NURSING GUIDELINES ON TAKING BLOOD CULTURES FROM PERIPHERAL OR CENTRAL VENOUS ACCESS DEVICE
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1 NURSING GUIDELINES ON TAKING BLOOD CULTURES FROM PERIPHERAL OR CENTRAL VENOUS ACCESS DEVICE Version Number V22 Date of Issue June 2017 Reference Number Review Interval Approved By Name: Fionnuala O Neill Title: Nurse Practice Development Coordinator Authorised By Name: Rachel Kenna Title: Director of Nursing Author/s Location of Copies TBCPCVAD FON-V2 3 yearly Signature: Date: June 2017 Signature: Date: June 2017 Name: Fionnuala O Neill Title: Nurse Practice Development Coordinator On Hospital Intranet and locally in department Document Review History Review Date Reviewed By Signature 2020 Document Change History Change to Document Reason for Change 1
2 Date of Issue: June 2017 Page 2 of 6 CONTENTS Page Number 1.0 Introduction Applicable to Guidelines References 6
3 Date of Issue: June 2017 Page 3 of Introduction A blood culture is a blood test which is designed to remove blood from the patient and test it to determine if infection is present in the blood stream. Isolating the organism is enhanced by the careful collection of sterile samples to avoid contamination by the operator s skin flora. Blood cultures are requested by the medical/surgical teams caring for the infant or child and can be requested as peripheral or central samples or both. Peripheral blood cultures Blood cultures will be requested for a variety of reasons. If taking blood cultures from a peripheral line it is advisable to take the samples if possible when an Intravenous Cannula is inserted. In the event that this is not possible the Phlebotomy team will take the requested sample. (Please see Guidelines for Clinical Staff undertaking Venepuncture, OLCHC (2017). Central Blood Cultures When taking blood cultures from a Central Venous Access Device please follow the steps in the Guidelines on the Insertion and Care of a Central Venous Access Device for Clinical Staff, OLCHC (2017). Blood Culture Bottles Use the Paediatric bottle and the anaerobic bottle as standard. Fill the paediatric bottle first then the anaerobic bottle
4 Date of Issue: June 2017 Page 4 of Applicable to All healthcare staff who take blood cultures 3.0 Guidelines ACTION RATIONALE AND REFERENCE USE level 3 ASEPTIC NON-TOUCH TECHNIQUE Explain the procedure to the patient and child if appropriate, ensuring the privacy and dignity are maintained. Ensure adequate light is available. It is advisable to take the blood culture samples when the infant/child is pyrexial. Ensure the completed request form for blood cultures is available. Identify the child with Identity band, healthcare record and request form with the correct details. To gain the patient and child cooperation for the procedure. Ensure the patient and child understands the reason for the procedure. (Dougherty and Lister, 2015). To ensure the operator has the light available to carry out the procedure. The organism is present in greater numbers when temperature is elevated, (Dougherty & Lister, 2015) To verify the patient and type of cultures requested. To ensure the correct details are placed on the bottles and it corresponds with the request form. (NHO, 2011) To ensure the correct test is carried out for the correct child. Detail the patient details on the blood culture bottles Decontaminate hands.. Cleanse the child s skin with the appropriate cleansing wipes and allow to dry for at least 40 seconds... Cleanse the CVAD catheter hub with cleansing swab and allow to air dry for at least 40 seconds. Take the blood samples as for Peripheral or Central blood sampling as detailed in guidelines. See above. Discard the appropriate volume if taking blood cultures from a central line as per CVAD guidelines for clinical staff. Open the caps of the blood culture bottles and decontaminate tops and allow to air dry for at least 40 secs. To prevent cross infection (OLCHC, 2010a) To ensure skin is dry prior to procedure( Epic 3, 2014)) To ensure the hub is decontaminated and allowed to dry prior to the procedure (Epic 3, 2014) To prevent contamination of the top of the culture bottles. (Dougherty and Lister, 2015).
5 Date of Issue: June 2017 Page 5 of 6 Place the vial adaptor on to the top of the blood culture bottle, one adaptor for each bottle. To ensure clean and dry prior to blood transfer (Epic, 2014) Decontaminate the needle free device on the vial adaptor with a new cleansing wipe for each adaptor and allow to air dry for at least 40 seconds. Adding blood to culture bottles via syringe Attach the syringe with blood to the needlefree vial adaptor and place 3-5mls into the bottles. See over Inoculation of the culture bottles should take place before using blood in the syringe for other samples. Adding blood to culture bottles via Multifly system If the blood sample has been taken with the Multifly system please use the adaptor which will pierce the culture bottle and allow access. Once the blood has been added to the blood culture bottles remove the vial adaptors and dispose of the vial adaptors appropriately. Place the labelled blood culture bottles in the appropriate transport device with the correct completed request form in a timely fashion. Blood culture bottles can be transported in the Chute. To ensure contamination does not occur (Maddox & Pearson 2010). To prevent cross contamination (OLCHC 2011) Transport the blood cultures to the laboratory in a timely fashion. Document the blood collection in the patients healthcare records.
6 Date of Issue: June 2017 Page 6 of 6 Adator for use with Multifly(Multiuse holder with leur adaptor) To ensure the bottles are transported safely. To ensure best practice and safety (NPC 2016, NHO 2011) 4.0 References Nursing and Midwifery Board of Ireland (2015). Recording Clinical Practice. Guidance to Nurses and Midwives. NMBI, Dublin. Health Service Executive (2011) Code of Practice for Healthcare Records Management, National Hospitals Office, Dublin. Maddox, C. and Pearson, B. (2010) Specimen Collection, Practices, in Children Nursing OLCHC (2015) Documentation Guidelines for Nursing Staff, Nurse Practice Committee, OLCHC Dublin. OLCHC (2011a) Standard Universal Precautions, Our Lady s Children s Hospital, Crumlin, Dublin. OLCHC (2011b) OLCHC Safety Statement, Our Lady s Children s Hospital Dublin. Our Lady s Children s Hospital (OLCHC) (2010a) Guideline for Hand Hygiene, OLCHC, Dublin. Our Lady s Children s Hospital (OLCHC) (2017) The Hospital Formulary and Prescribing Guide, OLCHC, Dublin. Dougherty and Lister (2015) The Royal Marsden Manual of Clinical Nursing Procedures, 9 th Edition, Loveday, H.P. and Wilson, J.A et al (2014) Epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England. University of Southampton and Leeds OLCHC Copyright and Our Lady s Children s Hospital Crumlin, Dublin 12. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior written permission of the copyright holder. Every effort has been made to ensure that the information provided is accurate and in accord with standards accepted at the time of printing.
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