Use of hair nets and face masks to decrease blood culture contamination rates

Owing to a persistently high blood culture contamination rate of 3.2% exceeding the target rate of <3%, a midwestern United States hospital began a series of 3 additive interventions. After collecting phlebotomist data for approximately 3 months, reporting of individual contamination rates commenced. A specialized trainer reeducated staff with high rates, which resulted in a modest decrease in contamination rates (3.2% to 2.8%, P = 0.23). A second, additional intervention requiring phlebotomists to wear hair nets and face masks resulted in marked improvement from a mean of 2.8% to 1.1% (P < .0001). In a final, third addition, whenever possible, the replacement of nursing staff by phlebotomy staff for blood specimen collection did not result in a significant change in mean contamination (P = 0.81). Overall, the mean contamination rate progressively declined in a stepwise manner from 3.2% to 1.2% (P = .0013), with the greatest decline after adding hair nets and face masks.