSTRATE the finger prick procedure step by      |
| Demonstration** | step.                                               |
|                 |                                                     |
| **10 Minutes**  |                                                     |
+-----------------+-----------------------------------------------------+
| ![](m           | Depending on the number of participants you have    |
| edia/image2.gif | and the number of instructors available, you may    |
| ){width="0.4479 | want to break the participants into smaller groups  |
| 166666666667in" | for the demonstration.                              |
| height="0.54166 |                                                     |
| 66666666666in"} | When demonstrating,                                 |
| ***TIPS***      |                                                     |
|                 | -   Show each step slowly and methodically.         |
|                 |                                                     |
|                 | -   Talk out loud as you perform, but keep your     |
|                 |     statements brief.                               |
|                 |                                                     |
|                 | -   Repeat the procedure a few times, making sure   |
|                 |     each time you do exactly the same thing so you  |
|                 |     don't confuse participants.                     |
|                 |                                                     |
|                 | -   Share tips from your experience.                |
+-----------------+-----------------------------------------------------+
| **12**          | **[Role Play: Rehearsing Finger-Pricking a          |
|                 | Client]{.underline}**                               |
| **Role Play**   |                                                     |
|                 | FOLLOW the procedure below when conducting the role |
| **15 Minutes**  | play:                                               |
|                 |                                                     |
|                 | > INFORM participants that they are going to have a |
|                 | > role play to practice performing a finger prick   |
|                 | > on a client.                                      |
|                 | >                                                   |
|                 | > POINT OUT the instructions on the slide.          |
|                 | >                                                   |
|                 | > PASS OUT the supplies (except the lancets).       |
|                 | >                                                   |
|                 | > EMPHASIZE that no actual finger prick is to       |
|                 | > happen.                                           |
|                 | >                                                   |
|                 | > SIGNAL when it is time to switch roles.           |
|                 |                                                     |
|                 | DEBRIEF the role play by asking:                    |
|                 |                                                     |
|                 | -   What went well? What did not?                   |
|                 |                                                     |
|                 | -   What was difficult for you? What was easy?      |
|                 |                                                     |
|                 | -   What did you learn form this experience?        |
+-----------------+-----------------------------------------------------+
| ![](m           | ***WARNING*** -- No actual finger pricking is done  |
| edia/image2.gif | at this role play. It only involves "acting out"    |
| ){width="0.4479 | the procedure without using the lancets. If you     |
| 166666666667in" | choose to pass out the lancets, make sure           |
| height="0.54166 | participants understand that they are not to stick  |
| 66666666666in"} | their partner's fingers.                            |
| ***TIPS***      |                                                     |
+-----------------+-----------------------------------------------------+
| **13**          | **[Hands-on Practice: Transfer                      |
|                 | Pipette]{.underline}**                              |
| **Practice**    |                                                     |
|                 | DEMONSTRATE the right way to use the pipette.       |
| **10 Minutes**  |                                                     |
|                 | -   Grasp the transfer pipette by the bulb and      |
|                 |     depress the bulb completely.                    |
|                 |                                                     |
|                 | -   Insert the tip of the pipette into the blood or |
|                 |     liquid requiring pipetting with the tip close   |
|                 |     to the bottom of the vial or close to the       |
|                 |     finger and release the bulb pressure.           |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   The liquid in the vial will be aspirated into   |
|                 |     the long part of the pipette.                   |
|                 |                                                     |
|                 | ```{=html}                                          |
|                 | <!-- -->                                            |
|                 | ```                                                 |
|                 | -   Gently squeeze the bulb to dispense the         |
|                 |     required number of drops.                       |
|                 |                                                     |
|                 | CONDUCT the practice session:                       |
|                 |                                                     |
|                 | > DISTRIBUTE materials to each participant.         |
|                 | >                                                   |
|                 | > POINT OUT the instructions on the slide.          |
|                 | >                                                   |
|                 | > REMIND participants of the time limits.           |
|                 |                                                     |
|                 | DEBRIEF by:                                         |
|                 |                                                     |
|                 | -   Pointing out the commonly-made mistakes you     |
|                 |     have observed during the practice session.      |
|                 |                                                     |
|                 | -   Asking participants to share their experience   |
|                 |     and key learning from the practice.             |
+-----------------+-----------------------------------------------------+
| **14**          | **[Hands-On Practice: Finger Prick]{.underline}**   |
|                 |                                                     |
| **Practice**    | CONDUCT the practice session.                       |
|                 |                                                     |
| **60 Minutes**  | > INFORM participants what they are going to do.    |
|                 | >                                                   |
|                 | > DISTRIBUTE to all participants the supplies       |
|                 | > required to perform a finger prick.               |
|                 | >                                                   |
|                 | > POINT OUT the instructions on the slide.          |
|                 | >                                                   |
|                 | > REFER participants to the one-pager job aid in    |
|                 | > their manual.                                     |
|                 | >                                                   |
|                 | > SIGNAL when it is time to switch roles (every 15  |
|                 | > minutes).                                         |
|                 |                                                     |
|                 | DEBRIEF by:                                         |
|                 |                                                     |
|                 | -   Pointing out the commonly-made mistakes you     |
|                 |     have observed during the practice session.      |
|                 |                                                     |
|                 | -   Asking participants to share their experience   |
|                 |     and key learning from the practice.             |
|                 |                                                     |
|                 | -   Reassuring participants that they will improve  |
|                 |     as they gain more experience.                   |
+-----------------+-----------------------------------------------------+
| ![](m           | Be prepared to provide plenty of personal attention |
| edia/image2.gif | and one-on-one assistance to participants during    |
| ){width="0.4479 | hands-on practice. This is particularly important   |
| 166666666667in" | when teaching people without health or lab          |
| height="0.54166 | background.                                         |
| 66666666666in"} |                                                     |
| ***TIPS***      | Set up the groups in such a way that you are able   |
|                 | to monitor 3 or 4 groups at a time.                 |
+-----------------+-----------------------------------------------------+
| **15**          | **[Summary]{.underline}**                           |
|                 |                                                     |
|                 | ASK participants to answer the questions on the     |
|                 | slide.                                              |
|                 |                                                     |
|                 | ANSWER any questions participants may have.         |
+-----------------+-----------------------------------------------------+