Prevention Of Blood Culture Contamination
Publication Date: May 8, 2018
Last Updated: March 14, 2022
Decision Options
Standard Procedures
Divert the initial 1–2 ml of blood into a sterile receptacle when drawing blood culture specimens via peripheral venipuncture. (B)
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Use a standard sterile process to draw blood cultures. (B)
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Draw blood cultures from a dedicated peripheral venipuncture site, not an intravenous catheter. (B)
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Use pre-assembled blood culture collection packs. (C)
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Education
Provide education and training for personnel who collect blood cultures. (B)
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Monitor contamination rates and provide performance feedback to personnel who draw blood cultures. (B)
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Personnel
Establish a dedicated staff to draw blood cultures. (B)
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Skin Preparation
Allow the skin cleansing agent to air dry before venipuncture when drawing blood cultures. (A)
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Use chlorhexidine alcohol to clean the skin before drawing blood cultures in patients over 2 months of age. (A)
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Use products containing alcohol to cleanse the skin prior to collecting blood cultures. (A)
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Use alcohol to clean the skin before drawing blood cultures in children under 2 months of age. (C)
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Apply alcohol-containing solutions with 30 seconds of vigorous back and forth scrubbing. If povidone-iodine is used, it should be applied in concentric circles. (C)
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Sterile Gloving
There is inadequate evidence to recommend that routine sterile gloves use was associated with 10% povidone-iodine and cleaned the bottle tops with 70% isopropyl alcohol decrease contamination rates. (I/E)
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Cleaning Culture Bottle Tops
Clean blood culture bottle tops with 70% isopropyl alcohol and air dry prior to blood culture bottle inoculation. (C)
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Blood Volume
Inadequate evidence exists to make a recommendation regarding blood sample volume and prevention of contamination of blood cultures. (I/E)
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Specimen Collection for Intravenous Catheter
There is inadequate evidence to recommend drawing blood cultures from a newly inserted (less than one hour) intravenous catheter with appropriate skin preparation. (I/E)
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Specimen Diversion
Diversion devices reduces in overall blood contamination rates. (B)
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Double Needle Technique
Inoculate the blood culture bottle with a different needle from that used for venipuncture. (B)
Note: Changing needles is not recommended due to the risk of blood exposure.
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Recommendation Grading
Overview
Title
Prevention of Blood Culture Contamination
Authoring Organization
Emergency Nurses Association
Publication Month/Year
May 8, 2018
Last Updated Month/Year
January 9, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Emergency care, Hospital
Intended Users
Nurse, laboratory technician, nurse practitioner, physician, physician assistant
Scope
Prevention
Diseases/Conditions (MeSH)
D000071997 - Blood Culture
Keywords
blood culture, contamination