The UMB Digital Archive is getting an upgrade! The upgrade requires a content freeze starting 1/27/25 and is expected to last two weeks. Any new user accounts or submissions made to the Archive during this time will not be transferred to the upgraded site. Contact ArchiveHelp@hshsl.umaryland.edu for questions.
Assessing Implementation Adherence to a Blood Culture Bundle to Reduce Contamination Rates
Abstract
Problem: Blood culture (BC) collection remains the gold standard in diagnosing septicemia. The contamination of collected blood samples by organisms that should not be present results in false-positive cultures. The national benchmark for blood culture contamination rates (BCCR) is less than or equal to three percent. The emergency department of a large, urban, level 1 trauma center is experiencing a 4.02% BCCR, higher than the three percent or less national benchmark for blood culture acquisition. Purpose: This quality improvement project is planned to assess whether adherence to a bundled approach to the blood culture collection process will improve the contamination rates in the emergency department. Methods: The QI Project Lead (QI-PL) mobilized a team of nurses, clinical technicians, providers, and a quality coordinator to review the evidence-based BC acquisition process. A modified intervention bundle included manual diversion of 2-3 ml of blood or “waste” before bottle inoculation, conducting a one-hour education session and competency review, and receipt of performance cards on specimen acquisition. Chart audits were conducted weekly by the QI-PL on each BC specimen collected to retrieve values for contamination rates and compliance with the bundled interventions. Results: The total number of blood culture specimens collected by the participants was four hundred eighteen. After fifteen weeks of implementation, staff compliance with the use of BC manual diversion was 92% (385/418). All 36 participants attended a competency review and received their feedback scorecards. Of these specimens, only ten specimens resulted in contamination upon verification with the hospital’s Microbiology Department. The blood culture contamination rate was 2.39% (10/418). This is a significant improvement from the pre-implementation contamination rate of 4.02%. Conclusions: Findings suggest implementing a bundled approach to blood culture specimen collection, which includes manual diversion or “waste” of initial 2-3 ml blood specimens before inoculation of culture bottles, a competency review, and a peer feedback system have positive effects. However, it is essential to note that these results, while promising, are based on a small number of participantsIdentifier to cite or link to this item
http://hdl.handle.net/10713/22752Collections
The following license files are associated with this item: