Document Type
Article
Publication Title
Reducing Blood Culture Contamination in the Emergency Department: A Multi-Method Quality Improvement Project.
Abstract
Blood cultures are a diagnostic tool used to determine the presence of bacteremia. Blood culture contamination (BCC) can lead to inappropriate use of antibiotics, increased length of stay, and increased healthcare costs. Many hospitals should have benchmarked BCC rates of <3%. However, BCC rates or false positives are known to be highest in emergency departments and there has been limited research on integrating multi-method approaches to reduce BCC rates. Purpose: The aim of this quality improvement project was to reduce the monthly percentage of BCC in an academic emergency department through implementation of a robust multi-method intervention targeting nurses and patient care technicians who perform phlebotomy for blood cultures.
The intervention was implemented in four approaches beginning in June 2022: Focused Education, Dashboard Utilization, Campaign Initiatives, and Improvement to RN Workflow. Focused education consisted of numerous electronic and in-person trainings. Dashboard utilization involved consistently updating staff of real time metrics of BCC. Campaign Initiatives involved increased hand hygiene prior to BCC draws. Finally, workflow for RNs were improved by having easily accessible supplies in IV carts. BCC rates were tracked monthly as a percentage of total blood cultures drawn in the unit every month. Pre- and post-intervention data were compared over time using descriptive statistics.
A total of 93 registered nurses and 35 patient care technicians received the interventions. Prior to the implementation of the intervention, the highest average monthly BCC rate for this emergency department was 4.6% of the 950 draws per month in from January 2022 to June 2022. Following the multi-phase implementation of the intervention, the BCC rate dropped to 1.5% of a total of 900 blood draws by November 2022, around a 64% decrease in BCC.
The use of multi-method approaches was shown to be effective in reducing the percentage of BCC and increasing positive quality outcomes. Further research is needed to explore the effectiveness of implementing these interventions in a nationally representative sample and to explore which of the interventions may have had to most effect on blood culture contaminations.
Publication Date
2024
Recommended Citation
Brauner, Daryn; Schmidt, Marlene; Campbell, Nikki; Bill, Keri; and Alfano, April, "Reducing Blood Culture Contamination in the Emergency Department: A Multi-Method Quality Improvement Projec" (2024). Abstracts. 1.
https://scholar.bridgeporthospital.org/abstract_presentations/1