Authors

Raúl Sánchez-Bermejo1, Carmen Cortés-Fadrique2, Ana Cecilia Marín Guerrero3, Miguel Ángel Díaz-Chaves4, Yonatan Marín Martín4, Gerardo Ávila-Martín5

Position

1Enfermero. Máster en Gestión de Recursos de Enfermería. Supervisor de Enfermería. Servicio de Urgencias. Hospital General Nuestra Señora del Prado. Talavera de la Reina (Toledo). Asociado Clínico Universidad Castilla La Mancha2Enfermera. Servicio de Quirófano. Hospital General Nuestra Señora del Prado. Talavera de la Reina (Toledo)3PhD en Medicina Preventiva. Unidad de Apoyo a la Investigación. Área Integrada de Talavera de la Reina (Toledo)4Enfermero. Servicio de Urgencias. Hospital General Nuestra Señora del Prado. Talavera de la Reina (Toledo). Asociado Clínico Universidad Castilla La Mancha5PhD en Neurofisiología y farmacología. Grupo de función Sensitivomotora. Hospital Nacional de Parapléjicos. Unidad de Apoyo a la Investigación. Área Integrada de Talavera de la Reina (Toledo)

Contact address

Raúl Sánchez Bermejo. Hospital General Nuestra Señora del Prado. Carretera de Madrid, km. 114. 45600 Talavera de la Reina (Toledo).

Contact email: raulsanchezbermejo@gmail.com

Abstract

Objective: to understand the variability in the technique for blood culture extraction in the clinical practice of nurses, as well as to assess any differences based on whether there is a protocol or not.
Method: a descriptive cross-sectional study conducted in 2018 through an on-line survey with voluntary and anonymous participation; it was distributed through the General Council of Nurses, 200 managements of national hospitals, private and institutional profiles, and group webpages. A 23-question ad-hoc questionnaire was designed, in order to explore sociodemographical, and occupational variables, as well as those associated with blood culture extraction: the existence of a protocol in the unit, correct indications of application, and technical matters. A descriptive analysis of the sample was conducted, as well as bivariate analysis through Pearson’s x2 test.
Results: the study included 1,516 professionals (84.4% were women, 64.4 % with >10-year experience); 53.2% of them reported there was a specific protocol in their unit. Those who had a protocol used more frequently the sterile equipment, chlorhexidine 2% for skin disinfection, and some type of antiseptic for disinfecting the stoppers (p< 0.001). In the case of central venous catheter samples, it was more frequent that they extracted another sample from a peripheral (p< 0.001), changed the needle in order to inject the blood into the vials (p< 0.05) without discarding any (p< 0.001), and collected 10cc vs. other volumes (p< 0.01).
Conclusions: there is high variability in terms of conducting the technique, as well as differences based on whether there is a protocol or not. The standardization of procedures by consensus becomes necessary in order to optimize and make the most of blood culture extraction.

Keywords:

Blood culture; contamination; sepsis; blood extractiondescriptive cross-sectional study

Versión en Español

Título:

Variabilidad de la práctica clínica en la extracción de hemocultivos en España