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Establishing best practice in blood collection for culture

Establishing best practice in blood collection for culture

What is a blood culture?

A blood culture is a specific test to identify bacteria present in the blood. Results from a blood culture can verify that an infection is present, and they can identify the type (or types) of microorganism that is responsible for the infection (such as bacteraemia, septicaemia amongst others). This is possible because the bloodstream is usually a sterile environment.

What are we trying to achieve?

Our aims were to:

  • ensure that we are following international best practice guidelines in the collection of blood samples for culture
  • reduce costs associated with contaminated blood samples and the need to resample

What did we find?

Blood cultureA review of Laboratory data from Jan 2013 to Sep 2013 showed that:

  • our total blood sample contamination rate was 2.6%
  • of all blood cultures that tested positive for an infection, 78% were from single sets of blood cultures*

* Blood samples can be contaminated if the site of blood withdrawal is not prepared properly as skin bacteria can get into the blood sample. This can result is a ‘false positive’ for a blood infection, and lead to patients being prescribed antibiotics that they don’t need. Best practice is to take a second set of blood culture samples from a different site to confirm whether the bacteria is present in the bloodstream.

What have we done?

  1. Developed and published a "Blood Culture" policy based on best practice guidelines
  2. Provided clinical areas with resource list and advice on how to equip and manage blood collection for cultures in their area
  3. Introduced training of new technique for blood collection to key areas in the organisation and established an e-Learning module
  4. Promoted the "Blood Culture" policy and the profile of the new technique for blood collection with posters, teaching and education
  5. Encouraged clinicians to challenge poor practice in drawing of blood for cultures

Blood culture collection poster
Blood culture collection poster

Did we make a difference?

Establishing best practice in the collection of blood samples for culture has resulted in:

  • a consistent and standardised approach that adheres to international best practice for the process of taking blood samples for culture and the equipment used
  • an increase in the use of two sets of blood samples for culture to confirm bacteria in blood (up 18%)
  • a reduction of total blood sample contamination rates (2.6% to 1.8%)
  • a reduction in unnecessary antibiotic use
  • a significant saving to the organisation through standardised equipment and processes

Total Number of Blood Cultures Taken

Estimated Total Cost

Cost of 8000 Samples Pre intervention


Cost 8000 Samples Post intervention


Cost Difference



Where to from here?

We will continue to:

  • work on improving our processes and monitoring contamination rates
  • raise awareness across the organisation about best practice and the availability of our e-Learning module

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