Shaji Rosemary, Madigubba Haritha, Priyadarshi Ketan, Anandh P, Nathan Balamurugan, Vivekanandan M, Sastry Apurba Sankar
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Microbiology, Yashoda Hospitals, Malakpet Branch, Hyderabad, Telangana, India.
J Glob Infect Dis. 2022 Feb 28;14(1):10-16. doi: 10.4103/jgid.jgid_138_21. eCollection 2022 Jan-Mar.
The blood culture (BC) contamination was a significant problem in our hospital, especially in the emergency department (ED). The study, therefore, was undertaken to improve the BC collection in the ED.
The study was conducted for 1 year divided into two phases of 6 months each: Preintervention phase and intervention phase (regular and phlebotomist groups). The interventions comprised implementing standard protocol for BC collection and conducting educational sessions. In preintervention and regular groups, the BCs were collected by interns and technicians, while dedicated phlebotomist did so in the phlebotomist group. Data were analyzed and interpreted for the contamination rate as well as compliance in adequate filling of the requisition form. Statistical Package for the Social Sciences (SPSS) version 22. A value of < 0.005 was considered statistically significant, and < 0.01 was considered statistically significant.
In the preintervention group, 13.7% of specimens were reported as contaminated which was reduced to 4.2% and 3.2% in the regular and phlebotomist group, respectively, after intervention. Compliance of health-care workers to various elements of BC collection protocol was also found to be significantly improved in the intervention phase compared to the preintervention phase ( < 0.001).
Implementation of this multimodal intervention resulted in a drastic reduction in BC contamination and improvement in compliance to BC collection protocol and filling of various parameters in the BC requisition form, thus improving the overall effectiveness of BC testing. It was also noted that the contamination rate was further reduced by implementing dedicated phlebotomist.
血培养(BC)污染在我院是一个重大问题,尤其是在急诊科(ED)。因此,开展了这项研究以改善急诊科的血培养采集工作。
该研究为期1年,分为两个阶段,每个阶段6个月:干预前阶段和干预阶段(常规组和采血员组)。干预措施包括实施血培养采集的标准方案和开展教育课程。在干预前组和常规组中,血培养由实习生和技术人员采集,而在采血员组中由专门的采血员进行采集。对污染率以及申请单填写是否合规的数据进行了分析和解读。使用社会科学统计软件包(SPSS)版本22。<0.005的值被认为具有统计学意义,<0.01被认为具有高度统计学意义。
在干预前组中,13.7%的标本被报告为污染,干预后常规组和采血员组的这一比例分别降至4.2%和3.2%。与干预前阶段相比,干预阶段医护人员对血培养采集方案各项内容的依从性也显著提高(<0.001)。
实施这种多模式干预导致血培养污染大幅减少,血培养采集方案的依从性以及血培养申请单各项参数填写情况得到改善,从而提高了血培养检测的整体有效性。还注意到,通过配备专门的采血员,污染率进一步降低。