Obtaining Blood Culture - South Central Association for Clinical

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					                                                                Obtaining Blood Culture
       Poor/Improper                                          Poor/Improper
       Venipuncture                                             Line Draw                                      Incorrect                                 Length of
        Technique                                              Technique                                       Supplies                                    Time
     No hand                                                                                  Lack of safety
hygiene prior                                Hub not disinfected
                                                                                                 devices for
 to beginning                                  prior to obtaining
                                                                                               venipuncture                                   Once obtained,
   of process                                   blood specimen
                                                                                                                                                 cultures not
                                                                                                  Lack of blood                                   sent to lab
     Inadequate skin                                     IV fluids not
                                                                                                transfer device                                     within 30
  disinfection before                              discontinued prior
        venipuncture                               to obtaining blood                                  Chlorhexidine/                                minutes
                                     Vascular end                                                   alcohol skin prep
         Contamination of                caps not                                                           not used
         venipuncture site               changed
            with local skin           according to                                                         Infusion device
                anesthetic                                         Waste blood
                                            policy                                                            components
                                                                 aspirated prior
         Site contaminated                                                                                     outdate/not                         Improper timing of
                                                                      to culture
            when palpation                                                                                        changed                           repeated cultures
                                                  Multiple lumens                                             according to
          occurs after skin                       of CVC used for
                preparation                                                                                          policy
                                                    multiple blood
                                                                                                                                                       Improper or lack of
                                                          cultures         Vascular end
                   Multiple sticks                                                                                                                       time notation on
                                                                             care in line                                  Wrong blood                     bottles/reports
                      with same
                                                                          with blood left                               culture bottle(s)                                                      Flawed
                                                                         in the end cap                                            used                                                         Blood
        Top of culture bottle                    Not enough blood                                                                                               Nurses are too
        not disinfected prior
                                                                                                                                                                 busy to follow
                                                           drawn                              clinicians
           to blood transfer                                                                                                                                             policy

     Blood transfer                                                           Resident unfamiliar                              Inability to
                                      Insufficient volume                             with policy
              device                     added to culture                                                                 determine time               MDs too busy to
  contaminated due                                   bottle                                                                to positivity of               follow policy
         to reuse or                                                      Policy variations                                        bottles
       incorrect use                                                      between nursing                                                            Agency, pool
                                                                          and phlebotomy                                                          staff not familiar
                                                                                                                 Once in lab,                            with policy
                                                                      No written/                                 cultures not
                                                                    poorly written                           processed within
                                                                            policy                                 30 minutes

                                                        Policy unavailable
                                                        to physicians and

                                                                                                                                                                                   Ruth Carrico PhD RN CIC
                                                                                                                                                                                  School of Public Health and
  Contamination                       Blood                              Education                             Microbiology                            Staffing                      Information Sciences
                                                                                                                                                                                    University of Louisville
 During Transfer                     Volume                                                                                                           Acuity/Time                          Rev 09/07
     of Blood to                                                                                                                                                        
   Culture Bottle

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