Developing a protocol for obtaining blood cultures from central venous catheters and peripheral sites

Blood cultures frequently are obtained from patients with cancer who are suspected to have infection. A review of the literature revealed that consistent clinical guidelines or standards for obtaining blood cultures from patients with cancer do not exist. The published literature varies greatly with respect to site selection (peripheral or central), frequency, and timing. In addition, a survey at the researchers' institution revealed that blood culture orders were written and interpreted in various ways. After a multidisciplinary discussion, a review of the literature, and receiving expert advice, an institutional protocol for obtaining blood cultures from patients with cancer was developed. The protocol specifies between peripheral and central line sampling and establishes timing, frequency, and other guidelines so nurses can perform consistent and evidence-based blood culture sampling. Use of the protocol has improved patient care and helped standardize the practice of obtaining blood cultures.