TABLE 2.
Interventions to prevent blood culture contaminationa
| Intervention | Comment |
|---|---|
| Patient selection | Blood cultures should be performed for patients with a reasonable likelihood of bacteremia. |
| Skin disinfection | Use of an alcohol containing disinfectant is recommended. |
| Blood culture bottle cap disinfection | Tops of blood culture vials should be disinfected prior to inoculation of blood. |
| Phlebotomy site (intravascular catheter vs peripheral vein) | Blood cultures should not be obtained via intravascular catheters unless the catheter is thought to be the source of bacteremia. |
| Single-needle vs double-needle transfer | Although double-needle technique may be helpful, it is not recommended due to risk of needlestick injury. Use direct transfer technique. |
| Sterile gloves/hand hygiene | Limited data to support sterile glove use |
| Standardized kits | Standardized kits and procedures helpful in preventing blood culture contamination |
| Sterile drapes | Not studied as an isolated intervention; sometimes included in blood culture kits |
| Appropriate blood volume | Contamination and false-positive results associated with under- and overfilling blood culture bottles |
| Phlebotomy team/education | Proven useful in decreasing blood culture contamination in numerous studies |
| Multidisciplinary quality improvement | Requires both technical and adaptive work |
| Surveillance and feedback | A key part of any comprehensive program to decrease blood culture contamination |
| Initial specimen diversion | Commercially available device shows promise as a cost-effective means to decrease contamination |