Blood Culture Collection Protocols Quiz

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Questions and Answers

Match the following conditions with the reasons for ordering blood cultures:

Sepsis = To evaluate for bacteremia or septicemia Meningitis = To detect systemic infections Endocarditis = To identify potential bloodborne pathogens Fever of unknown origin = To rule out bacterial causes

Match the antiseptic agents with their concentration used for skin decontamination:

70-95% Alcohol = Antiseptic agent 2% Chlorhexidine = Antiseptic agent 1-2% Tincture of Iodine (TIO) = Antiseptic agent Betadine = Antiseptic agent

Match the following steps with their importance in blood culture collection:

Decontaminate skin surface = Reduces contamination risk Optimal collection technique = Ensures accurate results Multiple cultures from separate sites = Increases detection chances Adequate contact time with antiseptic = Maximizes antiseptic effect

Match the terminology with their definitions in the context of blood cultures:

Bacteremia = Presence of bacteria in the blood Contamination = Introduction of normal flora into culture Septicemia = Systemic illness caused by bacteria in the blood Fungemia = Presence of fungi in the blood Signup and view all the answers

Match the blood culture collection protocols with their significance:

Take blood cultures before therapy = Ensures accurate pathogen identification Use large volumes for cultures = Improves sensitivity for detection Randomized venipuncture sites = Prevents contamination from one site Follow standard decontamination protocols = Reduces false-positive results Signup and view all the answers

Match the potential complications with their descriptions:

False-positive results = Misleading indication of infection Systemic disease = Caused by normal skin flora Intermittent bacteremia = Infrequent presence of pathogens in blood Contaminated cultures = May be easy to misinterpret Signup and view all the answers

Match the following conditions with their relation to blood culture sensitivity:

Osteomyelitis = May lead to bacteria in the bloodstream Pneumonia = Can cause systemic bacteremia Peritonitis = Associated with increased bacterial presence Arthritis = Potential source of infection in joints Signup and view all the answers

Match the blood culture collection factors with their effectiveness:

Number of cultures = Directly affects detection rates Volume of blood = Critical for accurate pathogen isolation Timing of collection = Less significant compared to other factors Technique quality = Essential to prevent contamination Signup and view all the answers

Match the following methods with their purpose in blood culture collection:

Chlorhexidine solution = Preferred antiseptic for skin disinfection Alcohol swabs = Cleanses the skin to reduce contamination Povidone-iodine swabs = Provides enhanced decontamination Gauze dressing = Covers the venipuncture site post-collection Signup and view all the answers

Match the following steps with their correct order in the blood culture collection process:

Disinfect the venipuncture site = First step in blood culture collection Insert needle into vein = To withdraw appropriate blood amount Label the culture bottles = Done in the presence of the patient Send specimens to the laboratory = Final step in the collection procedure Signup and view all the answers

Match the following blood culture collection precautions with their descriptions:

Tourniquet application = Helps in identifying the venipuncture site Wearing sterile gloves = Prevents contamination during palpation Using alcohol pad = Cleanses skin in a circular motion Avoiding existing IV line = Reduces interference in culture results Signup and view all the answers

Match the following antiseptic effects with their characteristics:

Chlorhexidine = Required drying time is 30 seconds Alcohol = Used to remove excess iodine Povidone-iodine = Allows for better decontamination than chlorhexidine alone Alcohol swabs = Should be used in repeated circular motions Signup and view all the answers

Match the following blood specimen conditions with their implications:

Infants and younger children = Require less blood than adults Central catheter site collection = Should be the most recently inserted site Blood cultures prior to other samples = Ensures contamination is minimized Culture bottles filled precisely = 8-10 ml of blood is necessary Signup and view all the answers

Match the following instructions for skin preparation with their necessary actions:

Cleanse with alcohol = Remove excess iodine to prevent burns Allow cleansing site to dry = Gives proper antiseptic effect Scrub for 30 seconds = Disinfects a 10 cm area of skin Do not touch venipuncture site = Maintains sterility post-preparation Signup and view all the answers

Match the following blood culture handling tips with their significance:

Do not refrigerate specimens = Preserves culture viability Document collection details = Ensures accurate lab processing Fill out lab slip = Indicates suspected diagnosis Remove tourniquet after collection = Prevents site complications Signup and view all the answers

Match the following recommended actions with their context in blood culture collection:

Drawing a second set of cultures = Should utilize the same procedure as the first Documenting cultures on nursing form = Ensures proper tracking of samples Inoculating culture bottles = Requires exactly 8-10 ml of blood Using a butterfly needle = Facilitates access to veins Signup and view all the answers

Match the medical conditions with their corresponding blood culture procedures:

Catheter sepsis = Draw two sets from a catheter and peripheral site Acute endocarditis = Draw 2-3 culture sets within 30 minutes Subacute endocarditis = Draw 2-3 sets spaced 30-60 minutes apart Fungal cultures = Follow routine procedures for bacterial cultures Signup and view all the answers

Match the specimen types with their collection requirements:

Blood cultures = Indicate time of collection for both specimens Bone marrow = Aspirate using a sterile needle and syringe Fungal culture = Use mycobacteria/fungal blood culture bottle Catheter tip = Send with concomitant blood cultures Signup and view all the answers

Match the timing of culture collections with their descriptions:

