RESEARCH ARTICLE
Successful Reduction of Blood Culture Contamination in an Emergency Department by Monitoring and Feedback
Arif M. Al-Hamad1, *
Article Information
Identifiers and Pagination:
Year: 2019Volume: 13
First Page: 279
Last Page: 285
Publisher ID: TOMICROJ-13-279
DOI: 10.2174/1874285801913010279
Article History:
Received Date: 03/06/2019Revision Received Date: 25/10/2019
Acceptance Date: 28/10/2019
Electronic publication date: 11/12/2019
Collection year: 2019
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Blood Culture (BC) contamination is a common problem in the Emergency Department (ED) and is associated with prolonged length of patient stay and excess costs.
Objective:
The study aimed to investigate the impact of monthly monitoring and feedback of BC results on contamination rates.
Methods:
Data from a previous study showed that the contamination rate in the ED consistently exceeded the recommended level. This triggered an ad hoc Quality Improvement team to develop and implement a corrective action plan. In 2017, BC contamination rates were reported to the ED on a monthly basis. In response to this, ED staff conducted intensified educational workshops, followed by private counselling and competency assessment of nurses who collected contaminated BCs.
Results:
A total of 12 educational workshops were conducted in February and March, 2017. The intervention resulted in >60% reduction in the contamination rate, from 8.6% baseline level to less than 3%. Of the 2660 BC sets drawn in 2017 from 1318 patients, 128 (4.8%) were contaminated, accounting for 39.5% of the total number of positive cultures. Sixty percent of the contaminated BCs grew Coagulase-negative Staphylococcus species; other contaminants included Corynebacterium spp., Micrococcus spp., Propionibacterium spp., viridans Streptococcus, and Neisseria spp.
Conclusion:
Continuous monitoring and feedback of contamination rates reduced BC contamination.