Pediatrics. 2013 Jan;131(1):e292-7. doi: 10.1542/peds.2012-1030. Epub 2012 Dec 3.
Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings.
SourceDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
BACKGROUND AND OBJECTIVE:Blood culture contamination in the pediatric population remains a significant quality and safety issue because false-positive blood cultures lead to unnecessary use of resources and testing. In addition, few studies describe interventions to reduce peripheral blood culture contamination rates in this population. We hypothesized that the introduction of a standardized sterile collection process would reduce the pediatric emergency department's peripheral blood culture contamination rate and unnecessary use of resources.
METHODS:A sterile blood culture collection process was designed by analyzing current practice and identifying areas in which sterile technique could be introduced. To spread the new technique, a web-based educational model was developed and disseminated. Subsequently, all nursing staff members were expected to perform peripheral blood cultures by using the modified sterile technique.
RESULTS:The peripheral blood culture contamination rate was reduced from 3.9% during the baseline period to 1.6% during the intervention period (P < .0001), with yearly estimated savings of ~$250,000 in hospital charges.
CONCLUSIONS:Subsequent to our intervention, there was a significant reduction of the peripheral blood culture contamination rate as well as considerable cost savings to the institution. When performed in a standardized fashion by using sterile technique, blood culture collection with low contamination rates can be performed via the insertion of an intravenous catheter.
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