DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20194642

Knowledge and practice among the pediatric post graduate residents regarding the technique of blood culture sampling

Nusrat R. Inamdar, Minal R. Wade, Anupama Mauskar

Abstract


Background: Errors in sampling during blood culture, may lead to contaminants or poor yield which result in faulty reports increasing patient's suffering, endanger patient safety and increasing cost of health care. Optimal knowledge about the sampling method for important microbiological test like blood culture translates into appropriate practices. Authors objectives was to assess the knowledge and practice of the Pediatric resident doctors, regarding sterile technique during blood culture collection. The change in the knowledge of the residents during blood culture sampling with regards to maintaining asepsis after watching educational video was evaluated.

Methods: A quasi experimental, questionnaire based study with pre–post intervention,  involved post graduate resident’s knowledge and  practice regarding the sterile technique during blood culture collection. The data   analyzed using paired t test and Chi-square Test.

Results: 18(60%) participants accepted that they have collected blood culture not maintaining complete asepsis at some time in past. The reasons for the same were lack of knowledge 14 (46.66%), no assistance from staff for the procedure 14 (46.66%), non-availability of sterile gloves 4 (13.33%), non-availability of antiseptic solution 4(13.33%), time consuming 8 (26.66%).

Conclusions: Ultimately, blood culture contamination is a complex, challenging problem that requires a multidisciplinary approach. Regular teaching modules for the health personnel and ensuring environment conducive to correct practises would definitely help in improving the sampling practises for aseptic procedures.


Keywords


Knowledge and practice among the pediatric post graduate residents regarding the technique of blood culture sampling

Full Text:

PDF

References


Garcia RA, Spitzer ED, Beaudry J, Beck C, Diblasi R, Gilleeny-Blabac M, Haugaard C, et al. Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteraemia’s, reducing contamination, and eliminating false-positive central line-associated bloodstream infections. Am J Infection Control. 2015 Nov 1;43(11):1222-37.

Lamy B, Dargère S, Arendrup MC, Parienti JJ, Tattevin P. How to optimize the use of blood cultures for the diagnosis of bloodstream infections? A state-of-the art. Frontiers Microbiol. 2016 May 12;7:697.

Clinical and Laboratory Standard Institutes (CLSI). Principles and Procedures for Blood Cultures; Approved Guideline. Wayne. Available at: https://clsi.org/media/1448/m47a_sample.pdf

Weinstein MP. Current blood culture methods and systems: clinical concepts, technology, and interpretation of results. Clini Infectious Dis. 1996;23:40-6.

Smith-Elekes S, Weinstein MP. Blood cultures. Inf Dis Clin North Am. 1993 Jun;7(2):221-34

Marini MA, Truog AW. Reducing false-positive peripheral blood cultures in a pediatric emergency department. J Emergency Nursing. 2013 Sep 1;39(5):440-6.

Hall KK, Lyman JA. Updated review of blood culture contamination. Clini Microbiol Reviews. 2006 Oct 1;19(4):788-802.

Bates DW, Goldman L, Lee TH. Contaminant blood cultures and resource utilization: the true consequences of false-positive results. JAMA. 1991 Jan 16;265(3):365-9.

Segal GS, Chamberlain JM. Resource utilization and contaminated blood cultures in children at risk for occult bacteremia. Arch Pediatr Adolesc Med. 2000 May 1;154(5):469-73.

Souvenir D, Anderson DE, Palpant S, Mroch H, Askin S, Anderson J, et al. Blood cultures positive for coagulase-negative staphylococci: antisepsis, pseudo bacteremia, and therapy of patients. J Clini Microbiol. 1998 Jul 1;36(7):1923-6.

Thuler LC, Jenicek M, Turgeon JP, Rivard M, Lebel P, Lebel MH. Impact of a false positive blood culture result on the management of febrile children. Pediatric Infectious Disease J. 1997 Sep 1;16(9):846-51.

Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, et al. Epidemiology of sepsis in Germany: results from a national prospective multi center study. Intensive Care Med. 2007 Apr 1;33(4):606-18.

Alahmadi HA. Assessment of patient safety culture in Saudi Arabian hospitals. Qual Saf Health Care. 2010 Oct 1;19(5):e17.

Hernández-Bou S, Álvarez Álvarez C, Campo Fernández MN, García Herrero MA, Gené Giralt A, Giménez Pérez M, et al. Blood cultures in the paediatric emergency department. Guidelines and recommendations on their indications, collection, processing and interpretation. An Pediatr (Barc). 2016;84:294.

Aseptic non touch technique - a guide for healthcare workers. Available at: http://antt.org/ANTT_Site/home.html.

Ojide CK, Onwuezobe AI, Asuquo EE, Obiagwu CS. Knowledge, attitude and practice of blood culture: A cross sectional study among medical doctors in a Nigerian tertiary hospital. African J Clini Experiment Microbiol. 2013;14(3):174-9.

Parada JP, David N Schwartz DN, Schiff GD, Weiss KB. Effects of type and level of training on variation in physician knowledge in the use and acquisition of blood cultures: a cross sectional survey. BMC Infect Dis. 2005;5:71

Li J, Plorde JJ, Carlson LG. Effects of volume and periodicity on blood cultures. J Clini Microbiol. 1994 Nov 1;32(11):2829-31.

Mermel LA, Maki DG. Detection of bacteremia in adults: consequences of culturing an inadequate volume of blood. Annals Internal Med. 1993 Aug 15;119(4):270-2.

Raupach-Rosin H, Klett-Tammen CJ, Schmalz O, Karch A, Castell S, Mikolajczyk R. " I cannot kiss my wife"-An Anal Daily Experiences MRSA-carriers. 2016;78(12):822-7.

Connell TG, Rele M, Cowley D, Buttery JP, Curtis N. How reliable is a negative blood culture result? Volume of blood submitted for culture in routine practice in a children's hospital. Pediatrics. 2007 May 1;119(5):891-6.

Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, Gonzalez MD, Jerris RC, Kehl SC, Patel R, Pritt BS. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the Infectious Diseases Society of America and the American Society for Microbiology. Clini Infectious Dis. 2018 Jun 28;67(6):e1-94.

Atalla HR, Henedy WM. Effectiveness of Structured Teaching Program on Knowledge and Practice Regarding Blood Specimen Collection among Nurses. J Nursing Health Sci. 2018 Jan-Feb;7(1):15-23.