Reducing Blood Culture Contamination in the Emergency Department.

BACKGROUND

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.

LOCAL PROBLEM

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.

METHODS

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.

INTERVENTIONS

A staff educational program, blood culture collection checklist with protocol, and monthly collective and individual feedback were implemented.

RESULTS

Blood culture contamination rates decreased from 3.39% to 2.6%. Same-site collection rates decreased from 15.13% to 4.14%.

CONCLUSIONS

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.