|
|
| Line 27: |
Line 27: |
|
| |
|
| ===Special considerations for the above criteria=== | | ===Special considerations for the above criteria=== |
| *Criterion elements must occur within a time frame that does not exceed a gap of one calender day. "Criterion Elements" refer to the fever, and other symptoms of infection and the timing of the first positive culture.
| |
| Separate occasions for the [[Blood culture]]s can range from 15 minutes apart to within 48 hours of each culture.
| |
|
| |
|
| {{Discussion}}{{discuss@task}}
| | Regarding how we define the number of blood cultures done: |
| | This issue is applicable not only in the case definition of CVC-BSI (where consistent findings from least 2 blood cultures are required), but more generally for counting how many blood cultures were done for a given patient. |
|
| |
|
| I question the 15 minutes in our definition above,the CDC defines separate occasions as referring to the act of disinfection of the access site.Also the nurses are not accurate at recording the time of the blood draw accurately.For example blood cultures drawn from different sites or at different times should undergo separate decontamination(skin prep).Both of these are separate occasions. I have asked the task committee to look at our definition separate occasions.[[User:GHall|GHall]] 07:48, 2016 July 25 (CDT)
| | And it’s simple: A single blood culture is any amount of blood that is obtained from a single site at a single time, and inoculated into any number of tubes/bottles. Examples: |
|
| | (a) If 40 mL of blood is obtained from a venipuncture site at noon and squirted into 12 different bottles, this is ONE blood culture. The # of bottles is completely irrelevant to how many cultures were done. |
| **Gail is correct. The task committee agrees that it is the act of decontamination at each site used that counts regardless of the number of bottles filled. For example, if you disinfect the right antecubital and draw two bottles at 1000 Dec31 this counts as one. If you were to go back and prep the right antecubital again at 1400 Dec 31 to stab for another two bottles, this would count as one. On Dec 31 you would count two blood cultures in total.--[[User:CMarks|CMarks]] 13:08, 2016 July 26 (CDT)
| | (b) If at one point in time, 1 person obtains blood for culture from the L antecubital vein, while another person simultaneously obtains blood for culture from a R IJ triple lumen catheter, those are TWO blood cultures. |
| | (c) If a person obtains blood for culture from the L antecubital vein at noon, and then comes back 5 (or 15 or 1000) minutes or hours later, cleans off that site again, and obtains blood for culture from the same L antecubital vein, these are TWO blood cultures. |
|
| |
|
| | | Thus, if EITHER the sites and/or the times were different when the blood was obtained, then you have separate cultures. This is easy when the sites are different. An easy way to think about what separates distinct blood cultures from the same site (which could be a line, or the same venipuncture site) is that the site was cleaned off separately for the 2 cultures. |
| *Different ports of the same line is considered 2 sites.
| |
| *One [[blood culture]]is defined as one site (at least one of two bottles from a [[Blood culture]] set is reported as having grown at least one organism).
| |
| **For counting on the [[Labs collected list]] see what is a [[Blood culture]].
| |
| *If the central line tip is positive but the [[Blood culture]]s are negative then it is '''not''' a central line infection. You must have positive [[Blood culture]](s) as listed in the above criteria.
| |
| * patients who were previously colonized with MRSA or VRE or both can be coded as having a central line infection (criterion #1). The MRSA or VRE can not be related to an''' active infection''' in another site.
| |
|
| |
|
| == Related temporary study collection instructions == | | == Related temporary study collection instructions == |