Table 3.
Body of evidence summary table: prepackaged prep kits.
| Study (Quality and Effect Size Ratings) | Population/Sample | Setting | Time period | Results (Blood Culture Contamination Rates) |
|---|---|---|---|---|
| McLellan 2008 -Fair -Minimal/None |
1,115 total blood cultures collected by Doctor Support Workers (DSWs), junior and on call doctors No prep kit (Pre): 563 Prep kit (Post): 552 (2% chlorhexidine gluconate in 70% isopropyl alcohol) |
Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK Academic Medical Center; 2 units; accident/emergency and general practice | Pre: 5/2007- 7/2007 Post: 8/2007–10/2007 |
Overall: No prep kit (Pre): 8.88% Prep kit (Post): 7.43 % OR= 1.22 (CI: 0.79 –1.87) |
| Trautner 2002 -Fair -Substantial |
813 total blood cultures collected by phlebotomists, house staff (medical students/residents) and healthcare technicians No prep kit:383 Prep kits: 430 paired sets from 215 patients-2 separate sites (chlorhexidine and tincture of iodine) |
VA Medical Center, Houston, TX; Tertiary-care teaching hospital, inpatient service wards (telemetry, oncology, geriatric), medical and cardiac ICU. | 11/2000–5/2001 | No prep kit: 6.5% Prep kits: 0.9% OR = 3.68 (CI: 1.27 –10.73) |
| Weinbaum 1997 -Good -Moderate |
495 total blood culture specimens collected by house staff (interns & residents No prep kit: 287 Prep kits: 208 (isopropanol and tincture of iodine) |
New York Medica Center Hospital of Queens Flushing, NY.; 487-bed community hospital); general medical unit | 3 months (1995); dates not reported | No prep kit: 6.5% Prep kits: 0.9% OR = 1.81 (CI: 0.85 –3.87) |
| Wilson et al. (2000) -Fair -Minimal/None (4 studies) |
12,367 total blood samples; 6,362 with alcohol pledgets; 6005 with prep kits (70% isopropyl alcohol & 2% iodine tincture on separate sterile applicators). By site: Site a: No kit: 3536; Prep kit 2924; Site b: No kit: 1632; Prep kit 1801; Site c: No kit: 1007; Prep kit 906; Site d: No Kit: 187; Prep kit 374; collected by house staff physicians/medical students except phlebotomy teams at Site c. |
4 Academic medical centers: Duke Univ. Med. Ctr., Durham, NC (Site a), Robert Wood Johnson Univ. Hosp., New Brunswick, NJ (Site b), Denver Health Med. Ctr., Denver, CO (Site c), and Salt Lake Veterans Affairs Med. Ctr., Salt Lake City, UT (Site d) | Dates not reported; prior to 2000 | Overall: No prep kit: 5.5% Prep kits:* 5.5% By site: Conventional; Prep kit Site a: 4.4%; 4.3% OR = 1.03 (CI: 0.81–1.31) Site b: 8.1%; 7.5% OR = 1.09 (CI: 0.85–1.39) Site c: 5.5%; 6.0% OR = 0.91 (CI: 0.62–1.34) Site d: 3.7%; 3.5% OR = 1.08 (CI: 0.42 –2.75) |
| BODY OF EVIDENCE RATINGS |
# Studies by Quality and Effect Size Ratings 1 Fair/Substantial 1 Good/Moderate 5 Fair/Minimal/None |
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| Consistency | NO | |||
| Overall Strength | INSUFFICIENT | |||
Bibliographic information for all studies is provided in Appendix C.