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					MWHC - ED Blood Culture
  Contamination Rate




1.9%     1.7%
                  0.99%

Jan      Feb      March



                Good Job!
Let’s continue this downward trend of reducing blood
          culture contamination in the ED!!!

Here’s a quick review:

        Step 1

      Verify Order.

  Only WRITTEN orders
  are to be accepted.
  Always verify and
  validate.
Step 2: Ensure positive patient identification using
        at least 2 patient identifiers.
                                              MR#                DOB
                        Doe, Johnoscar




                                                               Test Ordered


                                              Doe, Johnoscar




                               000001111111
                        Step 2

 Choose TWO (2) sites for venipuncture blood culture
 collection to distinguish skin contamination from true
                         bacteria.

Step 3

Sanitize hands. Flip the cap
from the blood culture bottle
and swab top of bottle with
alcohol.
                               Step 4
Anaerobic   Aerobic

                       Mark the blood culture
                      bottles at the 10 ml mark
                       above culture diluent to
                      ensure adequate sample.
                      Sanitize hands and apply
                               gloves.
         Step 5

Prepare the needle and
vacutainer. Clean peripheral
venipuncture site with
70% alcohol followed by
chlorhexidine scrubbing
side to side for 30 seconds.     Side to side for
Do not touch the area once       30 seconds

cleaned. Do not fan dry. It is
not necessary to let the area
dry before venipuncture.
                             Step 6

Aerobic         Place tourniquet above site for
(Blue top) is   venipuncture. Collect specimen
drawn 1st.
                keeping culture bottles upright
                to fill the 10 ml mark. Fill Aerobic
                bottle first followed by Anaerobic.
                Fill up to 10 ml mark.




                            2nd bottle
                            drawn
                       Step 7

Release the tourniquet and remove needle and place
Band-aid or gauze on site. Label specimens
accordingly with RN initials, date and time drawn and
site. Repeat procedure on 2nd site. Document on RN
flowsheet.




                            5/18/12
                            5/18/12
Blood Culture Frequently asked questions:

How many bottles in total should I draw?
You should draw one (1) Aerobic and (1) Anaerobic bottle from each site for a total
of 4 bottles with each bottle containing at least 10 ml of sample.

How soon should I draw the second set?
Draw the second set as soon as possible. All four (4) bottles ideally should be
drawn within 10 minutes.

What if I am unable to obtain a sample from another site?
When unable to obtain 40 ml of blood, one site may be used with an absolute
minimum of 20 mls of blood (10 mls each for one aerobic and one anaerobic bottle)
should be obtained. If the patient has poor venous access and 40 ml of blood
cannot be obtained, pediatric culture bottles may be used if able to obtain at least 3
ml of blood. Bottles are obtained from the lab.

When should blood cultures be drawn?
Cultures should be drawn promptly to prevent delay in the initiation of antibiotic
therapy. Blood cultures are more likely to be positve if the blood sample is collected
as soon as possible after the development of fever.
Blood Cultures frequently asked questions:

Can I obtain blood cultures from a patient’s dialysis access?
Obtaining blood cultures from a patient’s dialysis catheter can be done only during
emergent situations and/if sepsis is suspected. Obtain an order from MD. Follow
VAD procedure.

Can I obtain blood cultures from an existing IV peripheral access?
Blood cultures may not be obtained from an existing peripheral IV catheter. Blood
cultures can only be drawn AT THE TIME of IV INSERTION. Draw blood cultures
FIRST before drawing other samples.

When do I obtain blood cultures from a central line?
If the patient has a central line in place and venipuncture is not possible and/if
source of infection is suspected, then two or more blood cultures from different
catheter lumens may be obtained.

				
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posted:8/4/2012
language:English
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