Changing the needle when inoculating blood cultures. A no-benefit and high-risk procedure
M. K. Leisure, D. M. Moore, J. D. Schwartzman, G. F. Hayden and L. G. Donowitz
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908.
Although the Centers for Disease Control recommends that needles should
never be recapped, many phlebotomists routinely recap and change needles
before blood culture inoculation. This study compared the extrinsic
contamination rate in blood cultures when the needle was and was not
changed. One hundred eight medical students obtained 182 blood specimens
from each other by means of standard methods. Each specimen was inoculated
into two culture bottles. The first bottle was inoculated with the needle
used for phlebotomy, and the second was inoculated after needle change.
Four (2.2%) of 182 bottles were contaminated when the needle was not
changed, compared with one (0.6%) when the needle was changed. This small
difference was not statistically significant, and the likelihood of having
failed to detect a 5% difference in contamination rate was small. The risk
of needle-stick injury incurred by changing the needle before inoculation
of blood culture bottles seems to be unjustified.
