Checklist
| Preparation | Wash – Name – Explain | |
| Ensure patient and test request details match | ||
| Check for allergies | ||
| Position patient appropriately for procedure | ||
| Clean preparation surface | ||
| Gather equipment | Clean equipment tray | |
| Wash hands | ||
| Tourniquet | ||
| Skin cleaning equipment | ||
| Blood culture collection needle system | ||
| Aerobic & anaerobic blood culture bottles | ||
| Cleaning wipes for culture bottles | ||
| Gauze | ||
| Plaster | ||
| Safe sharps disposal | ||
| Site identification & cleaning | Return to patient | |
| Wash hands | ||
| Remove caps and clean culture bottles | ||
| Select appropriate site | ||
| Place tourniquet | ||
| Identify appropriate vein | ||
| Clean skin | ||
| Allow skin to dry | ||
| Venepuncture | Wash hands and put on gloves | |
| Insert needle into vein | ||
| Observe flashback | ||
| Attach & fill aerobic culture bottle | ||
| Attach & fill anaerobic culture bottle | ||
| Release tourniquet | ||
| Cover site with gauze | ||
| Withdraw needle | ||
| Apply pressure to gauze | ||
| Dispose of sharps safely | ||
| Ensure haemostasis | ||
| Cover wound | ||
| Finishing | Label bottles at bedside | |
| Dispose of all waste appropriately | ||
| Wash hands |
Explanation
Preparation
Wash, name, explain:
- Wash your hands
- Introduce yourself by name and role
- Check the patient’s name and date of birth
- Explain the task and get consent
- Check whether the patient has any known allergies, e.g., to plasters
“Hello, I’m one of the doctors. I’ve been asked to take a test called a blood culture. This will involve taking a sample of blood from your arm using a small needle which the lab will test for infection. It may be slightly uncomfortable but should not be painful. You can ask me to stop at any time. Would that be okay?”
Position the patient appropriately for the procedure. For blood cultures, ensure the patient is sitting in a comfortable position, able to fully extend their arm at the elbow, and you are able to comfortably access the procedure site. You may wish to place a pillow under the patient’s arm for support.
Clean your preparation space, typically a clinical trolley, using appropriate surface cleaning agents.
Gather Equipment
Clean an equipment tray and place it on your preparation surface. Wash your hands again after cleaning surfaces.
Remember that it is very important to maintain a clean environment, clean equipment and not to contaminate the venepuncture site when taking a sample for blood culture. This is because any cross–contamination of the site may affect and possibly invalidate the test results.
Gather the following equipment and place it in your clean tray, ensuring that key parts remain protected. Most hospitals will make up blood culture taking kits, which usually contain the items with an*:
- Tourniquet
- Skin cleaning apparatus* – usually alcohol-based
- Blood culture needle system* – the type used will depend on your local equipment but usually consists of a butterfly needle with an adaptor for blood culture bottles. Ensure the adaptor is attached to the needle.
- Blood culture bottles* – the type of bottles and their colour coding will depend on your local equipment but usually consist of a blue aerobic bottle and a purple anaerobic bottle.
- Alcohol wipes* to clean the culture bottles
- Gauze
- Plaster
- Safe sharps disposal e.g., sharps bin
Site Identification & Cleaning
Return to the patient, wash your hands, and confirm that they are still happy to proceed.
Remove the caps from the blood culture bottles and clean the tops of the bottles for 30 seconds using the alcohol wipes. Leave the bottles covered with the alcohol wipe to minimise any contamination and do not touch the area you have cleaned.
Ask the patient if they have a preference which arm you take the blood sample from. Ensure that there are no contraindications to using an arm e.g., active or recent infusion, fistula, lymphoedema. Identify the best site on the chosen arm, usually this is the antecubital fossa.
Attach the tourniquet proximal to the preferred site. Look and feel for an appropriate vein. The best veins will be palpable, bouncy feeling, straight, and not too close to a venous junction.
Clean the skin using the appropriate equipment for at least 30 seconds and then allow the site to air dry for a further 30 seconds.
Venepuncture
Wash your hands and put on your gloves. Do not touch the venepuncture site you have cleaned.
Unsheathe the butterfly needle. Using your non–dominant hand, anchor the skin just distal to the venepuncture site to stabilise the vein and minimise movement. Insert the needle into the vein at an angle of approximately 30° to the skin.. You should see flashback of blood in the butterfly needle tubing, this tells you the needle is sited in the vein correctly.
Keeping the needle as still as possible, attach the aerobic blood culture bottle to the needle via the adaptor. Once the bottle is adequately filled, detach it and repeat with the anaerobic bottle.
Once you have taken the required samples, release the tourniquet while keeping the needle as still as possible. Place gauze over the needle insertion site, remove the needle and immediately dispose of it in your sharps disposal. Apply firm pressure to the venepuncture site using the gauze.
Ensure pressure is applied until the site has stopped bleeding. This may take longer if the patient is taking anticoagulants. Once haemostasis has been established, cover the site with a plaster.
Finishing
Confirm that the patient is feeling well.
Ensure you label the blood bottles at the bedside, either handwriting the labels on the bottles or applying pre–printed stickers depending on your local procedure.
Dispose of all waste appropriately and clean your tray and trolley. Wash your hands.
Last updated Mar 2025
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