Blood cultures and antibiotic iv meds

[cview110]

In the er where I work we are having issues with getting blood cultures drawn before antibiotics ae given on pneumonia patients. We have core measures that require antibiotics within six hours of being seen. We keep having antibiotic mess being given before blood culture draws. How do other ERs handle this?

[allstudentnurses, ASN, RN]

I have had MD's give antibiotics without drawing cultures many times, do I agree with it? Of course not, other hospitals I've worked at drew cultures on just about anyone getting antibiotics, but it was explained to me (by one of "those" physicians that routinely don't order cultures before antibiotics) that he doesn't order cultures because then they are "required" to follow a certain pathway because cultures have been done; take from that what you will.

[kimmie4476, ASN, RN]

Our hospital uses a special medium for blood cultures that contains pellets that will absorb antibiotics. Of course it's still always better to draw them first before starting the antibiotics.

[JKL33]

Another place for a possible reminder is at the medication dispensation machine (Pyxis). At some facilities RNs are prompted to indicate whether blood cultures have been obtained when removing antibiotics from Pyxis. If none have been ordered yet, it serves as a reminder to ask the physician. If the physician has already declined to order blood cultures, a comment to that effect can be typed in on the Pyxis screen. This could be useful both for RNs who might be forgetting to make sure cx are done AND for tracking the number of incidences where physicians are declining to order them for one reason or another.