New Document Outlines Best Practices for Obtaining Blood Cultures

Following best practices for ordering/collecting blood cultures helps us to select appropriate treatment for patients and avoid blood culture contamination. The housewide, multidisciplinary CLABSI Prevention Workgroup, in conjunction with representatives from departments across the hospital, recently created the Best Practices for Obtaining Blood Cultures (excluding neonates) to ensure all of us have access to information on evidence-based practice for ordering and collecting blood cultures.

Following evidence-based practices for ordering and collecting blood cultures helps us to select appropriate treatment for our patients to improve care. Substandard practices can result in blood culture contamination, leading to the inappropriate use of antibiotics, additional testing, longer lengths of stay, and increased costs.

The housewide, multidisciplinary CLABSI Prevention Workgroup, in conjunction with representatives from departments across the hospital, recently created Best Practices for Obtaining Blood Cultures (excluding neonates) to ensure all of us have access to information on evidence-based practice for ordering and collecting blood cultures.  Highlights from the document include:

  • The preferred method for obtaining blood cultures is by peripheral venipuncture (not through a central line) to minimize the frequency of false positive results.
  • Always obtain at least two sets of blood cultures for adults (three if you suspect endocarditis.)
  • For patients with pathogens other than those listed in the “Best Practices” document, who are clinically improving, evidence is weak that a “test of cure” ≥ 48 hours after the initiation of appropriate antimicrobial therapy improves clinical outcomes.  This means that if your patient is on appropriate antimicrobial therapy, is clinically improving, and does not have an infection with Candida, Carbapenem-resistant Enterobacteriaceae (CRE), Enterococcus, Staph aureus (MRSA or MSSA), or Staph lugdunensis, there is no requirement to order a second blood culture as a “test of cure.”
  • The PICC team will be aligning with these recommendations.  If the primary team provider is asking for a PICC in a patient who does not have one of the listed pathogens, a member of the primary care team will need to attest that the patient is (1) on appropriate antimicrobial therapy and (2) clinically improving.

For more information, please see the Best Practices for Obtaining Blood Cultures

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