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Published on: October 15, 2014
Effectiveness of Multimodal Intervention to Improve Blood Culture Collection in the Emergency Department
Rosemary Shaji1, Haritha Madigubba2, Ketan Priyadarshi3
1Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Insights
Blood culture (BC) contamination in the emergency department (ED) was significantly reduced through a multimodal intervention. Implementing a standard BC collection protocol and utilizing dedicated phlebotomists further decreased contamination rates.
Area of Science:
- Clinical Microbiology
- Infection Control
- Healthcare Quality Improvement
Background:
- Blood culture (BC) contamination poses a significant challenge, particularly in emergency department (ED) settings.
- High contamination rates can lead to unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs.
Purpose of the Study:
- To reduce blood culture contamination rates in the emergency department.
- To improve compliance with blood culture collection protocols.
Main Methods:
- A 1-year study with two 6-month phases: pre-intervention and intervention.
- Interventions included implementing a standard BC collection protocol and educational sessions.
- Comparison of contamination rates between pre-intervention, regular collection, and dedicated phlebotomist groups.
Main Results:
- Blood culture contamination decreased from 13.7% pre-intervention to 4.2% (regular group) and 3.2% (phlebotomist group) post-intervention.
- Compliance with BC collection protocols significantly improved (P < 0.001).
- Dedicated phlebotomists further reduced contamination rates compared to regular staff.
Conclusions:
- A multimodal intervention effectively reduced BC contamination in the ED.
- Standardized protocols and staff education are crucial for improving BC collection quality.
- Employing dedicated phlebotomists offers additional benefits in minimizing contamination.
Introduction:
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.
Methods:
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 P < 0.005 was considered statistically significant, and P < 0.01 was considered statistically significant.
Results:
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 (P < 0.001).
Conclusions:
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.
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