Inoculating Blood Cultures: Recapping Needles and Contamination Rates

To the Editor.— I read with interest the article entitled "Changing the Needle When Inoculating Blood Cultures: A No-Benefit and High-Risk Procedure" by Leisure et al.¹ As medical director of an intravenous (IV) therapy department at a teaching hospital, I had just reinstituted the policy of changing needles to reduce a recently increased contamination rate. Therefore, I was most interested in the methods and conclusions of this article.

To my surprise, I found that the authors had instructed the phlebotomists (actually medical students) to recap the needles. This activity of recapping has been proved over and over again to result in needlestick injuries.² In our hospital, and in many others, recapping needles is vigorously discouraged. To further emphasize this point (forgive the pun), the authors noted that four of five injuries occurred during recapping. I am reluctant to give up the policy of changing needles on