Training activity information
Details
Select, perform and interpret tests for bloodstream infections caused by bacteria and fungi using the following techniques and suggest options for management:
- Blood cultures
- Microscopy
- Culture, identification and antimicrobial susceptibility testing, including detection of resistant organisms
- Rapid diagnostics
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- Why is the timely and accurate diagnosis of bloodstream infections so critical?
- What are the common bacterial and fungal pathogens associated with bloodstream infections?
- What is your understanding of blood culture techniques, microscopy, culture, identification, AST (including detection of resistant organisms), and rapid diagnostics in this context?
- What specific skills in interpreting blood culture results and subsequent identification and susceptibility testing do you hope to gain?
- How will you learn about the significance of detecting resistant organisms in bloodstream infections?
- What insights do you expect to gain regarding the role and limitations of rapid diagnostic tests in this setting?
- How will you prepare for this DTA? Will you review the laboratory workflow for processing positive blood cultures?
- Will you discuss with your training officer the local protocols for reporting and managing bloodstream infections, especially those involving resistant organisms?
- What challenges might you face in interpreting polymicrobial blood cultures or those with suspected contaminants?
- How will you approach interpreting complex resistance patterns?
- How do you feel about the responsibility associated with diagnosing potentially life-threatening bloodstream infections?
In action
- What specific bloodstream infection tests are you currently involved in (e.g., processing blood culture bottles, Gram staining a positive culture, performing identification and AST, using rapid molecular tests)?
- How are you approaching the execution of each of these techniques?
- Why are you doing it this way (e.g., following specific protocols for blood culture handling, using specific AST methods for resistance detection)?
- What decisions are you making regarding further testing based on initial results (e.g., which resistance mechanisms to investigate)?
- What aspects of performing these tests feel intuitive to you, and what requires more conscious effort (e.g., interpreting complex AST results, understanding the significance of different resistance markers)?
- How effective are your current actions in obtaining timely and accurate results?
- What challenges are you facing during the process (e.g., troubleshooting false positives or negatives in rapid tests, interpreting discordant AST results)?
- What can you learn about bloodstream infection diagnostics and the importance of rapid reporting and resistance detection as the activity unfolds?
- How does this activity connect to your understanding of sepsis, antimicrobial resistance, and patient management?
- Are there alternative approaches you could be considering if initial results are unexpected or if resistance is detected (e.g., using alternative AST methods, considering molecular resistance testing)?
- What support or guidance might you need in this moment from a senior colleague or the training officer regarding interpretation of results or further testing?
- Are you working within your scope of practice when selecting, performing, and interpreting these tests and considering management option?
On action
- Begin by summarising the key points of the experience working with blood cultures and investigating bloodstream infections.
- What were the most significant observations regarding the workflow, techniques (blood cultures, microscopy, culture, AST, rapid diagnostics), or the urgency of reporting results?
- What skills or knowledge did you develop or improve through this DTA, specifically in handling positive blood cultures, performing rapid diagnostics, interpreting AST results including resistance detection, or contributing to management suggestions for sepsis?
- Were there any unexpected challenges (e.g., contaminants, fastidious organisms, complex resistance patterns) or successes?
- What did you learn from these? In what ways did your ‘reflection-in-action’ influence your real-time decisions and actions during the activity, such as prioritising tasks or deciding on further testing?
- What areas for continued development have been identified, perhaps concerning the interpretation of rapid diagnostic results or complex antimicrobial susceptibility patterns?
- How can you apply the learning from this activity to your routine practice, particularly in the timely and accurate reporting of significant findings from blood cultures?
- Identify the specific actions or ‘next steps’ you will take to embed this learning.
- What support or resources might you need to further develop in these areas?
Beyond action
- Revisit your initial reflect-on-action notes for this DTA. What additional insights have you gained since the initial reflection?
- Has discussing positive blood culture cases at MDT meetings or with clinicians altered your perspective on the clinical urgency?
- How did this specific bloodstream infection testing experience compare to testing from other critical sites (e.g., CSF)?
- What patterns or recurring challenges (e.g., contamination, identifying significance of isolates) have you identified across multiple blood culture samples?
- Have you discussed bloodstream infection diagnostics or management during professional storytelling with peers or senior colleagues? What new perspectives did this bring regarding rapid diagnostics or resistance detection?
- How have the skills (e.g., rapid result reporting, interpreting AST including resistance mechanisms, applying rapid diagnostic techniques) you developed during this DTA influenced your handling of other urgent samples or resistant organisms?
- Have you applied the learning from this DTA, such as understanding the critical importance of timely and accurate results for sepsis management, to other aspects of your microbiology practice?
- How does the learning from this DTA contribute to your preparedness for observed assessments like reporting a positive blood culture or communicating results?
- What transferable skills in managing critical samples under pressure, applying a range of techniques including rapid methods, interpreting resistance data, and communicating urgent findings, developed through this DTA, will be invaluable throughout your training and beyond, especially in acute settings?
- Identify clear actions for continued development related to bloodstream infection diagnostics, rapid methods, or resistance reporting based on your cumulative experiences and reflections.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 1 |
Outcome
Select and perform tests to investigate common infections from a range of sample types following guidance and fulfilling health and safety requirements |
| # 2 |
Outcome
Interpret the results of tests used to investigate common infections from a range of sample types with consideration of laboratory quality assurance and quality control |
| # 3 |
Outcome
Identify options for management of common infections based on test results and clinical context, considering infection control, guidelines and public health requirements |
| # 5 |
Outcome
Select and interpret tests for the investigation and management of drug resistant pathogens |