From the Guidelines
No, using a blood collection tube that has been dropped on the floor is not sanitary and should not be used for blood collection. The nurse should discard the dropped tube and use a new, sterile one instead. When a collection tube falls on the floor, it becomes contaminated with microorganisms present on the floor surface, including potentially harmful bacteria, fungi, and viruses. Using such a contaminated tube risks introducing these pathogens into the patient's blood sample, which could lead to sample contamination, inaccurate test results, or even patient infection if the contamination is severe enough to affect the venipuncture site. According to the guidelines for preventing intravascular catheter-related infections 1, minimizing contamination risk is crucial, and accessing ports only with sterile devices is recommended. Although this guideline is specifically for intravascular catheter-related infections, the principle of maintaining sterility applies to all invasive procedures, including blood collection. Healthcare facilities have strict protocols for maintaining sterility during blood collection procedures, and these protocols require using only sterile, unopened collection tubes. If a tube is dropped, healthcare providers should always discard it and obtain a new sterile tube from the supply to ensure patient safety and accurate diagnostic results. Some may argue that the risk of contamination is low, but given the potential consequences of using a contaminated tube, it is always best to err on the side of caution and prioritize patient safety. The recommendation to replace tubing used to administer blood, blood products, or fat emulsions within 24 hours of initiating the infusion 1 further emphasizes the importance of maintaining sterility in procedures involving blood and blood products. In summary of the key points to consider:
- The dropped tube is contaminated with microorganisms from the floor
- Using a contaminated tube can lead to sample contamination, inaccurate test results, or patient infection
- Healthcare facilities have protocols for maintaining sterility during blood collection
- The nurse should discard the dropped tube and use a new, sterile one instead
- Prioritizing patient safety is crucial in this situation.
From the Research
Sanitary Concerns with Reusing a Dropped Blood Collection Tube
- The act of dropping a blood collection tube on the floor and then reusing it poses significant sanitary concerns, as it may lead to contamination of the sample 2, 3.
- Contamination rates in blood cultures can be high, ranging from 1% to 17% in some studies, with the most frequently identified contaminant bacteria being coagulase-negative staphylococci (CoNS) 2.
- The use of sterile equipment and proper disinfection techniques are crucial in minimizing the risk of contamination 2, 4.
- Reusing a dropped blood collection tube may compromise the sterility of the equipment and increase the risk of introducing contaminants into the sample.
Factors Contributing to Contamination
- The lack of a dedicated phlebotomy team, inadequate training of staff, and insufficient quality control measures can all contribute to higher contamination rates 2.
- The type of disinfectant used, such as povidone-iodine or alcohol, may also impact the risk of contamination 2.
- The timing of bacterial growth in blood cultures can be an indicator of whether an isolate is a pathogen or a contaminant, with contaminants often taking longer to grow 4.
Best Practices for Blood Collection
- It is recommended that blood collection tubes be handled carefully to avoid contamination, and that any tubes that have been dropped or compromised in any way be discarded and replaced with new, sterile tubes 3.
- Proper training and quality control measures can help minimize the risk of contamination and ensure the accuracy of blood culture results 2, 3.