CHECKLIST: BLOOD CULTURE PROCEDURE USING

ASEPTIC TECHNIQUE

STEP 1 : VERIFY THE PATIENT’S IDENTITY

1. Ask the patient for his or her name. PATIENT INTUBATED
2. Check the armband. DONE

3. Review the patients notes to confirm indication of blood culture and

patients identity DONE

4. Inform the patient of your intentions and explain the procedure. Always
obtain verbal consent. PATIENT INTUBATED

STEP 2 : KIT PREPARATION

1. Remove white coat & do Hand Hygiene DONE

Done
2. Clean trolly with surface wipes
3. Prepare the Trolley according to instructions below:
Done
I. Upper trolly:
- Disposable sterile blood culture sampling pack [disposable
container, forceps, cotton swab, plastic sheet for draping]
- Blood culture bottles – required bottles only
II. Bottom trolly:
- Syringe (10 ml or more)
- Needle (22 gauge or more)
- Sterile gloves
- Tourniquet
- Adhesive strip
- Cotton
- Skin antiseptic: Chlorhexidine 2% and isopropyl alcohol 70%
- Isopropyl alcohol 70% impregnanted swab
- Clinical waste
- Sharp bin
- Domestic bin
- Patient labels & PER PAT form
  Prepare the PPE: Clean surgical mask, sterile gloves Done

& Isolation gown.

 Change to clean surgical mask. Do hand hygiene Done
before & after change of mask.
 Bring trolley to patients’ bedside & get assistant
Done
ready
STEP 3 : PREPARING BLOOD CULTURE SAMPLE KIT

Assistant :
Help prepare the kit using NON-TOUCH TECHNIQUE, do not touch any area
inside the sterile field (opened blood culture pack)
1. Do hand hygiene
2. Open the disposable blood culture pack onto the trolley and drop
sterile gloves into sterile pack
3. Pour Chlorhexidine 2% and isopropyl alcohol 70% into fluid recess
located on blood culture tray/pack
4. Drop needle and syringe onto sterile field
5. During the procedure, after venepucture has been done, the
assistant should help open the top of the blood culture bottle and
let stand on trolley. Do not touch the top once opened.

STEP 4 : CHOOSING A VEIN

Doctor:
DONE
1. Do hand hygiene. Wash hands with soap and water then dry
2. Apply a disposable tourniquet 4-5 –finger – widths above the planned
venepuncture site
3. Palpate to identify the desired vein. Once you have found the vein, then
we are ready to proceed.
4. Do hand hygiene. Wash hands with soap and water then dry.
5. Proceed to wear PPE in next step.
STEP 5 : WEAR PPE & SKIN PREPARATION
1. Don PPE (apron, sterile gloves). Surgical mask should have been Done
changed earlier.
2. Clean skin with 2% chlorhexidine in 70% isopropyl alcohol in circular
motion outwards and allow to dry for 30 seconds. This area is now
aseptic. Done

3. DO NOT re-palpate skin following cleaning. The procedure should now

proceed using the ASEPTIC NON TOUCH TECHNIQUE. Followed
4. If a culture is being collected from a central venous catheter, disinfect
the access port with isopropyl alcohol 70% impregnated swab. Done

5. Cover the non sterile site with an appropriate drape, exposing only the
clean site Done

STEP 6 : BLOOD CULTURE PROCEDURE

1. Insert needle, collect sample and release tourniquet. Done

2. Remove needle and syringe from puncture site. Place dry swab on Done
puncture site and apply pressure.
3. Disinfect the top of the blood culture bottle with an alcohol swab Done
4. Do not change needles between blood sample collection and Followed

inoculation of blood culture bottle.

5. If taking multiple types of blood samples, always inoculate blood
culture bottles first. (Anaerobic followed by aerobic bottle) Followed
6. Gently rotate the blood culture bottle to mix the blood and culture
Followed
medium (do not shake vigorously).
STEP 7 : TO COMPLETE PROCEDURE
1. Discard needle and syringe in a sharps container. Done
2. Dispose the used items in appropriate bins. Done
3. Remove PPE Done
4. Wash hands with soap and water then dry Done

STEP 8 : PACKAGING AND TRASNPORTATION

1. Label the blood culture bottle, making sure not to remove the ‘tear-off’ Done
label on the bottle.
2. Make sure that patient labels do not cover the blood culture bottle bar
code label and are not stuck across the bottom of the blood culture Followed
bottle.
 3. Complete a laboratory request form:
Remember to include the site, date and time of collection, full clinical
information regarding the suspected diagnosis, and contact details for Done
the clinician responsible for the patient
4. Deliver the blood culture bottle and laboratory form in a biohazard Done

plastic bag to the laboratory as soon as possible.

5. If there is a delay in getting the sample to the laboratory, do not
refrigerate the bottle; rather leave it at room temperature

References :

1. Guideline for the optimal use of blood cultures, Ntobeko Ntusi et al , 2012

2.Taking blood cultures : A summary of best practice, NHS, UK. 2007

BLOOD COLLECTION PROCEDURE - IMPORTANT STEPS

Clean the venipuncture site using chlorhexidine 2%

and 70% isopropyl alcohol in circular motion outwards.
Allow to dry 30 seconds.

Disinfected the top of the blood culture

bottle with an isopropyl alcohol 70% swab

alcohol swab
Order of Draw

VARIETY OF BLOOD CULTURE BOTTLES & VOLUME

 Maximizing the Effectiveness of Blood Cultures

A. Infective Endocarditis (IE)

1. Timing of blood cultures

• obtained at anytime: continuous nature of bacteremia
• No necessity to wait for spikes of fever.
• Taken at 30-minute intervals between samples.
2. Number of blood culture sets and the blood volume
• At least 3 sets of blood cultures

3. Sampling sites of blood cultures

• Strict aseptic techniques
• Separate peripheral venepuncture sites.

B. Catheter Related Blood Stream Infection (CRBSI)

CLABSI DEFINITION:

1. Primary BSI in a patient that had a central line within the 48-hour period
before the development of the BSI and is not bloodstream related to an
infection at another site.
2. In suspected case of BSI, a PAIRED (central/ catheter & peripheral) blood
culture sample must be sent to the lab at the SAME TIME
Kit Preparation for Blood Culture method

Upper trolly:
- Disposable sterile blood culturesampling pack
- Blood culture bottles
- PPE: surgical mask, sterile gloves, isolation gown
Bottom trolly:
-Syringe (10 ml or more)
-Needle (22 gauge or more)
-Sterile gloves
-Tourniquet
-Adhesive strip
-Cotton
-Skin antiseptic: Chlorhexidine 2% and isopropyl alcohol 70%
- Isopropyl alcohol 70% impregnanted swab
- Clinical waste
- Sharp bin
- Domestic bin
 Skin antiseptic for Blood culture:
Chlorhexidine 2% and
isopropyl alcohol 70%

Appropriate PPE for blood culture

procedure

Disposable isolation gown Reusable surgical gown

Unit Mikrobiologi & UKI Hosp Melaka,2020