Comparison of Blood Culture Contamination Rates Between Intravenous Catheters and Venipuncture in a Pediatric Emergency Room

2.50
Hdl Handle:
http://hdl.handle.net/10755/162744
Type:
Presentation
Title:
Comparison of Blood Culture Contamination Rates Between Intravenous Catheters and Venipuncture in a Pediatric Emergency Room
Abstract:
Comparison of Blood Culture Contamination Rates Between Intravenous Catheters and Venipuncture in a Pediatric Emergency Room
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:Dunn Childers, Kimberly, RN, MS, CEN, CPNP
P.I. Institution Name:Texas Children's Hospital and Baylor College of Medicine
Contact Address:6621 Fannin Street, Suite A165, MC1-1481, Houston, TX, 77030, USA
Contact Telephone:(713) 770-1627
Co-Authors:Kimberly Dunn Childers, and Milton H. Nirken
Purpose: The objectives of our study were to compare contamination rate of blood cultures drawn through newly inserted intravenous catheters to venipuncture at different sites; blood culture contamination rate between laboratory technicians and emergency room nurses; and contamination rates among different inoculation blood volumes used in the culture bottles. Defining the procedure least likely to contaminate the blood culture is of great utility for emergency nurses. A contamination rate of 1 % to 6% has been reported in the literature.

Design: A cross-sectional design was used.

Setting and Sample: University affiliated pediatric emergency room. Convenience sample of 2,431 blood cultures in a six-month period. Patients requiring blood culture, but without congenital heart disease, central venous lines, and implanted subcutaneous ports were enrolled. Each patient was enrolled only once.

Methodology: Data collected included age, personnel obtaining the sample (laboratory technician versus nurse), volume of blood inoculated (<lcc, 1-2cc, 3-5cc, >5cc), method (intravenous catheter or venipuncture) and site used (hand, foot, or antecubital). The nurses used three sequential betadine swabs followed by three sequential alcohol swabs. The laboratory technicians used one betadine swab followed by one alcohol swab.

Results: Among 2,431 blood cultures drawn in the emergency room (54% by intravenous catheter) the overall contamination rate was 2.7%. The contamination rate by intravenous catheter was 3.4% compared to 2.0% by venipuncture (p=0.0043). The site of lowest contamination was the antecubital fossa. The difference in contamination rate between the laboratory technicians and the nurses was not statistically significant (p=0.807). Among the various blood volumes inoculated into the culture bottles, the difference in contamination rates was not statistically significant (p=0.589).

Chi-square analysis was used to compare contamination rates for the categorical variables. Fisher's exact test was used when cell counts were less than 5. Confounding factors, controlled with stratification, were tested using the Cochran-Mantel-Haenszel general association statistic. Statistical significance for all tests was set at a p value of <0.05.

Conclusions: Emergency nurses should be aware that there was a significantly higher contamination rate for blood cultures drawn through intravenous catheters as compared to venipuncture in this study. Blood cultures drawn via venipuncture from the antecubital fossa, when possible, should decrease the contamination rate. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleComparison of Blood Culture Contamination Rates Between Intravenous Catheters and Venipuncture in a Pediatric Emergency Roomen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162744-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Comparison of Blood Culture Contamination Rates Between Intravenous Catheters and Venipuncture in a Pediatric Emergency Room</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dunn Childers, Kimberly, RN, MS, CEN, CPNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Texas Children's Hospital and Baylor College of Medicine</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">6621 Fannin Street, Suite A165, MC1-1481, Houston, TX, 77030, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(713) 770-1627</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kschilly@pdq.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kimberly Dunn Childers, and Milton H. Nirken</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The objectives of our study were to compare contamination rate of blood cultures drawn through newly inserted intravenous catheters to venipuncture at different sites; blood culture contamination rate between laboratory technicians and emergency room nurses; and contamination rates among different inoculation blood volumes used in the culture bottles. Defining the procedure least likely to contaminate the blood culture is of great utility for emergency nurses. A contamination rate of 1 % to 6% has been reported in the literature.<br/><br/>Design: A cross-sectional design was used.<br/><br/>Setting and Sample: University affiliated pediatric emergency room. Convenience sample of 2,431 blood cultures in a six-month period. Patients requiring blood culture, but without congenital heart disease, central venous lines, and implanted subcutaneous ports were enrolled. Each patient was enrolled only once.<br/><br/>Methodology: Data collected included age, personnel obtaining the sample (laboratory technician versus nurse), volume of blood inoculated (&lt;lcc, 1-2cc, 3-5cc, &gt;5cc), method (intravenous catheter or venipuncture) and site used (hand, foot, or antecubital). The nurses used three sequential betadine swabs followed by three sequential alcohol swabs. The laboratory technicians used one betadine swab followed by one alcohol swab.<br/><br/>Results: Among 2,431 blood cultures drawn in the emergency room (54% by intravenous catheter) the overall contamination rate was 2.7%. The contamination rate by intravenous catheter was 3.4% compared to 2.0% by venipuncture (p=0.0043). The site of lowest contamination was the antecubital fossa. The difference in contamination rate between the laboratory technicians and the nurses was not statistically significant (p=0.807). Among the various blood volumes inoculated into the culture bottles, the difference in contamination rates was not statistically significant (p=0.589).<br/><br/>Chi-square analysis was used to compare contamination rates for the categorical variables. Fisher's exact test was used when cell counts were less than 5. Confounding factors, controlled with stratification, were tested using the Cochran-Mantel-Haenszel general association statistic. Statistical significance for all tests was set at a p value of &lt;0.05.<br/><br/>Conclusions: Emergency nurses should be aware that there was a significantly higher contamination rate for blood cultures drawn through intravenous catheters as compared to venipuncture in this study. Blood cultures drawn via venipuncture from the antecubital fossa, when possible, should decrease the contamination rate. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:25Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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