Neonatal Intensive Care Unit, Nepean Hospital, Penrith, New South Wales, Australia.
Neonatal Intensive Care Unit, Nepean Hospital, Penrith, New South Wales, Australia
Arch Dis Child Fetal Neonatal Ed. 2020 Nov;105(6):600-604. doi: 10.1136/archdischild-2019-318080. Epub 2020 Mar 20.
Neonatal sepsis is the leading cause of mortality and morbidity in neonatal intensive care units. The volume of blood taken for culture remains one of the most important factors in isolating microorganisms.
To evaluate the impact of the intervention on the blood volume submitted for culture and to identify factors influencing the volume as determined by the phlebotomist.
Blood culture volume was determined by weighing the culture bottle before and immediately after blood inoculation. A 3-month preintervention audit revealed that in 126/130 samples (96.9%), the volume of blood submitted was suboptimal. Multiple intervention measures were instituted, and volume was monitored over the next 9 months.
637 blood culture samples were included in the study, 130 were in preintervention and 507 were in postintervention epochs. Following the intervention, suboptimal volume samples reduced from 96.9% (126/130 samples) to 25% (126/507 samples), p<0.0001 and the median (IQR) sample volume improved from 0.36 (0.23) ml to 0.9 (0.27) ml, p<0.0001. Poor blood flow was identified as the most common reason for an inadequate sample.
The study underscores the role of educational intervention in improving the blood culture volume in newborn infants. Poor backflow from the cannula is an important cause of inadequate volume collection.
新生儿败血症是新生儿重症监护病房死亡和发病的主要原因。用于培养的血量仍然是分离微生物的最重要因素之一。
评估干预措施对培养血样量的影响，并确定影响采血人员所采血量的因素。
通过在接种血液前后称重培养瓶来确定血培养量。在 3 个月的干预前审核中，发现 130 个样本中有 126 个（96.9%）样本提交的血量不足。实施了多种干预措施，并在接下来的 9 个月内监测了血样量。
本研究共纳入 637 份血培养样本，其中 130 份为干预前样本，507 份为干预后样本。干预后，血量不足的样本比例从 96.9%（126/130 个样本）降至 25%（126/507 个样本），p<0.0001，样本量中位数（IQR）从 0.36（0.23）ml 提高到 0.9（0.27）ml，p<0.0001。血流不畅被确定为样本不足的最常见原因。
该研究强调了教育干预在提高新生儿血培养量中的作用。从导管回流不良是导致采血量不足的一个重要原因。
