Successful Reduction of Blood Culture Contamination in an Emergency Department by Monitoring and Feedback



Arif M. Al-Hamad1, *
1 Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, Qatif 31911, Saudi Arabia

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.

Keywords: Pseudobacteremia, Aseptic technique, Phlebotomy team, Hospital stay, Antibiotic use, Hospital cost.


Abstract Information


Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOMICROJ-2019-17

Article History:

Received Date: 03/06/2019
Revision Received Date: 25/09/2019
Acceptance Date: 28/09/2019
Electronic publication date: 25/10/2019
Collection year: 2019

© 2019 Arif M. Al-Hamad

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.


* Address correspondence to this author at the Division of Clinical Microbiology, Pathology and Laboratory Medicine, Qatif Central Hospital, PO Box 18476, Qatif 31911, Saudi Arabia; Tel: +966 (13) 8361000 Ex. 4306; Fax: +966 (13) 8360040; E-mail: arifhamad@doctors.org.uk