一次做对：质量改进与污染血培养
Doing it right the first time: quality improvement and the contaminant blood culture.
作者信息
Weinbaum F I, Lavie S, Danek M, Sixsmith D, Heinrich G F, Mills S S
机构信息
Department of Surgery, New York Hospital Medical Center of Queens, Flushing 11355, USA.
出版信息
J Clin Microbiol. 1997 Mar;35(3):563-5. doi: 10.1128/jcm.35.3.563-565.1997.
Abstract
The aim of the project was to determine whether the rate of contaminant blood cultures could be reduced by using a team of dedicated phlebotomists. Comparisons were made between adult patients requiring blood cultures for suspected bacteremia on medical and surgical units before and after the introduction and withdrawal of a dedicated blood culture team. The results showed that a significant reduction in the contaminant blood culture rate was achieved by the blood culture team (P < 0.001; chi(2) test). Therefore, in our experience, the rate of contaminant blood cultures can be reduced in a teaching hospital by using a team of dedicated phlebotomists. Calculations made with our data and those published by others suggest that cost savings from reducing false-positive blood cultures are greater than the cost of the blood culture team.
摘要
该项目的目的是确定使用一组专门的采血人员是否可以降低血培养污染率。在引入和撤出专门的血培养团队之前及之后，对内科和外科病房因疑似菌血症而需要进行血培养的成年患者进行了比较。结果显示，血培养团队使血培养污染率显著降低（P < 0.001；卡方检验）。因此，根据我们的经验，在教学医院使用一组专门的采血人员可以降低血培养污染率。根据我们的数据以及其他人发表的数据进行的计算表明，减少假阳性血培养所节省的成本大于血培养团队的成本。
相似文献
1
Doing it right the first time: quality improvement and the contaminant blood culture.一次做对：质量改进与污染血培养
J Clin Microbiol. 1997 Mar;35(3):563-5. doi: 10.1128/jcm.35.3.563-565.1997.
2
Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile collection kits and phlebotomy teams.急诊科减少血培养污染策略的成本分析：无菌采集套件和采血团队。
Infect Control Hosp Epidemiol. 2014 Aug;35(8):1021-8. doi: 10.1086/677161. Epub 2014 Jun 20.
3
Improvement of blood culture contamination rate, blood volume, and true positive rate after introducing a dedicated phlebotomy team.引入专门的采血团队后，血培养污染率、采血量和真阳性率得到改善。
Eur J Clin Microbiol Infect Dis. 2019 Feb;38(2):325-330. doi: 10.1007/s10096-018-3430-4. Epub 2018 Dec 7.
4
Comparison of contamination rates of catheter-drawn and peripheral blood cultures.导管采血与外周血培养污染率的比较。
J Hosp Infect. 2005 Jun;60(2):118-21. doi: 10.1016/j.jhin.2004.10.020.
5
Efforts to improve diagnosis of bacteraemia by reducing blood culture contamination in an emergency department: strategies and outcome.努力通过减少急诊科血培养污染来改善菌血症的诊断：策略和结果。
J Pak Med Assoc. 2020 May;70(5):835-839. doi: 10.5455/JPMA.12462.
6
Reducing blood culture contamination in a pediatric emergency department.减少儿科急诊科血培养污染情况。
Pediatr Emerg Care. 2011 Mar;27(3):179-81. doi: 10.1097/PEC.0b013e31820d652b.
7
Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions.血培养污染趋势：美国病理学家学会对356家机构的Q-Tracks研究
Arch Pathol Lab Med. 2005 Oct;129(10):1222-5. doi: 10.5858/2005-129-1222-TIBCCA.
8
Blood cultures positive for coagulase-negative staphylococci: antisepsis, pseudobacteremia, and therapy of patients.凝固酶阴性葡萄球菌血培养阳性：患者的抗菌、假菌血症及治疗
J Clin Microbiol. 1998 Jul;36(7):1923-6. doi: 10.1128/JCM.36.7.1923-1926.1998.
9
Effectiveness of a Novel Specimen Collection System in Reducing Blood Culture Contamination Rates.一种新型标本采集系统在降低血培养污染率方面的有效性。
J Emerg Nurs. 2018 Nov;44(6):570-575. doi: 10.1016/j.jen.2018.03.007. Epub 2018 Apr 21.
10
Reducing false-positive peripheral blood cultures in a pediatric emergency department.减少儿科急诊科外周血培养的假阳性结果
J Emerg Nurs. 2013 Sep;39(5):440-6. doi: 10.1016/j.jen.2011.12.017. Epub 2012 May 2.
