Optimizing Blood Culture Collection Volumes.
Leslie Smith, Ruth Ali-Napo, Deborah Ben-Zeev and 1 others
PMID 37882404WHAT IT FOUND
Blood culture overfill and underfill events were reported to decrease after the project corrected volume guidance, adjusted laboratory weight tolerance, and retrained nurses and patient care technicians on stopcock technique.
Key findings
01Empty blood culture bottles did not all weigh 60 grams; their dry weights ranged from 59 to 62 grams, so a bottle with exactly 10 ml could be recorded as overfilled.
02Some nurses connected the bottle directly to the vacutainer rather than drawing blood into the syringe first, so the volume was estimated; because bottles can hold up to 30 ml, overfill could easily occur.
03The institution reported 263 overfill/underfill events in 2020 and 76 by December 2021, a reported 71% decrease.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a quality improvement project without a control group, so the event decrease cannot be attributed only to the education and procedure changes. The investigative phase stopped after fewer collections than originally planned, so it may not capture all practice variation. Peripheral blood culture collection was not observed in the initial phase, although it was addressed later, so the first findings may not apply to all collections. The paper reports fill-volume events but not patient outcomes such as culture sensitivity, false-negative rates, antibiotic selection, or survival. The supplied text does not describe statistical testing or concurrent controls for the before-after event trend.
Declared interests
No funding or conflict-of-interest statement is reported in the article text.
The easy way to misread this
Do not read the decrease in overfill/underfill events as proof that patient outcomes improved or that education alone caused the change. This was a quality improvement project without a control group, and it measured collection events rather than culture sensitivity, sepsis treatment, or survival.