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

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.