Medical University of South Carolina College of Nursing, Charleston.
J Nurs Care Qual. 2020 Jul/Sep;35(3):245-251. doi: 10.1097/NCQ.0000000000000441.
Blood culture contamination results in delayed or unnecessary treatments, increased morbidity risk, extended lengths of hospital stay, and increased health care costs. Collecting 2 sets of blood cultures from separate sites helps differentiate bloodstream infections (BSIs) from contamination.
Blood culture contamination rates trailed the national threshold of less than 3% in one southeastern US emergency department (ED). Same-site and single-set collection issues were also identified.
This pre-/postintervention quality improvement study included 1137 patients (preintervention: n = 560; postintervention: n = 577) of all ages with blood culture orders in a 13-bed tertiary care ED.
A staff educational program, blood culture collection checklist with protocol, and monthly collective and individual feedback were implemented.
Blood culture contamination rates decreased from 3.39% to 2.6%. Same-site collection rates decreased from 15.13% to 4.14%.
The interventions effectively reduced blood culture contamination rates and same-site blood culture collections in the ED, enhancing the quality of care for patients with BSIs.
血培养污染会导致治疗延误或不必要、发病率风险增加、住院时间延长和医疗保健费用增加。从不同部位采集 2 套血培养有助于区分血流感染 (BSI) 和污染。
美国东南部的一个急诊科的血培养污染率低于全国 3%的阈值，但仍存在同部位和单次采集的问题。
这项在干预前后进行的质量改进研究纳入了一家拥有 13 张床位的三级护理急诊科中所有年龄段、有血培养医嘱的 1137 名患者（干预前：n=560；干预后：n=577）。
实施了一项员工教育计划、带有方案的血培养采集检查表以及每月的集体和个人反馈。
血培养污染率从 3.39%降至 2.6%，同部位采集率从 15.13%降至 4.14%。
这些干预措施有效地降低了急诊科的血培养污染率和同部位血培养采集率，提高了 BSI 患者的护理质量。