引用本文的文献
1
A Practical Guide to Creating a Pareto Chart as a Quality Improvement Tool.创建帕累托图作为质量改进工具的实用指南。
Glob J Qual Saf Healthc. 2021 Apr 28;4(2):83-84. doi: 10.36401/JQSH-21-X1. eCollection 2021 May.
2
Patient-specific risk factors contributing to blood culture contamination.导致血培养污染的患者特异性风险因素。
Antimicrob Steward Healthc Epidemiol. 2022 Mar 18;2(1):e46. doi: 10.1017/ash.2022.22. eCollection 2022.
3
Utility of cell-free DNA concentrations and illness severity scores to predict survival in critically ill neonatal foals.无细胞 DNA 浓度和疾病严重程度评分对预测危重病新生儿驹存活率的作用。
PLoS One. 2021 Apr 26;16(4):e0242635. doi: 10.1371/journal.pone.0242635. eCollection 2021.
4
Practical Guidance for Clinical Microbiology Laboratories: A Comprehensive Update on the Problem of Blood Culture Contamination and a Discussion of Methods for Addressing the Problem.临床微生物学实验室实用指南：血液培养污染问题的全面更新及解决方法讨论。
Clin Microbiol Rev. 2019 Oct 30;33(1). doi: 10.1128/CMR.00009-19. Print 2019 Dec 18.
5
Improvement of blood culture contamination rate, blood volume, and true positive rate after introducing a dedicated phlebotomy team.引入专门的采血团队后，血培养污染率、采血量和真阳性率得到改善。
Eur J Clin Microbiol Infect Dis. 2019 Feb;38(2):325-330. doi: 10.1007/s10096-018-3430-4. Epub 2018 Dec 7.
6
Chlorhexidine versus Tincture of Iodine for Reduction of Blood Culture Contamination Rates: a Prospective Randomized Crossover Study.洗必泰与碘酒降低血培养污染率的比较：一项前瞻性随机交叉研究。
J Clin Microbiol. 2016 Dec;54(12):3007-3009. doi: 10.1128/JCM.01457-16. Epub 2016 Oct 5.
7
Tackling the problem of blood culture contamination in the intensive care unit using an educational intervention.采用教育干预措施解决重症监护病房血培养污染问题。
Epidemiol Infect. 2015 Jul;143(9):1964-71. doi: 10.1017/S0950268814003008. Epub 2014 Nov 12.
8
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.成人重症监护病房中洗必泰沐浴能否减少血培养污染？一项实用的整群随机试验。
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3(Suppl 3):S17-22. doi: 10.1086/677822.
9
Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile collection kits and phlebotomy teams.急诊科减少血培养污染策略的成本分析：无菌采集套件和采血团队。
Infect Control Hosp Epidemiol. 2014 Aug;35(8):1021-8. doi: 10.1086/677161. Epub 2014 Jun 20.
10
Quality assurance in blood culture: A retrospective study of blood culture contamination rate in a tertiary hospital in Nigeria.血培养中的质量保证：尼日利亚一家三级医院血培养污染率的回顾性研究。
Niger Med J. 2014 May;55(3):201-3. doi: 10.4103/0300-1652.132038.
本文引用的文献
1
The effect of skin disinfection materials on reducing blood culture contamination.皮肤消毒材料对减少血培养污染的影响。
Am J Clin Pathol. 1993 May;99(5):536-8. doi: 10.1093/ajcp/99.5.536.
2
Effect of iodophor vs iodine tincture skin preparation on blood culture contamination rate.碘伏与碘酒皮肤准备对血培养污染率的影响。
JAMA. 1993 Feb 24;269(8):1004-6.
3
Continuous improvement as an ideal in health care.持续改进作为医疗保健领域的一种理想状态。
N Engl J Med. 1989 Jan 5;320(1):53-6. doi: 10.1056/NEJM198901053200110.
4
Antimicrobial misuse in patients with positive blood cultures.血培养阳性患者的抗菌药物滥用情况。
Am J Med. 1989 Sep;87(3):253-9. doi: 10.1016/s0002-9343(89)80146-9.
5
Contaminant blood cultures and resource utilization. The true consequences of false-positive results.污染血培养与资源利用。假阳性结果的真实后果。
JAMA. 1991 Jan 16;265(3):365-9.
6
Rapid classification of positive blood cultures. Prospective validation of a multivariate algorithm.血培养阳性的快速分类。多变量算法的前瞻性验证。
JAMA. 1992 Apr 8;267(14):1962-6.
Zotero 插件