Novis D A, Dale J C, Schifman R B, Ruby S G, Walsh M K
Department of Pathology, Wentworth-Douglass Hospital, Dover, NH 03820, USA.
Arch Pathol Lab Med. 2001 Oct;125(10):1290-4. doi: 10.5858/2001-125-1290-SBC.
To determine the frequency with which solitary blood culture samples were submitted to laboratories serving small hospitals and to ascertain whether certain hospital practices relating to the performance of blood cultures were associated with lower solitary blood culture rates (SBCRs).
Participants in the College of American Pathologists Q-Probes laboratory quality improvement program collected data prospectively on the numbers of solitary blood culture sets from adult patients submitted to their laboratories and answered questions about their institutions' practice characteristics relating to the collection of blood culture specimens.
Three hundred thirty-three public and private institutions with a median occupied bed size of 57. Participants were located in the United States (n = 329), Canada (n = 3), and Australia (n = 1).
The solitary blood culture rate was defined as the number of instances in which only 1 blood culture venipuncture was performed on an individual patient during a 24-hour period divided by the total number of blood culture venipunctures that were performed during the study period.
Participants submitted data on 132 778 adult patient blood culture sets. The SBCRs were 3.4% or less in the top-performing 10% of participating institutions (90th percentile and above), 12.7% in the midrange of participating institutions (50th percentile), and 42.5% or more in the bottom-performing 10% of participating institutions (10th percentile and below). In half the participating institutions, the SBCRs for inpatients were 8.3% or less and for outpatients, 22% or less. Solitary blood culture rates were lower for institutions in which phlebotomists rather than nonphlebotomists routinely collected blood culture specimens, in which internal policies required drawing at least 2 blood culture sets, in which hospital personnel contacted clinicians when their laboratories received requests for solitary blood culture sets, and in which quality control programs monitored SBCRs routinely.
Hospitals can achieve SBCRs under 5%. Those hospitals with particularly high SBCRs may lower their rates by altering certain institutional practices.
确定提交至为小型医院服务的实验室的单个血培养样本的频率，并确定与血培养操作相关的某些医院做法是否与较低的单个血培养率（SBCR）相关。
美国病理学家学会Q-Probes实验室质量改进计划的参与者前瞻性收集了提交至其实验室的成年患者单个血培养集的数量数据，并回答了有关其机构血培养标本采集的实践特征问题。
333家公立和私立机构，中位占用床位数为57。参与者位于美国（n = 329）、加拿大（n = 3）和澳大利亚（n = 1）。
单个血培养率定义为在24小时内对个体患者仅进行1次血培养静脉穿刺的次数除以研究期间进行的血培养静脉穿刺总数。
参与者提交了132778例成年患者血培养集的数据。在表现最佳的10%的参与机构（第90百分位数及以上）中，SBCR为3.4%或更低，在参与机构的中等水平（第50百分位数）中为12.7%，在表现最差的10%的参与机构（第10百分位数及以下）中为42.5%或更高。在一半的参与机构中，住院患者的SBCR为8.3%或更低，门诊患者为22%或更低。对于由采血员而非非采血员常规采集血培养标本、内部政策要求至少采集2套血培养集、当实验室收到单个血培养集的请求时医院工作人员联系临床医生以及有质量控制计划常规监测SBCR的机构，单个血培养率较低。
医院可以将SBCR控制在5%以下。那些SBCR特别高的医院可以通过改变某些机构做法来降低其比率。
