Factors associated with blood culture sampling for adult acute care hospital patients with suspected severe infection: a scoping review using a socioecological framework

<p dir="ltr">Background<br>Reliable blood culture (BC) sampling for patients with suspected severe infection is critical, but<br>evidence suggests that BC samples are not always reliably collected for acute hospital patients with<br>severe infection. There is a pressing need to understand the barriers and facilitators of optimal BC<br>sampling practices for patient safety and antimicrobial stewardship.<br>Methods<br>We conducted a scoping review to identify evidence of factors associated with reliable BC sampling,<br>for adult patients with suspected severe infection in acute care in high-income countries. We<br>searched bibliographic databases (MEDLINE, Scopus, Web of Science, CINAHL), reference lists and<br>citations, between 2013 and February 2024. Findings were mapped to a socioecological framework.<br>Results<br>We retrieved 1,823 records from the database searches; seven studies were eligible for inclusion,<br>with eight additional studies identified from reference lists and citation searches. All 15 included<br>papers identified factors at the individual level of influence, including patient factors (demographics,<br>clinical signs and symptoms); and staff factors (knowledge of guidelines, attitudes and beliefs,<br>emotion, clinical experience and training, and perception of economic cost). Evidence gaps existed in<br>relation to factors at interpersonal, situational, organisational, community and policy levels.<br>Conclusions<br>Our review provides insights into BC sampling practices in hospitals, and highlights possible evidence<br>gaps as potential areas to guide future research and inform the development of interventions to<br>improve BC sampling in hospitals. Existing research has been dominated by a focus on individual<br>levels of influence with a paucity of evidence on influences at the interpersonal, situational,<br>organisation, community and policy levels.</p>