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

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