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Blood culture procedures and practices in the neonatal intensive care unit: A survey of a large multicenter collaborative in California

Published online by Cambridge University Press:  16 March 2023

Linda Lefrak ,
Kristen E. Schaffer ,
Janine Bohnert ,
Peter Mendel Open the ORCID record for Peter Mendel [Opens in a new window] ,
Kurlen S.E. Payton Open the ORCID record for Kurlen S.E. Payton [Opens in a new window] ,
Henry C. Lee Open the ORCID record for Henry C. Lee [Opens in a new window] ,
Michael A. Bolaris  and
Kenneth M. Zangwill Open the ORCID record for Kenneth M. Zangwill [Opens in a new window]
Linda Lefrak
Affiliation:
Nurse Consultant, State of California Department of Public Health, Center for Health Care Quality, Healthcare-Associated Infections Program, Sacramento, California
Kristen E. Schaffer
Affiliation:
California Perinatal Quality Care Collaborative, Palo Alto, California Division of Neonatology, Stanford University, Palo Alto, California
Janine Bohnert
Affiliation:
California Perinatal Quality Care Collaborative, Palo Alto, California Division of Neonatology, Stanford University, Palo Alto, California
Peter Mendel
Affiliation:
RAND Corporation, Santa Monica, California
Kurlen S.E. Payton
Affiliation:
California Perinatal Quality Care Collaborative, Palo Alto, California Division of Neonatology, Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, California
Henry C. Lee
Affiliation:
California Perinatal Quality Care Collaborative, Palo Alto, California Division of Neonatology, Stanford University, Palo Alto, California
Michael A. Bolaris
Affiliation:
Department of Pediatrics, Rancho Los Amigos Rehabilitation Center, Downey, California
Kenneth M. Zangwill*
Affiliation:
Division of Pediatric Infectious Diseases, Department of Infection Prevention and Control, Harbor-UCLA Medical Center and The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California
*
Author for correspondence: Kenneth M. Zangwill, E-mail: [email protected]
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Abstract

Objective:

To describe variation in blood culture practices in the neonatal intensive care unit (NICU).

Design:

Survey of neonatal practitioners involved with blood culturing and NICU-level policy development.

Participants:

We included 28 NICUs in a large antimicrobial stewardship quality improvement program through the California Perinatal Quality Care Collaborative.

Methods:

Web-based survey of bedside blood culture practices and NICU- and laboratory-level practices. We evaluated adherence to recommended practices.

Results:

Most NICUs did not have a procedural competency (54%), did not document the sample volume (75%), did not receive a culture contamination report (57%), and/or did not require reporting to the provider if <1 mL blood was obtained (64%). The skin asepsis procedure varied across NICUs. Only 71% had a written procedure, but ≥86% changed the needle and disinfected the bottle top prior to inoculation. More than one-fifth of NICUs draw a culture from an intravascular device only (if present). Of 13 modifiable practices related to culture and contamination, NICUs with nurse practitioners more frequently adopted >50% of practices, compared to units without (92% vs 50% of units; P < .02).

Conclusions:

In the NICU setting, recommended practices for blood culturing were not routinely performed.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 10 , October 2023 , pp. 1576 - 1581
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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