SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE TITLE
Contents
1. Package Insert 2011 BD Infusion Nurses Society 2010 Infusion Nursing An Evidence Based Approach 3 edition St Louis MO Author Infusion Nurses Society 2011 4 ed Policies and procedures for infusion nursing BLOOD CULTURE COLLECTION PROCEDURE spe20 PAGE 4 of 4 AUTHORS Olevia Fulkert Supervisor Laboratory Chris Wirth MSN RN Pediatrics Unit APPROVAL Clinical Practice Council 5 7 152. SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE EZ TITLE BLOOD CULTURE COLLECTION DATE 6 10 PROCEDURE spe20 REVIEWED 5 15 PAGES 1 of 4 ISSUED RESPONSIBILITY FOR Nursing RN LPN II select MST The staff member will follow standard procedures and protocols PURPOSE during blood culture collection in order to prevent contamination of the specimen DEFINITIONS Each blood culture order consists of two bottles defined as one aerobic bottle silver top injected with 5 10 ml of blood and one anaerobic botile red top injected with 5 10 ml of blood Recovery of microorganisms is improved when using a smaller volume closer to the recommended 10 ml EQUIPMENT Equipment for Peripheral Venipuncture 1 ChloraPrep One Step Swabstick or equivalent Chlorhexidine Gluconate 2 and Isopropyl Alcohol 70 NOTE Do not use on children less than 2 months of age NOTE For Pediatric patients use Chloro Prep Sepp or equivalent 2 70 alcohol swab 3 Blood culture bottles aerobic silver and anaerobic red NOTE For pediatric patients use single aerobic bottle silver Gauze Tourniquet Butterfly with short adapter or syringe 21 g 12 Tubing with Multiple Sample Luer Adapter Butterfly 22 or 23 g needle for patients with small or fragile veins 23 gauge blood collection set butterfly for pediatric patients 10 Adhesive bandage 11 Non Sterile gloves DEOU o Note Do not use blood collection supplies that a
3. d 4 ml from the patient Place in aerobic bottle If additional blood is required for other tests insert tubes directly into adapter Remove needle from puncture site activating safety device push button butterfly needles remove the needle upon activation and apply pressure to prevent bleeding Discard sharps into a sharps container Cleanse area before bandaging if blood is visible Label the bottle with the appropriate label Do not place label on top of the barcode label or the lot numbers Orient patient label vertically for scanning efficiency Place bottles in plastic zip lock bag If the blood culture bottles are to be sent via the tube system individual biohazard bubble bags must also be used or pink blood culture transport tube needs to be used for safer transport Adult recommended fill is 5 10ml do not fill over 10ml and minimum is 0 5ml Pediatric patients over 12 recommended fill is 5 10ml do not fill over 10ml amount drawn depends on age of child and minimum is 0 5m Neonate recommended fill is 0 5ml and absolute minimum is 0 1m NOTE Pediatric Patients Blood specimen may be obtained BLOOD CULTURE COLLECTION PROCEDURE spe20 PAGE 3 of 4 REFERENCES with IV start following the above procedure Nursing Staff Only Central Line Draws if ordered by the MD 1 Clean needleless connector at connection to hub with 15 second scrub with alcohol 2 Remove existing needleless co
4. nnector 3 Clean the hub of the central line catheter with 15 second scrub with alcohol Attach new primed needleless connector Do NOT discard blood waste Scrub the needleless connector with alcohol for 15 seconds Allow to air dry naturally 7 Collect one set of blood cultures only 8 Flush the needleless connector and catheter until clear of blood residual 9 Indicate on the blood culture bottle that the sample was withdrawn from the central line by writing line draw Infusion Nurse s Society Policies and Procedures pg 135 oor AFB Blood Culture Collection 1 5 mls of blood is collected by the methods described above and inoculated into BacTAlert MB bottle black cap or equivalent Contact micro department for the bottle prior to collection 2 Specimen is delivered to the lab for processing 3 An additional 1 ml of supplement MB BacT enrichment fluid is added and then incubated 6 weeks Fungus or Yeast Blood Culture Collection 1 Regular 5 10 ml blood culture collection into the Aerobic silver bottle 2 Specimen is delivered to the lab and incubated for 4 weeks Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture Approved Standard 6 Edition Clinical and laboratory Standards Institute 2007 VersaTREK Automated Culture System User Manual Version 2 1 Revision A October 2013 ChlorPrep manufacturer directions for use CarFusion 12 23 2010 BD Persist Skin Prep
5. re expired Do not use if any defect is noted in the bottles such as cracks contamination excessive cloudiness and bulging or indented stoppers BLOOD CULTURE COLLECTION PROCEDURE spe20 PAGE 2 of 4 PROCEDURE Procedure for Peripheral Venipuncture o oS oo 10 11 Identify patient per SMH policies Perform hand hygiene Don gloves Select an appropriate venipuncture site Vigorously cleanse the site with ChloraPrep for 30 seconds Use gentle back and forth strokes to prep the site Allow the area to AIR dry Do not blow or wave hand The bottle has been pre marked with 5 ml increments Mark the desired fill volume level on the bottle to 10 ml to help for correct volume collection The blood culture bottles should be rubbed with an alcohol prep to disinfect the septum Obtain the blood sample without touching cleaned site prior to drawing or site must be cleaned again see step 4 NOTE Needle may be changed before inoculating the bottles if you have contamination issues documented Safety devices must be activated before changing the needle If there is a delay sterile gauze may be used to cover the venipuncture site Using the adapter insert the needle through the septum top of the aerobic bottles first silver and then the anaerobic bottle red Proceed with other blood specimens following the blood cultures NOTE Pediatric patients use a syringe in order to ensure maximum volume withdrawn does not excee
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