We are updating policy--Can you clarify the best/proper way to draw a Blood Culture from a CVAD
Primary point of disagreemeent is whether to flush with NS prior to drawing the specimen
Robbin George RN VA-BC Vascular Access Resource Department Inova Alexandria Hospital Virginia
I thought I posted a response to this earlier but it did not go through. No, you do not need to withdraw or flush before drawing blood cultures from a VAD.
1. M Wilson, M. Mitchell, A. Morris, P. Murray LR, L. Reller, M. Towns, M. Weinstein, S. Wellstood, W. Dunne, R. Jerris, D. Welch. Principles and Procedures for Blood Cultures; Approved Guideline. Clinical and Laboratory Standards Institute. 2007;27(17).
You do need to always remove the old used and dirty needleless connector to avoid false positives from the biofilm inside these connectors. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Point of clarification--You say that the clinician does not NEED to flush with NS--BUT--Is there a contraindication to flushing with NS before drawing a Blood Culture from a CVAD
In other words will the Blood Culture specimen be comprimised if the clinician flushes first with NS--I ask this very specific question because there are valved catheters
[Both Groshong and Prox valved PICCs] that are difficult to draw from if the valve technology is not primed with a positive flush first--There are those at the table that feel the specimen
will somehow be suboptimal if the clinician flushes away the "content of the catheter" immediately prior to the collection
Robbin George RN VA-BC Vascular Access Resource Department Inova Alexandria Hospital Virginia
Robbin George RN VA-BC
There is no contraindication to flushing before drawing cultures from a VAD written in any set of standards and guidelines. There is really no way to answer your question using scientific evidence because there are no studies assessing this. So I guess you could do your own assessment from several patients by doing cultures of the first drawn sample, then flushing and drawing a second sample for culture and comparing the results. The patient would act as their own control and you can assess any differences between those samples. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861