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.

Doe, Johnoscar000001111111

MR#

Doe, Johnoscar 111 M 01Jan01

DOB

Muppet, Piggy Muppet, Piggy

Doe, Johnoscar Doe, Johnoscar

000001111111000001111111

Doe, Johnoscar

WHC - 000001111111 Doe, Johnoscar

WHC - 000001111111 Doe, Johnoscar

WHC - 000001111111 Doe, Johnoscar

WHC - 000001111111

111 M 01Jan01 111 M 01Jan01

Test Ordered

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

Mark the blood culture bottles at the 10 ml mark above culture diluent to

ensure adequate sample. Sanitize hands and apply

gloves.

Anaerobic Aerobic

Step 5

Prepare the needle and vacutainer. Clean peripheral venipuncture site with 70% alcohol followed by chlorhexidine scrubbing side to side for 30 seconds. Do not touch the area once cleaned. Do not fan dry. It is not necessary to let the area dry before venipuncture.

Side to side for 30 seconds

Step 6

Place tourniquet above site for venipuncture. Collect specimen keeping culture bottles upright to fill the 10 ml mark. Fill Aerobic bottle first followed by Anaerobic. Fill up to 10 ml mark.

Aerobic (Blue top) is drawn 1st.

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.

5/18/125/18/12

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.