10 minutes = Wait between sets if same site is used 30 minutes = Time interval between cultures for acute endocarditis 1-3 hours = Draw a third set for specific diagnoses 30-60 minutes = Spacing for subacute endocarditis collections Signup and view all the answers

Match the procedure with the corresponding medical advice:

Immediate antibiotics = Less important for subacute endocarditis Drape surrounding skin = Prepare skin for bone marrow collection Submit catheter section = Cut aseptically if removed Transport specimens immediately = At ambient temperature Signup and view all the answers

Match the type of culture with its unique collection instruction:

Bacterial culture = Do not send in a Heparin tube AFB culture = Use a mycobacteria/fungal blood culture bottle Blood cultures = Draw sets from separate sites Fungal culture = Follow bacterial culture routine procedures Signup and view all the answers

Study Notes

Specimen Collection for Microbiological Studies

Blood cultures are ordered when a patient's condition necessitates evaluating for bacteremia or septicemia.
Poor aseptic technique or inappropriate specimen handling can result in either sterile or contaminated blood cultures.
Known or suspected conditions like sepsis, meningitis, osteomyelitis, arthritis, endocarditis, peritonitis, pneumonia, or fever of unknown origin often require blood cultures.
Blood cultures are a crucial diagnostic tool for identifying bacteremia or fungemia.
The quality of blood specimens submitted for analysis significantly impacts accurate results.
Bacteremia in adults is typically intermittent.

Important Considerations

Blood specimens are critical for microbiological analysis.
Blood culture is a highly sensitive method for identifying bacteremia or fungemia.
Proper collection techniques and decontamination procedures are vital for accurate results.
Initial collection protocol includes optimal collection and appropriate antiseptic precautions (standard decontamination methods).
Decontamination involves using 70-95% alcohol, 2% chlorhexidine, or 1-2% tincture of iodine (TIO/Betadine) on the skin, with a 2-minute contact time.
Multiple blood cultures (each with substantial blood volume) are necessary for detecting bacteremia. At least two sets of cultures from different venipuncture sites are ideal before administering antimicrobial therapy.
The technique, number of cultures, and volume of blood are more crucial for accurate bacteremia detection than the exact timing of specimen collection.
Skin flora can contaminate blood cultures and lead to false positives which can lead to misdiagnosis.
Disinfection and avoiding existing intravenous lines diminish contamination, improving accuracy of results.

Technique

Sterile technique is critical to prevent contamination of blood culture media by skin flora during collection.
Skin flora can cause systemic disease; inaccurate results occur where blood cultures are contaminated.
Proper disinfection of the venipuncture site and avoiding existing intravenous lines is essential to minimizing blood culture contamination.
Apply a tourniquet, locate the phlebotomy site, and use a chlorhexidine solution or 2-3 alcohol swabs to clean the area. Allow to dry for at least 30 seconds.
Wear sterile gloves. Use a firm scrubbing motion for 30 seconds to disinfect the 10 cm area of skin. Allow to dry again at least 30 seconds before venipuncture.
Povidone-iodine swabs are more effective than chlorhexidine alone for skin decontamination.
Avoid touching the venipuncture site after preparation. If palpation is needed, apply sterile gloves.
Withdraw appropriate blood volume.
Draw blood cultures before other blood samples.
Keep hands sterile (especially the dominant hand). Alcohol pads should be removed from the top of the culture bottles immediately.
Inoculate culture bottles (8-10 ml per bottle), using properly marked indicator lines. Volumes are different for pediatric samples compared to adult samples.
Remove the tourniquet and butterfly needle, cover with gauze dressing, and apply pressure as needed.
Label the bottles in the patient's presence, avoiding covering bar-coded areas.
Fill out the Microbiology-routine lab slip.
Indicate suspected diagnosis.
Document date and time of collection.
Document cultures obtained on the correct nursing form and send to the lab as soon as possible.
Do not refrigerate blood cultures.

Suspected Catheter Sepsis

Two sets of blood cultures. One from the suspected catheter and one from a separate peripheral site.
Time of collection should be documented for each specimen.
Remove a section of catheter (about 1 inch).
Send the catheter section and concomitant blood cultures to the microbiology lab in a dry sterile container.

Acute Endocarditis

Draw 2-3 blood cultures from separate sites within 30 minutes. Samples should be drawn before initiating antibiotic therapy.
Begin antibiotic therapy after obtaining cultures.

Subacute Endocarditis

Draw 2-3 blood cultures on Day 1, spaced 30-60 minutes apart.
Additional sets can be drawn on Days 2 and 3 (maximum 4 sets in 24 hours) if negative, as help to document continuous bacteremia.
Immediate antibiotics are less important than confirming the specific microbial diagnosis

Fungal Cultures

Follow routine procedure for bacterial cultures if fungal cultures are ordered.

Bone Marrow

Wear the appropriate personal protective equipment during bone marrow collection.
Prepare the skin as for blood cultures.
Aspirate the marrow percutaneously using a sterile needle and syringe, and transfer 3-5 ml into a separate blood culture bottle.
Do not place the bone marrow sample in a heparin tube. Instead, send AFB and fungal cultures separately in separate mycobacteria/fungal blood culture bottles.
Transport immediately at ambient temperature.

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Description

Test your knowledge on blood culture collection protocols and related factors. This quiz will cover antiseptic agents, reasons for ordering blood cultures, and the importance of procedures. It's designed for healthcare professionals seeking to enhance their understanding of best practices in microbiology.