[Matthias.Maiwald@KKH.COM.SG Subject: Re: Blood collection In-Reply-To:]

P.S. Sorry, forgot to insert this reference, citing our letter to the
editor, into the brackets in my previous e-mail:

http://www.ncbi.nlm.nih.gov/pubmed/20812820

—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

Jodie Burr
To
Sent by: AICA AICALIST@AICALIST.ORG.AU
Infexion cc
Connexion
Re: Blood collection

19/05/2011 09:46
AM

Please respond to
AICA Infexion
Connexion

Hi Teresa
Thats not a dumb question at all!!!!
Currently we are using 70% Alcohol for blood cultures
We have recently implemented the 5 Moments into all of our Collections
centres (including metro and country, hospital ward services, community
collection centres and domicilliary services)
Most staff have been very keen to improve infection control practices and
therfore we have had a very good uptake. Most staff are trying hard to
comply.
I found by invloving the staff and getting them to help in determining how
we can fit the 5 moments into their practice helped greatly.
We also involved the State Hand Hygiene Coordiantor and Dept of Health
Infection control Service in determining how we can meet the requirements
of the 5 moments whilst still providing safe patient care and quality
specimen collection.
We had to “modify” the 5 moments to enable this. I teach staff to hand
hygiene, apply gloves and then place the tourniquet and take blood as we
found that by doing it the 5 Moments way the tourniquet would be on for
more than a minute, especially if the blood taker was new or not as fast.
this would cause a safety concern for patients and the quality of the
specimen would be compromised.
We also introduced cleaning of the tourniquet with an alcohol wipe between
patient uses so that at least only clean items would be touched after HH
and glove donning (ie moment 2).
I modified their phlebotomy procedure to include HH and am currently in the
process of developing a diagram poster outling when to HH and clean
tourniquet etc.
I have now provided education to 98% of our staff on IC practices including
when to HH during phlebotomy and 95% of the staff have completed their
assessment (including doing the HHA online learning package).
We have alot of new staff always starting so the education will continue
and competency assessments will also be conducted to ensure the staff know
what to do.
Hope this helps

Jodie Burr
Infection Control Project Officer
SA Pathology
jodie.burr@health.sa.gov.au

Hello everyone

I would like to know what the practice is in other facilities for skin
preparation prior to blood collection, especially prior to collection of
blood for blood cultures?

I believe best practice is to prep skin with 70%alcohol + 2% chlorhexidine,
am I correct in this?

Yet I find that the practice of most blood collectors is to use just 70%
alcohol. And I note that as much education I give to them re-the 5 Moments,
their habits are very difficult to change.
They are performing a procedure which involves great risk of contamination
to the patient yet, it appears that all staff do their own thing
re-technique and sequence of doing things and glove use.

It also seems that as soon as I have trained someone in the correct
technique in regards to hand hygiene they are then moved to another
location and I need to start all over again. Some of the staff feel that
they have been doing the same job for 20 years and don’t feel there is need
to change anything.
Has anyone had any success in involving the pathology/ blood collecting
staff in the ownership of prevention of infection? If you have, could you
please share how you have done it.

Thanks, hope you all have a great day.
PS. (Sorry if this is a dumb query)
Teresa

Teresa Lewis
Infection Control/Prevention
Clinical Nurse Consultant
Newcastle Private Hospital
Email:teresa.lewis@healthscope.com.au

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