Blood Cultures & Blood Bank Specimens

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1 Blood Cultures & Blood Bank Specimens Five Minute Forum By Michelle Cooper RN BSN Staff Development

2 Strict attention to technique and procedure are critical for any collection of laboratory specimens. However, this is especially true of obtaining blood cultures and blood bank specimens. Blood cultures are performed to detect bacteria in the blood stream. Blood samples are collected and incubated for 24 to 72 hours. In most cases (67% of the time) if the culture is positive bacteria will grow within 24 hours. By 72 hours, 90% of the positive cultures will demonstrate growth. The procedure for obtaining the cultures must be followed exactly to prevent false positives. The first step as always is to correctly identify your patient using the two step identifier system. Then gather your equipment. Refer to the policy. Remember blood cultures must be drawn prior to any other specimen collection and the cultures can only be obtained using a syringe or butterfly system (NO VACUTAINER). Following equipment collection: Cleanse the puncture site with cloraprep for 30 seconds. Allow the site to dry for 30 seconds. Do not wipe area dry. Remove plastic caps from the blood culture bottles and disinfect the bottle top. Blood culture bottles must be at room temperature.

3 Do not touch the tops after cleaning. Do not use if the bottom is yellow. Do not use if past the expiration date. Do not use if the stoppers are indented or bulging. Perform the venipuncture. Draw 20cc of blood. Dispense the blood equally in the bottles If using a syringe inoculate the anaerobic (orange) bottle first. If using a butterfly system inoculate the aerobic (green) bottle first. Mix the bottles 2-3 times. Properly label the specimen. Hand write the collector s ID #, date and time of collection. Label if specimen was draw from an IV line. Do not cover bar code label. Do not place label on bottom of bottle. Blood cultures are usually ordered x 2 Obtain the second specimen from a different site. The physician determines the time interval. If no time interval is written wait a minimum of 60 minutes to draw the second culture. For more details and information regarding Mycobacterium and Fungal blood cultures refer to the policy and procedure. Blood bank specimens are obtained to determine blood type and Rh compatibility. Blood is a tissue. In essence blood transfusions are tissue transfusions. Patients transfused with incompatible blood products run the risk of developing mild febrile reactions to organ damage and death. Due to

4 the fatal consequences of incompatible blood transfusions this procedure must be followed exactly. Blood Bank also reserves the right to discard any questionable specimen requiring the patient to be redrawn. As with other phlebotomy procedures you must gather your equipment. Blood specimens are obtained using pink evacuated tubes. Be sure to follow the correct order of draw for a vacutainer or order of fill for a syringe. Follow the procedure for obtaining the specimen: Identify the patient using the two-identifier system. Once proper identification is made the Typenex blood recipient band (yellow band) is completed at the bedside with: Patient s last name, first name Patient s medical record number. Date and time of collection. Technical Partner s ID # or the initial of the first name and full last name of the RN obtaining the specimen. Obtain the specimen. Peel off the top layer of the Typenex label and place it on the tube where to paper label is with the band # toward the top. Place the Typenex band on the patient s wrist. Make sure the clamp is shut tight. Remove the end strip of the band next to the clamp. Peel off the backing paper of the end strip and adhere it to the top of the tube. All blood bank specimens must have at least one RN identify the patient and verify the blood specimen.

5 The RN must sign the specimen label- first initial, full last name and title. The blood specimen is taken to the lab with the extra labels in the biohazard bag.

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