Jeonghyun Chang; Taegeun Lee; Heungsup Sung; Mi-Na Kim; Youn-Jung Kim; Yoon-Seon Lee

doi:10.14192/kjhaicp.2018.23.1.14

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Chang, Lee, Sung, Kim, Kim, and Lee: Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lok™ Blood Collection Sets in the Emergency Room

Original Article

Korean Journal of Healthcare-Associated Infection Control and Prevention 2018; 23(1): 14-23.

Published online: 26 June 2018

DOI: https://doi.org/10.14192/kjhaicp.2018.23.1.14

Evaluation of the Safety and Performance of Blood Culture Practices Using BD Safety-Lok™ Blood Collection Sets in the Emergency Room

Jeonghyun Chang¹, Taegeun Lee¹, Heungsup Sung¹, Mi-Na Kim¹, Youn-Jung Kim², Yoon-Seon Lee²

¹Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

²Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence to: Mi-Na Kim, Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: 02-3010-4511, Fax: 02-478-0884, mnkim@amc.seoul.kr

Received 20 February 2018 Revised 2 April 2018 Accepted 16 April 2018

Korean Society for Healthcare-Associated Infection Control and Prevention

Abstract

Background

A safety device is recommended to improve the safety and performance of blood culture practice. BD vacutainer® Safety-Lok™ blood collection sets with pre-attached holder (Safety-Lok) were evaluated in the emergency room (ER) of a tertiary care hospital.

Methods

Interns and nurses in the ER were surveyed regarding blood culture practices with a questionnaire before and after 2 or 3 weeks of experience with using Safety-Lok from April to June 2017. All participants underwent a 1-h exercise workshop combined with video education before the initial survey. The blood volume, positivity, and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of the overall blood cultures.

Results

A total of 18 interns and 30 nurses were enrolled. The result of the initial survey showed that interns had higher rates of needle stick incidence (27.8%), higher rates of carriage of blood-filled syringe with needle (88.9%), and lower rates of Vacutainer® one-use holder (BD, USA) use (38.9%) than nurses had (13.3%, 53.3%, and 60.0%, respectively). Compared with nurses (40.0%), interns preferred to use safety devices (88.9%). The number of overall blood cultures and SD blood cultures were 9,053 and 555, respectively, during the study period. The overall blood volume collected in aerobic bottles was 2.6±2.1 mL, and the SD blood volumes collected in aerobic and anaerobic bottles were 5.0±3.0 mL and 6.0±3.0 mL, respectively. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures, respectively.

Conclusion

The introduction of the safety device would encourage healthcare workers to collect adequate blood volume and would lead to safer practices in the ER.

Keywords: Blood culture, Needlestick, Safety device, Volume

Figures and Tables

Fig. 1

Moments of the needle stick injury among interns, novice nurses, and experienced nurses.

Fig. 2

Device which is necessary to improve the safety of blood culture in interns, novice nurses and experienced nurse.

Table 1

Initial survey of blood culture practices for interns and nurses in emergency room

^aPhlebotomy experience <5 years, ^bPhlebotomy experience ≥5 years, All CNS belonged to this group. ^cvacutainer® one-use holder (BD Diagnostics, Sparks, MD, USA) ^dto transfer the syringe from bedside to a nursing station which the blood culture bottles were placed.

Table 2

Survey of blood culture practices for interns and clinical nurse specialists after use of BD Safety-Lok™ blood collection sets in emergency room

^*Other than 1–2 uses: immediate after education in 2 (11.1%), 1 week in 5 (27.8%), never during study period in 1 (5.6%) for interns and 1 week in 3 (30.0%) for CNS.

Abbreviation: CNS, clinical nurse specialist.

Table 3

Comparison of blood culture performance between use of BD Safety-Lok™ blood collection sets and syringe use

Abbreviation: NA, not applicable.

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