Genoud N W, Alonso Serena M, Díaz M H, Esteban J A, Peroni J H, Giunta D H, Grande Ratti M F, Martínez B
Sección de Infectología, Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Central de Emergencias de Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Área de Investigación en Medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
J Healthc Qual Res. 2018 Sep-Oct;33(5):278-283. doi: 10.1016/j.jhqr.2018.05.006. Epub 2018 Aug 9.
The aim of this study was to describe 2 process indicators related to taking blood cultures (BC) in an Adult Emergency Department of a tertiary university hospital in Buenos Aires,and to describe the changes after a series of educational activities for health professionals was implemented during May 2016 as regards the appropriate indication of BC and the proper collection technique.
A retrospective cohort study was designed to assess its effectiveness, which consecutively included all patients admitted during 2015-2016. The BC request rate was used as a process indicator, and the percentage of contaminated BCs and the true positives rate were used as quality indicators. Both were measured monthly and prospectively during the period of study.
The annual adjusted rate of BC requests was 4.9% (95% CI 4.8-5) in 2015 and 2.9% (95% CI 2.8-2.9) in 2016. The rate of false positive (contaminated) BCs was 4.5% in 2015 and 4.3% after the educational intervention. The true positive BCs were 8.3% in 2015 and 12% post-intervention.
These findings prove how important and effective the educational interventions are.
本研究旨在描述布宜诺斯艾利斯一所三级大学医院成人急诊科与采集血培养标本（BC）相关的2个过程指标，并描述2016年5月针对卫生专业人员开展一系列教育活动后，在BC的适当指征和正确采集技术方面所发生的变化。
设计一项回顾性队列研究以评估其有效性，该研究连续纳入了2015 - 2016年期间所有入院患者。血培养标本申请率用作过程指标，污染的血培养标本百分比和真阳性率用作质量指标。在研究期间每月进行前瞻性测量。
2015年血培养标本申请的年度调整率为4.9%（95%可信区间4.8 - 5），2016年为2.9%（95%可信区间2.8 - 2.9）。2015年假阳性（污染）血培养标本率为4.5%，教育干预后为4.3%。2015年真阳性血培养标本率为8.3%，干预后为12%。
这些结果证明了教育干预的重要性和有效性。
