This document provides instructions for nurses on properly collecting blood cultures to diagnose infections. It outlines the goals of ensuring correct procedure and preventing unnecessary contamination. It details the supplies needed, including blood culture bottles and kits, and instructs nurses to clean any infusion caps, use sterile technique, and vigorously clean the bottle septa with alcohol before injecting blood samples. The document provides step-by-step guidance on setting up the collection adapter, order of drawing from different lines, labeling samples, and timely submission to the lab.

1. Norman Swope BSN, RN Infection Control Resource Nurse
University of Arkansas for the Medical Sciences

2. Purpose/ Goals
 To provide initial education for new nurses.
 To provide a refresher for veteran nurses.
 To ensure the proper procedure in performing task.
 To prevent unnecessary contamination and additional
blood draws.

3. Gather and Inspect your supplies/
ID your patient(2ways).
 EQUIPMENT:
 2 sets of B.C. = 4 bottles
 2 Blood Culture Kits (available from Distribution Center/Central
Supply) containing:
 · Blood culture (skin) prep/Chloraprep
 · Biohazard Bag
 · Aerobic bottle (Blue Bottle)
 · Anaerobic bottle (Red Bottle)
 · Blood culture bottle adapter
 · Alcohol applicator
 A cap (needleless valve) for each lumen used for obtaining blood
culture
 Patient Lab specimen labels
 Gloves

4. Change and Clean Infusion Caps
 1. Get a secure grip on leur-lock cap.
 2. Remove old cap.
 3. Clean if visibly soiled with chlorhexadine(CHG) scrub,
otherwise attach new clean cap.
 4. Clean the cap with Chloraprep before drawing culture.
 KEYPOINT: If drawing from central or arterial line, change the cap (needleless
valve) before obtaining blood. Clean each new infusion cap (needleless valve)
or leur-lock connection with a separate blood culture Chloraprep. Allow to dry
before collecting blood.

5. Use sterile/ aseptic technique
 Did you know that the replacement caps are sterile?
 Did you know that the adapter needles are sterile?
 Set up and clean your work area.
 Wash your hands before you begin.

6. Cleaning Culture Bottle
 Vigorously wipe septa of the blood culture bottles (or
Isolator tube) with 70% alcohol. Keep septa covered at all
times before injecting blood with alcohol prep pad to
prevent airborne containments away from septa.
 KEYPOINT: The septum of the blood culture bottle (or
Isolator tube) is not sterile and must be disinfected before
injecting blood.
15-20 seconds Leave them there until
used.

7. Setting up the Multi-vial Adapter and
drawing specimens.
 At the bedside attach Blue/White needle to the multi-vial adapter. (Butterfly
needles are not approved for CVL culture draws.)
 Clean the lumen to be used for 30 seconds with CHG swab then allow to dry for
30 seconds.
 Vigorously wipe septa of the blood culture bottles (or Isolator tube) with 70%
alcohol. Keep septa covered at all times before injecting blood with alcohol
prep pad to prevent airborne containments away from septa.
 4. Apply gloves and collect a full 10 ml per bottle (adults)
 KEYPOINT: The septum of the blood culture bottle (or Isolator tube) is not
sterile and must be disinfected before injecting blood.

8. Drawing blood culture cont.
 If drawing with a syringe, either directly or from a central line, then
you must inject the pink topped Anaerobic tube first then the blue
topped Aerobic tube last.
 Flush per unit protocol when competed.
 KEYPOINT: If drawing with a winged butterfly set you must inject the
blue topped Aerobic (Blue) bottle first then the purple topped
Anaerobic (Pink)bottle.
 Do Not waste any blood.
Anaerobic
(red)is 1st
for CVL.
Aerobic
(blue) is 1st
for
Peripheral.

9. Label the vial and the
transmittal.
 Fill out microbiology specimen transmission slip or Sunrise
transmission slip. Always sign the slip and have another person verify
the label with the transmission slip and sign the form.
 Bottles should be labeled and patient verified at bedside.
 Send to lab As Soon As Possible!
 KEYPOINT: Put your initials, color of lumen, time and date drawn on
slip and on the Blood Culture bottle.

10. REFERENCES:
 http://intranet.uams.edu/nursingmanual/Procedures/proc
edure108.htm
 Isenberg, H. (editor in chief), Clinical Microbiology
Procedures Handbook, 2nd edition, (2005). pp. 3.4.1.2-
3.4.1.4,
 Mathew, A. et al. (2009). Central catheter blood sampling:
The impact of changing the needleless caps prior to
collection. Journal of Infusion Nursing, 32(4): 212-218.
 National Institute for Health and Clinical Excellence.
(2007). Blood Cultures. Retrieved July 23, 2009 from
http://www.pathology.leedsth.nhs.uk/pathology/Departm
ents/MicrobiologyVirology/How2Sample/BloodCultures/t
abid/158/Default.aspx