Reply To: needleless connector change and blood culture withdrawal

  • Sarah Walding

    Member
    July 10, 2019 at 12:16 pm

    We collect blood culture specimens by attaching a sterile syringe directly to the CVC using sterile technique (“hub to hub” as we call it). 

    We remove the old needless injection cap utilizing sterile gauze, then scrub the hub for 15 sec/dry for 15 sec (if visibly soiled).  Then attach the sterile syringe directly to the hub to draw the specimen, then put a new, primed cap on.

    Our central line policies were developed from
    Centers for Disease Control and Prevention. (2011). Guidelines for the prevention of intravascular catheter–related infections, 2011. Retrieved from http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf Infusion Nurses Society. (2016). Infusion nursing standards of practice. Journal of Infusion Nursing., Retrieved from hhtp://www.ins1.org.pdf Pedivan. (2010). Best practice guidelines in the care and maintenance of pediatric central venous catheters.

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    Sarah Walding, BSN, RN, CPN
    Clinical Practice Specialist
    Pediatric Hematology/Oncology
    Advocate Children’s Hospital Park Ridge
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    Original Message:
    Sent: 07-10-2019 01:00 AM
    From: Sarah Hakim
    Subject: needleless connector change and blood culture withdrawal

    ​​​Please it is highly appreciated if you can share with me your practice in the technique of blood withdrawal/blood culture withdrawal from  an implantable venous access device ( implanted port)
     what do you put on the extension tube of the port.

    I am asking because the new practice in drawing blood cultures from the central venous access device is to change the needleless connector prior to withdrawing a blood culture.

    Can you confirm if you do the below:

    – Put a needleless connector on the end of the extension tube of the port (IVAD) ; after IVAD insertion
    – Use  a trifuse or multiple lumen extension  , by connecting it to the needleless connector.
    – Draw blood after disconnecting the multiple lumen extension or the trifuse in a sterile way, draw the blood sample then reconnect the same trifuse.
    to note that the normal blood sample is taken from one of the lumens of the multiple lumen extension (trifuse)    and the blood culture is withdrawn from the needleless connector that is applied to the  end of the extension tube of the port (IVAD) (since needleless connector needs to be changed  prior to blood culture withdrawal)

    Appreciate your help
    Thank you

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    Sarah Hakim, MSN
    Clinical Educator
    Lebanon
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