Quality Improvement Project: Effectiveness of Diversion Tube Use on Blood Culture Contamination From Intravenous...

Background: Contaminated blood cultures complicate medical decision-making, leading to unnecessary testing and treatment. Objective: To evaluate the impact of an initial specimen diversion tube protocol on blood culture contamination rates in a community hospital emergency department. Methods: Over 9 weeks, 27 blood culture specimens were obtained using a diversion tube at the time of intravenous insertion. Trained nursing superusers collected samples. Contamination rates were compared with those from the standard protocol. Results: The standard protocol group demonstrated a 2.92% overall contamination rate (mean = 3.17%) with nine pathogens identified. The diversion protocol group showed a 3.70% overall contamination rate (mean = 2.38%) with only one pathogen isolated. Conclusions: Although the standard protocol had a slightly lower overall contamination rate, the diversion protocol yielded fewer pathogens and a lower mean contamination rate, suggesting greater potential for sustainable contamination reduction. Implications for Nursing: Nurse-driven interventions, including the use of diversion devices and superuser training, may enhance diagnostic accuracy and reduce unnecessary antibiotic exposure. Nursing engagement is essential to improving blood culture practices and sustaining quality outcomes.