Blood culture techniques???

[BeenThereDoneThat74, MSN, RN]

I'm currently per-diem at 2 places, which have different protocols regarding blood cultures: At one place, we use "clean technique", (clean gloves, wipe the port w/ alcohol, draw blood into syringe (or into bottle via vacutainer). The other place requires that we use "sterile technique" (sterlie gloves, three wipes of betadine on the port, and the rest is the same). I am referring only to CENTRAL LINE CULTURES, not regular bloods, dressing changes or peripheral cultures.

I am quite interested as to what people are doing, as I am about to start a new job, and I know this will come up.

[NotReady4PrimeTime, RN]

Most facilities have a P&P for cultures. I'd look there for guidance. My practice is assemble everything I'm going to need close at hand... syringe and "needle" for clearing the line, syringe and "needle" for the specimen, flushes, multiple chlorhexidine/alcohol prep pads and clean gloves. Then I place a sterile field (4x4 on top of its wrapper) under my desired port. I put any infusions on hold then vigorously swab the needleless port closest to the patient. I flush the line with about 5mL of NS, swab vigorously again with a new prep pad, then withdraw at least 5ml of blood and fluid from the line. I swab again with another new prep pad then collect my specimen. (We're still in the stone age here and continue to use needles for everything...) I put a sterile needle on the syringe, pop the cap on the culture bottle, swab the rubber diaphragm then put my sample into the culture bottle. That done, I flush the port with NS then restart any infusions. I know it sounds labor-intensive and time consuming but I can do a culture in under two minutes. So far I've never had a contaminant result... Shhh, them bugs'll hear us!

[Kim44]

At my facility, it is a clean procedure to draw cultures thru a central line.

[gwenith, BSN, RN]

We won't take the cutures from any line - not even an art line except as a last resort - clean technique and always a new puncture. I will amend some facilities do advocate sterile technique.

[pghfoxfan]

we were not allowed to take Blood Cultures from a line, it had to be a stick.

We used sterile vacutainers. Betadine to the top of the blood tube and wipe with alcohol, same with the site on the body.

[BarbPick]

New port access must be sterile. Lumens should have clean techniques.

[TexMedic]

My observations of this procedure have always been with sterile technique. Granted, I haven't actually done any yet (still a student). I'm very blessed, though, as there is a P.A. at the clinic where I work who directs me to lay out instruments and hand them to him as though we were in a surgery/sterile setting for all invasive procedures (even the "clean" ones), so I'll learn more. In fact, ALL of the docs at my clinic are great....more mentors than anything. This is a far cry from other clinics I've observed, where the docs don't even bother to learn the names of the nurses, let alone the lowly med techs.

[Loving Life]

I work on a peds. unit. If they come in with F&N we draw one peripheral. If it's a broviac that has been flushed with Heparin, Vanco, Cipro flush, we draw a #1 culture and a #2 culture from each line. If it's a port we draw one. Then we draw line cultures every 24 hrs if they continue to spike. If we open the line we use sterile technique, if we draw through the endcap we use clean. We always use betadine to the top of the culture bottle. We do not flush first and we do not waste. Of course we clean the endcap off first.

[Research Interest]

I have a need to identify the various Chlorhexidine/alcohol prep pads that are available on the market. I need this information to help me choose and obtain a product to be used for a clinical trial.

Thanks in advance for any help that you can offer.

Most facilities have a P&P for cultures. I'd look there for guidance. My practice is assemble everything I'm going to need close at hand... syringe and "needle" for clearing the line, syringe and "needle" for the specimen, flushes, multiple chlorhexidine/alcohol prep pads and clean gloves. Then I place a sterile field (4x4 on top of its wrapper) under my desired port. I put any infusions on hold then vigorously swab the needleless port closest to the patient. I flush the line with about 5mL of NS, swab vigorously again with a new prep pad, then withdraw at least 5ml of blood and fluid from the line. I swab again with another new prep pad then collect my specimen. (We're still in the stone age here and continue to use needles for everything...) I put a sterile needle on the syringe, pop the cap on the culture bottle, swab the rubber diaphragm then put my sample into the culture bottle. That done, I flush the port with NS then restart any infusions. I know it sounds labor-intensive and time consuming but I can do a culture in under two minutes. So far I've never had a contaminant result... Shhh, them bugs'll hear us!

[eph432girl]

"...let alone the lowly med techs."

what exactly is that supposed to mean?

[Nesher, BSN, RN]

I agree that you should check with the hospitals P and P.

[stbernardclub]

Yes I agree....that was ignorant. This person talks about mentors and being in school. First thing you need to learn is to respect those working with you.

"...let alone the lowly med techs."

what exactly is that supposed to mean?