Nurse Consultant, State of California Department of Public Health, Center for Health Care Quality, Healthcare-Associated Infections Program, Sacramento, California.
California Perinatal Quality Care Collaborative, Palo Alto, California.
Infect Control Hosp Epidemiol. 2023 Oct;44(10):1576-1581. doi: 10.1017/ice.2023.33. Epub 2023 Mar 16.
To describe variation in blood culture practices in the neonatal intensive care unit (NICU).
Survey of neonatal practitioners involved with blood culturing and NICU-level policy development.
We included 28 NICUs in a large antimicrobial stewardship quality improvement program through the California Perinatal Quality Care Collaborative.
Web-based survey of bedside blood culture practices and NICU- and laboratory-level practices. We evaluated adherence to recommended practices.
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).
In the NICU setting, recommended practices for blood culturing were not routinely performed.
描述新生儿重症监护病房（NICU）中血培养实践的变化。
对参与血培养和 NICU 级政策制定的新生儿医师进行调查。
我们通过加利福尼亚围产期质量护理合作组织，将 28 家 NICU 纳入了一项大型抗菌药物管理质量改进计划。
对床边血培养实践以及 NICU 和实验室级实践进行基于网络的调查。我们评估了对推荐实践的遵守情况。
大多数 NICU 没有程序性能力（54%），没有记录样本量（75%），没有收到培养物污染报告（57%），并且/或如果获得的血液<1 毫升，则不需要向提供者报告（64%）。NICU 之间的皮肤消毒程序不同。只有 71%有书面程序，但≥86%在接种前更换了针头并对瓶顶进行了消毒。超过五分之一的 NICU 仅从血管内装置中抽取培养物（如果存在）。在与培养和污染相关的 13 项可修改实践中，有执业护士的 NICU 比没有执业护士的 NICU 更频繁地采用了>50%的实践（92%比 50%的单位；P<.02）。
在 NICU 环境中，血培养的推荐实践并未常规进行。
