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Recommended Citation
Alter R. ED Blood Culture Contamination: Lowering rates through 1:1 Training, Competency, and Compliance to ENA Clinical Practice Guidelines. Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background:
Blood cultures are essential for diagnosing bloodstream infections including sepsis and fungal infections. Septicemia, the most costly condition treated in U.S. hospitals, affects one in 23 patients, incurring costs of $5,500 per contamination. False positives result in unnecessary expenses, excessive use of antibiotics, and extended hospital stays. According to guidelines from the American Society for Microbiology (ASM) and the Emergency Nurses Association (ENA), contamination rates should not exceed 3%.
Local Problem:
In an Emergency Department (ED) in hospital in the Midwest, blood culture contamination rose from 3.8% July 2023 to as high as 6.3% in October 2023. A quality improvement (QI) team was formed, identifying and implementing best practices to improve rates.
Method:
The QI team reviewed current blood culture collection procedures and conducted a literature search comparing site procedures to best practice standards. The team developed and administered a survey tailored to the blood culture collection steps. Utilizing the survey responses, the QI team crafted an educational presentation highlighting the most frequently overlooked steps, current departmental blood culture contamination rates, cost per contamination, and correct steps for blood culture collection, demonstrating steps individually. An additional champion was designated to support evening and night shifts. The final phase involved collaborating with the department educator to update and sustain site competencies.
Results/ Conclusion:
Approximately 50% of ED staff acknowledged omitting or incorrectly following steps during collection. The educational presentation was tailored based on survey findings and reinforced during one-on-one demonstrations. As a result, blood culture contamination rates decreased significantly from 6.3% in October 2023 to 2.8% in February 2024. The pre-survey will be repeated with results available at conference time.
Implications for Practice:
Champions serve as experts on blood culture collection best practices, addressing inquiries on technique, steps, and contamination rates, thereby reducing septicemia-related healthcare costs while enhancing patient safety and outcomes.
Document Type
Poster
Publication Date
11-13-2024
ED Blood Culture Contamination: Lowering rates through 1:1 Training, Competency, and Compliance to ENA Clinical Practice Guidelines
Background:
Blood cultures are essential for diagnosing bloodstream infections including sepsis and fungal infections. Septicemia, the most costly condition treated in U.S. hospitals, affects one in 23 patients, incurring costs of $5,500 per contamination. False positives result in unnecessary expenses, excessive use of antibiotics, and extended hospital stays. According to guidelines from the American Society for Microbiology (ASM) and the Emergency Nurses Association (ENA), contamination rates should not exceed 3%.
Local Problem:
In an Emergency Department (ED) in hospital in the Midwest, blood culture contamination rose from 3.8% July 2023 to as high as 6.3% in October 2023. A quality improvement (QI) team was formed, identifying and implementing best practices to improve rates.
Method:
The QI team reviewed current blood culture collection procedures and conducted a literature search comparing site procedures to best practice standards. The team developed and administered a survey tailored to the blood culture collection steps. Utilizing the survey responses, the QI team crafted an educational presentation highlighting the most frequently overlooked steps, current departmental blood culture contamination rates, cost per contamination, and correct steps for blood culture collection, demonstrating steps individually. An additional champion was designated to support evening and night shifts. The final phase involved collaborating with the department educator to update and sustain site competencies.
Results/ Conclusion:
Approximately 50% of ED staff acknowledged omitting or incorrectly following steps during collection. The educational presentation was tailored based on survey findings and reinforced during one-on-one demonstrations. As a result, blood culture contamination rates decreased significantly from 6.3% in October 2023 to 2.8% in February 2024. The pre-survey will be repeated with results available at conference time.
Implications for Practice:
Champions serve as experts on blood culture collection best practices, addressing inquiries on technique, steps, and contamination rates, thereby reducing septicemia-related healthcare costs while enhancing patient safety and outcomes.
Affiliations
Aurora Medical Center Kenosha