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We have a similar bundle that emphasizes strict sterile technique. Our second major intervention was to reduce the number of blood cultures ordered using evidence-based guidelines. We have reduced our blood culture contamination rate from a contaminant every 3 days to every 14 to 16 days.

Jim Chamberlain
Washington, DC



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-------- Original message --------
From: Rick Place <[log in to unmask]>
Date: 2/23/18 00:27 (GMT-05:00)
To: [log in to unmask]
Subject: Re: Second venipuncture for reducing blood culture contamination?

A medical question ?!?

We were running about 5% contamination rate last year with direct patient
consequences. We pulled nursing together, looked at best practices, and
created a bundle approach to peripheral blood cultures. We went 6 months
with an average of about 2%, so it seemed to work.

We do draw from the IV line, pretty much in all ages.

One question I might ask the group is what lower limit of contamination is
possible. I initially felt that 0% might be a stretch goal but have since
learned that there may be bacteria in the skin plug that prevents 0%.

There is a device the adult ED has initiative that diverts the first 1 ml
of blood to reduce contamination in adult patients. The company wants to
trial that in pediatrics but I am afraid that in our smaller kids, even 0.5
ml may simply be too much to waste.

Rick Place

On Thu, Feb 22, 2018 at 12:10 AM, Mathew George <[log in to unmask]> wrote:

> there has been an increasing number of blood culture contamination from our
> PED recently.
>
> All the peds EDs I work, we obtain the blood culture when the IV cath is
> inserted.
>
> How many of you use a second venipuncture for obtaining blood culture,
> particularly in infants 2 months and less
>
> Thanks
>
> Mathew
>
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>

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