Blood Culture Aseptic Technique: Central Line Draw (Recommend 2 staff members for this procedure)

Step Key Point Reason Evaluate central line, determine if the line is If the line is more than 24 hours old physician order is Verify with ordering physician that the line is greater than 24 hours old, ask if more than 24 hours old. If central line more required. preference is to obtain two peripheral draws. than 24 hours old physician order is required. 1 Gather supplies Saniwipe, 2 face masks, 4 alcohol pads, sterile gloves, 2 transfer devices, 3 10 mL syringes, central line cap, sterile 4x4, Use AIDET!! Hello I am ___ and I will be your RN today. I have received an lab bag, 10 mL NS flush, lab labels, BC bottles, instructions order from your doctor to draw blood cultures. This test is performed to see if 2 there is an infection in your blood. The process will take around 20-30 minutes Identify patient, verify and explain procedure to ensure that the test results are as accurate as possible. I will draw blood 3 from your arm and from your line (if indicated). Hand hygiene and don clean gloves 4 Apply face mask to self and patient (if patient not Additional mask needed for patient if not on ventilator or has respiratory 5 on ventilator) compromise requiring supportive therapy via mask. Clean bedside table with germicidal wipe Supplies should be placed on surface that is clean and dry. Decrease contaminates in work area. 6 7 Perform hand hygiene and don clean gloves Arrange supplies. Assemble new central line cap and waste syringe on sterile Cleaning work surface ensures that specimens are sterile and the bottle tops field. Ensure all supplies remain sterile and accessible. are clean. Obtaining and utilizing specific supplies is evidence based to 8 decrease contaminations. Place sterile 4x4 beneath distal port & clamp line. 9 Perform hand hygiene and don sterile gloves Keep sterile glove package available to place syringes of Aseptic technique is used while drawing blood cultures. The sterile gloves are blood for step 13 used to promote awareness & keep the site free of contaminants. 10 Clean current central line cap at connection and down Blood should be drawn through new central line cap. DO NOT Remove all visible debris then allow to dry before accessing port with new the line x 15 seconds with alcohol pad, remove current clean hub of catheter port. central line cap. Maintain sterility of new central line cap (DO NOT place on central line cap and connect new assembled central line any surface) 11 cap/syringe 12 Draw waste Waste "blood to the hub + 5 mL" of blood and dispose Connect 10 mL syringe and obtain two 10 mL 10 ml is the optimal volume of blood per blood culture bottle. syringes of blood and place on sterile field (sterile Do not over or under fill! glove package) 13 14 Flush the line To prevent the line from becoming clotted Clean tops of culture bottles with alcohol wipe, If you only have enough blood for one bottle, fill aerobic Fill aerobic bottle first, especially if only able to collect 10 mL of blood. Do not remove alcohol wipe and allow to dry. Attach 10mL bottle only. Most pathogens are aerobic. force blood into culture bottle - which may cause hemolysis. blood filled syringe to transfer device. Plunge Remove alcohol wipe: DO NOT plunge through alcohol wipe. Less volume increases risk of contamination. transfer device through bottle. Fill each bottle with 8-10 mL of blood. Do not over or under fill. 15 Remove gloves and perform hand hygiene 16 Label and scan specimen at bedside according to The patient label should not cover the bottle lot number or Refer to picture reference. policy with time, date, location of draw, and Cerner expiration date. Avoid covering the narrow window, on the (AIDET After procedure) Thank you for your time, and thank you for choosing sign in side of the bottle, this is used by lab to visually inspect the INTEGRIS Health. Please notify me if you have any questions or concerns. 17 specimen. 18 Send to Microbiology via central lab Revised 2/11/16