预防血培养标本污染的最佳证据集合

Evidence summary of blood culture contamination prevention

目的总结、评价国内外预防血培养标本污染的最佳证据。方法系统检索国内外数据库内关于预防静脉血液标本污染的证据,包括指南(BPG)、最佳实践信息册(BPIS)、证据总结(ES)、推荐实践(RP)及系统评价(SR)。检索时限为从建库至2019年3月27日。由2名研究者对文献质量进行评价和资料提取,对符合质量标准的文献进行证据提取。结果共纳入13篇文献,其中循证指南1篇,以专家共识为基础的指南4篇,证据总结1篇,最佳实践推荐1篇,系统评价6篇。最佳证据包括采血人员、采血时间、皮肤消毒、采血途径、采血部位、标本注入、无菌手套、标本转运等。结论护理部应与检验科合作,加强对于护理人员静脉血培养标本采集相关知识的教育,在进行血培养标本采集时,要注意采血时间,采血过程中要使用无菌手套,正确进行皮肤消毒,选择合适的采血途径、部位,采血完成后要及时转运血标本,以确保检测结果的准确性。

Objective To summarize and assess the best available evidence to reduce blood culture contamination.Methods The evidence in domestic and foreign databases were searched to collect literatures including guideline(BPG),evidence summary(ES),best practice information sheet(BPIS),recommend practice(RP)and systematic review(SR).The time limit for retrieval is from the establishment of the database to March 27,2019.Two authors independently assessed the quality and extracted data.Results Totally 13 articles were enrolled,including 5 guidelines,1 evidence summary,1 best practice information sheet and 6 systematic reviews.The best evidence included personnel,blood collection time,skin disinfection,blood collection method,blood collection site,sample injection,sterile glove,sample transportation and so on.Conclusions Nursing department should cooperate with the clinical laboratory,to strengthen staffs′education on blood culture collection.Attention should be paid to the time of blood culture collection.Sterile gloves should be used in the process of blood collection,skin disinfection should be carried out correctly,appropriate blood collection routes should be selected,and blood samples should be transferred in time after blood collection to ensure the accuracy of test results.