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Improving wound swab collection in paediatric patients: a quality improvement project
Sean H Leonard1, Ian Chin-Yee2,3, Johan Delport4
1Department of Paediatrics, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada.
Abstract:
Microbiology sample swabs may be unsuccessful or rejected for a variety of reasons. Typically, errors occur in the preanalytical phase of sample collection. Errors with collection, handling and transport can lead to the need to repeat specimen collection. Unsuccessful specimens contribute to delays in diagnosis, increased patient stress and increased healthcare costs. An audit of sample swabs from London Health Sciences Centre Children's Hospital from August through October 2021 yielded complete success rates of 100% for ear and eye culture swabs, 98.1% for methicillin-resistant Staphylococcus aureus swabs and 88.9% for wound swabs. This project aimed to improve wound swab success to 95% on the paediatric inpatient and paediatric emergency departments by May 2022.Stakeholders from paediatric clinical services including physicians, nurses and the laboratory medicine team at our centre were engaged to guide quality improvement interventions to improve specimen success rate. Based on feedback, we implemented visual aids to our electronic laboratory test information guide. Additionally, visual reminders of correct sample collection equipment were placed in high traffic areas for nursing staff.After the interventions were implemented, a three-month follow-up showed that wound swab success rate rose to 95.3%. This study achieved its aim of improving wound swab success rate to 95%. It adds to the growing pool of evidence that preanalytical phase intervention such as visual aids can increase swab success rates, in healthcare settings.
Insights
Improving microbiology wound swab success rates is crucial for timely diagnosis and reduced healthcare costs. Implementing visual aids significantly boosted wound swab success to 95.3% in pediatric settings.
Area of Science:
- Clinical Microbiology
- Healthcare Quality Improvement
- Patient Safety
Background:
- Preanalytical errors in sample collection negatively impact diagnostic accuracy and patient care.
- Unsuccessful microbiology swabs lead to delayed diagnoses, increased patient stress, and higher healthcare expenses.
- Initial audit revealed wound swab success rates at 88.9%, below the desired benchmark.
Purpose of the Study:
- To enhance the success rate of wound swabs to 95% in pediatric inpatient and emergency departments.
- To identify and implement effective interventions targeting preanalytical phase errors in sample collection.
- To reduce the incidence of repeat specimen collection and associated negative outcomes.
Main Methods:
- Engaged multidisciplinary stakeholders including physicians, nurses, and laboratory medicine teams.
- Implemented targeted quality improvement interventions based on stakeholder feedback.
- Introduced visual aids in the electronic laboratory test information guide and placed visual reminders for correct equipment in high-traffic nursing areas.
Main Results:
- Following the implementation of interventions, the wound swab success rate increased to 95.3%.
- The project successfully met its aim of achieving a 95% wound swab success rate.
- Post-intervention data demonstrated a significant improvement in specimen collection quality.
Conclusions:
- Preanalytical phase interventions, specifically visual aids, are effective in improving microbiology swab success rates.
- The study highlights the importance of stakeholder engagement in driving successful quality improvement initiatives.
- These findings contribute to the evidence base for optimizing laboratory specimen collection processes in healthcare settings.
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