Is this common practice or poor practice? IV policy? I have done research and notice most is based on pediatric care.........
Blood cultures require stict attention to skin preparation, as does PIV insertion. But obtaining cultures from the PIV would require additional manipulation of the device, which could add to the risk of contamination and a false positive. Also the amount of blood required for cultures is usually 20-30 mLs and the PIV may not produce that much blood. All things considered, I would prefer not to obtain cultures when the PIV is inserted. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Office Phone 770-358-7861
We actually do obtain peripheral blood cultures as well as other lab draws when placing PIVs to prevent an additional venipuncture. I work in a large urban pediatric teaching hospital. I think one factor that leans in favor of doing this procedure is that the PIVs are inserted by a highly skilled and experienced IV team at my hospital. For obtaining a peripheral blood culture, we clean the skin with Chloraprep for 30 seconds, allow to dry, insert the IV, attach a t-connector, obtain the blood specimen in a syringe, then usually hand the blood to the assistant to inject into the culture bottle, then proceed with the IV taping, etc. We don't have an issue with contaminated specimens so far, except when the blood is drawn by a less skilled person inserting the IV. There have been reports iin literature of contaminated cultures, but most of those reports discuss peripheral phlebotomy not IV insertion. We draw a single aerobic culture vs the anaerobic and aerobic cultures drawn for adults, anaerobic bacteremia is very rare in children. Our culture bottles take a minimum of 1ml. and a maximum of 4mls. Our head of microbiology said that as you approach the maximum level of blood in the bottle, the time to get a positive culture will decrease. Hope this is helpful info....
Anne Marie Frey RN, BSN, CRNI
The Children's Hospital of Philadelphia
Anne Marie Frey RN, BSN, CRNI, VA-BC
Vascular Access Service: I.V. Team
The Children's Hospital of Philadelphia[email protected]
I agree with Anne Marie. We also draw blood cultures as well as other labs from the peripheral IV on insertion. Our required volumes are much less than with adults and we are more conscious than ever about the number of venipunctures we inflict on our patients. We have had no problems with this method. Our older patients who are technically adults are also included in this practice.This is also a large teaching pediatric facility
Angela Lee,BSN, CRNI
Our blood culture bottles only need 3-5ml per bottle, thus one set can be obtained from the PIV with insertion. We use chloraprep to start all PIVs and draw all labs. No increased contamination noted.
Rose Feltner RN, CRNI
Rose Feltner RN, BSN, CRNI
Speciality Practice Nurse
Vascular Access Team
Indiana University Hospital Bloomington[email protected]