Reducing false-positive peripheral blood cultures in a pediatric emergency department.

INTRODUCTION

False-positive peripheral blood cultures due to contamination pose clinical and financial consequences for patients, families, and hospitals. Educating staff who draw peripheral blood cultures about hospital policy, using a blood culture-drawing kit, having a dedicated team obtaining peripheral blood cultures, and following up with staff who draw a contaminated peripheral blood cultures have been shown to reduce the rate of false-positive peripheral blood cultures. The objective of this study was to reduce the rate of false-positive peripheral blood cultures in a pediatric emergency department using the previously mentioned measures.

METHODS

This quality-improvement initiative used a retrospective chart-review approach to examine false-positive peripheral blood cultures drawn in 2009. In June 2010 a month-long education campaign about the initiative was conducted for nurses and clinical assistant staff to reduce false-positive peripheral blood cultures. From July 2010 through June 2011, monthly retrospective chart audits of false-positive peripheral blood cultures were completed in conjunction with bimonthly e-mail communication about the study, development of a blood culture-drawing kit, and follow-up with staff who drew the false-positive cultures.

RESULTS

In 2009 the false-positive peripheral blood culture rate in the emergency department was 2.1%. After educational interventions and use of a blood culture-drawing kit, the rate of false-positive peripheral blood cultures decreased to 1.4%.

DISCUSSION

The decline in contaminated blood cultures shows that the interventions described significantly reduced the rate of false-positive peripheral blood cultures in the emergency department.