Fabre Valeria, Cosgrove Sara E, Milstone Aaron M, Salinas Alejandra B, Degnan Kathleen O, Gettler Erin B, Glaser Laurel J, Johnson J Kristie, Moehring Rebekah W, Nelson George E, Rittmann Barry, Rodriguez-Nava Guillermo, Ryder Jonathan H, Salinas Jorge L, Schrank Gregory M, Talbot Thomas T, Van Schooneveld Trevor C, Wasylyshyn Anastasia, Xie Anping
Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Infect Control Hosp Epidemiol. 2024 Dec 20:1-9. doi: 10.1017/ice.2024.208.
To understand healthcare workers' (HCWs) beliefs and practices toward blood culture (BCx) use.
Cross-sectional electronic survey and semi-structured interviews.
Academic hospitals in the United States.
HCWs involved in BCx ordering and collection in adult intensive care units (ICU) and wards.
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.
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.
HCWs' understanding of best collection practices and yield of BCx was limited.
了解医护人员对血培养（BCx）使用的看法和做法。
横断面电子调查和半结构化访谈。
美国的学术医院。
参与成人重症监护病房（ICU）和病房血培养医嘱开具和采集的医护人员。
2023年2月至11月期间，我们对医护人员进行了匿名电子调查，并对这些机构的科室工作人员和质量改进（QI）负责人进行了半结构化访谈，以了解他们对血培养管理的看法。
在314名回复调查的医护人员中，大多数（67.4%）是医生，且参与血培养医嘱开具（82.3%）。大多数调查受访者表示，临床医生对发热患者进行血培养的阈值较低（84.4%），并同意他们可以安全地减少所在科室的血培养送检数量（65%）。然而，只有一半的人认为血培养存在过度使用的情况。尽管大多数人以团队形式做出血培养决策（74.1%），但少数人报告称这些团队讨论每天都进行（42.4%）。三分之一的受访者报告称通常没有采集每个血培养瓶的正确血量，一半的人不知道两套血培养瓶能提高检测灵敏度，大多数人不确定国家推荐的血培养污染阈值（87.5%）。关于血培养对常见感染效用的知识有限。
医护人员对血培养最佳采集方法和阳性率的理解有限。
