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Scholarly Commons > HCA Healthcare Journal > Vol. 5 > Iss. 5 (2024)

 

Keywords

blood/microbiology; bacteremia; bacteremia/diagnosis; bacterial infections; blood culture; bloodstream infections; cross infection; equipment contamination; infectious disease; quality improvement

Disciplines

Emergency Medicine | Infectious Disease | Internal Medicine | Interprofessional Education | Patient Safety | Quality Improvement

Abstract

Background

Blood cultures are vital to diagnostic workups among many hospitalized patients, providing valuable information about bloodstream infections (BSIs), which cause roughly 250 000 deaths annually between North America and Europe. Despite advances in health care, blood culture contamination remains a substantial problem, with deleterious effects on patient mortality, patient and hospital costs, and microbial resistance. This article reviews the repercussions of blood culture contamination on the health care system and delineates evidence-based strategies to decrease contamination rates.

Methods

To reduce blood culture contamination rates, our health care facility undertook a quality improvement initiative. A task force was created, consisting of leadership from the laboratory, phlebotomy, nursing, pathology, internal medicine teams, emergency medical services, and others. Measures included comprehensive staff training, standardization of protocols and supplies across facilities, and the introduction of waste tubes and smaller-volume chlorhexidine applicators for skin preparation. Data on blood culture contamination rates were collected before and after implementation.

Results

Prior to the intervention, the average monthly blood culture contamination rate across our facilities was 3.76%. Following the intervention, this rate decreased significantly to 2.07%, representing a reduction of 44.95%. Statistical analysis revealed a strong association between the implemented interventions and the decreased contamination rates, with a chi-square value of 62.3, 1 degree of freedom, and a P value of less than .001. These results indicate that the interventions were highly effective. Furthermore, the reduced contamination rates were sustained in the subsequent months, consistently remaining below 2%.

Conclusion

The study demonstrated a substantial reduction in blood culture contamination rates through targeted interventions, highlighting the efficacy of combining evidence-based strategies with interdisciplinary teamwork to improve patient care outcomes.

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