Mixed-methods multicenter assessment of healthcare workers' knowledge, perceptions, and practices related to blood culture utilization in hospitalized adults.

OBJECTIVE

To understand healthcare workers' (HCWs) beliefs and practices toward blood culture (BCx) use.

DESIGN

Cross-sectional electronic survey and semi-structured interviews.

SETTING

Academic hospitals in the United States.

PARTICIPANTS

HCWs involved in BCx ordering and collection in adult intensive care units (ICU) and wards.

METHODS

We administered an anonymous electronic survey to HCWs and conducted semi-structured interviews with unit staff and quality improvement (QI) leaders in these institutions to understand their perspectives regarding BCx stewardship between February and November 2023.

RESULTS

Of 314 HCWs who responded to the survey, most (67.4%) were physicians and were involved in BCx ordering (82.3%). Most survey respondents reported that clinicians had a low threshold to culture patients for fever (84.4%) and agreed they could safely reduce the number of BCx obtained in their units (65%). However, only half of them believed BCx was overused. Although most made BCx decisions as a team (74.1%), a minority reported these team discussions occurred daily (42.4%). A third of respondents reported not usually collecting the correct volume per BCx bottle, half were unaware of the improved sensitivity of 2 BCx sets, and most were unsure of the nationally recommended BCx contamination threshold (87.5%). Knowledge regarding the utility of BCx for common infections was limited.

CONCLUSIONS

HCWs' understanding of best collection practices and yield of BCx was limited.