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The 7 steps to Blood Culture Collection…
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1. Examine the blood culture bottles
2. Mark bottles for appropriate specimen collection amount
3. Disinfect the bottle tops
4. Appropriate Identification the patient
5. Apply the tourniquet
6. Skin Preparation
7. BD Butterfly Method
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Step 1: Examine the blood culture bottles
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Discard the bottles if any of the following is observed: |
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- Contamination, damage, or deterioration |
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- Cloudy or turbid MEDIA |
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- More or significantly less than 2 inches of liquid media is inside the bottle |
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- Media is expired |
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- Sensor is the wrong color. The sensor is located on the bottom of the bottles and is used by the blood culture instrument to detect growth. |
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Step 2: Mark bottles for appropriate specimen collection amount
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The bottles are marked in 5 mL increments along the label. The only way to ensure that the appropriate amount of sample is collected is to mark off the broth level and indicate the fill level.
8-10 mL of blood per bottle is recommended for adults. |
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Step 3: Disinfect the bottle tops
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Remove the protective caps from the Bactec blood culture bottles and disinfect the top of each bottle septum with 70% alcohol and allow to air dry. Use 1 alcohol wipe for each bottle septum.
Do Not Use Providine Iodine on the Bactec blood culture bottles. After disinfecting the bottle septums, do not retouch the bottle tops. |
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Step 4: Identify the Patient
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Appropriate identification of patient and explanation procedure to patient are required before proceeding. |
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Step 5: Apply the Tourniquet
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Just prior to blood collection, apply the tourniquet 4-6 inches from insertion site. The tourniquet should restrict venous flow only, can be easily released, and never tight enough to restrict the arterial blood flow. Never allow the tourniquet to be left on longer than two minutes. NEVER probe blindly in a patient's arm. Make only two attempts per person taking the blood. |
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Step 6: Skin Preparation
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Select the site of venipuncture. The practice of drawing blood for culture from catheters of the groin should never be performed when a peripheral (i.e., non-catheterized) site is available. Blood should be obtained from peripheral venous or arterial sites. Obtaining blood cultures from central venous catheters, arterial lines, and inguinal vessels increases the likelihood of obtaining a false positive blood culture. |
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Palpate for the site from which to draw the sample. Obtain 1 Chloroprep-Frepp. Place the sponge down onto the arm in the area of the intended puncture site and prime the sponge by pressing the sponge up and down on the arm until the alcohol can be seen on the skin. Scrub the arm vigorously with the sponge for 30 seconds. Allow to air dry completely for 30 seconds |
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DO NOT BLOW, FAN, OR WIPE THE AREA WITH GAUZE. DO NOT TOUCH THE AREA! |
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Step 7: BD Butterfly Method
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To be performed after inspecting bottles, disinfecting the tops, applying tourniquet, and skin preparation,: |
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1) |
Peel apart the package and remove blood collection set. Thread the Luer end of tubing set into Vacutainer holder. Remove sheath-covering needle at the wings. |
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2) |
Perform venipuncture. |
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3) |
Push and hold the Vacutainer holder over the top of the vial to puncture the septum. Collect blood in the aerobic bottle to the desired fill level on the vial. Inoculate the amount recommended on the bottle (8-10 cc for adults). The volume of the inoculum must never be less than 3.0 for the standard aerobic/F, standard anaerobic/F, aerobic plus, and anaerobic plus bottles. Pediatrics plus bottles will except 1-3 ml. |
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4) |
Monitor to ensure proper blood flow and fill level. Always keep the culture bottle sin the upright position while obtaining specimens. |
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Remove the holder from the vial. Immediately push and hold the holder onto the anaerobic bottle. |
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Collect blood to the desired fill level on the second vial. Remove the holder from vial. Note: If more samples are required, additional tubes may be drawn at this time using the Vacutainer holder. Follow the appropriate order of draw if further blood tests are required. |
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Removal-- When the final vial or tube is filled, activate the safety on the butterfly. Apply pressure to the insertion site. Only after bleeding has completely ceased apply a 2x2 gauze and tape or Band-Aid |
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Attach the patient label vertically (being careful not to completely cover the bottle barcode) to both blood culture bottles. These labels must include the patient's name, medical record number, room number, procedure ordered, collection date and time. The staff member who performed the venipuncture must also handwrite his/her initials, collection date and time, area of puncture site or if drawn from a central line on the patient's specimen label. All blood cultures are to be sent to the Laboratory within one hour. |
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