Abstract
The accuracy of blood culture results is highly dependent on proper technique. This audit sought to determine whether health care personnel are adhering to standard techniques for collection of blood for culture. Fifty episodes of blood culture collection were observed at the National Hospital of Sri Lanka between August and December 2008 using an observational check list to determine accuracy of technique. 44/50 of the cultures were drawn after commencement of antibiotics. 45/50 did not wash their hands prior to collection. Of the five who washed their hands only two used antiseptic soap. 37/50 wore sterile gloves. 16/50 used two antiseptics and 32/50 used one to disinfect the venepuncture site. 2 did not disinfect the entry site. Only 2 swabbed the site in a concentric manner. 11 touched the site after disinfection. Only 39 were able to collect blood with a single puncture. Almost all the participants (49/50) did not disinfect the lid of the culture bottle. Only 21/50 drew adequate blood for blood culture. Only two drew a second blood culture. Syringes used to collect blood should be discarded into a sharp bin without recapping. In our study 40 /50 participants recapped the syringe before disposal. However 45 /50 of the participants correctly disposed the sharps and gloves into the sharp bin and yellow bag respectively. Although written instructions have been given regarding collection of blood for culture a high percentage of health care workers do not adhere to these guidelines. This is an important quality assurance issue that needs to be addressed. DOI: http://dx.doi.org/10.4038/sljid.v1i1.3184 Sri Lankan Journal of Infectious Diseases Vol.1(1) 2011: 18-23
Highlights
Blood stream infections are an important cause of morbidity and mortality
Blood cultures should be routinely obtained in patients with suspected bacteraemia and serve as a reference for diagnostic, therapeutic and prognostic decisions
As only aerobic cultures are done in Sri Lanka we considered 5ml per venepuncture as adequate
Summary
Blood stream infections are an important cause of morbidity and mortality. Blood cultures should be routinely obtained in patients with suspected bacteraemia and serve as a reference for diagnostic, therapeutic and prognostic decisions. Collection procedures that emphasize that culture must be obtained prior to antibiotics and stipulate thorough disinfection of the skin, aseptic technique and adequate number and volume of cultures help achieve both of these goals. Request The question of whether an organism is a pathogen or a contaminant is often complex and the answer cannot be based solely on blood culture results Rather, this judgment must include a consideration of the patient’s history and clinical signs. The request form must state the clinical diagnosis, time of collection, anatomic site from which blood is drawn and list current antibiotic therapy and any special organisms to be isolated. We performed an audit to determine if health care personnel at the NHSL are adhering to standard techniques of collection of blood for culture
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