Evaluation of an intervention to decrease false positive blood culture contamination rates in Emergency Department

摘要

Background: The HGH Microbiology lab indicator showed that our blood culture contamination rate has been consistently higher than the international benchmark thereby we aim to reduce it in the critical area of Emergency Department by 50% by the end of July 2015 and at least 90% by end of February 2016. Methods: A pilot area was chosen in the Emergency Department to do a study for 44 weeks after which blood culture kits (previously trolleys & trays were used) containing sterile gloves, masks, and blood culture supplies were introduced into the Critical area of ED-HGH in August 2015. Training included- new instructions to have two staff members present when drawing blood cultures (preceptor-preceptee methodology) thereby prohibiting drawing blood cultures from pre-existing lines and proper follow-up of every step. False positive blood culture rates were measured in the weeks preceding and the weeks following, this intervention. Results: In the 8 weeks following the intervention, the average false positive blood culture contamination rate in HGH ED reached 1.9% (which was the benchmark) out of 318 blood culture samples. In the 6 months preceding, the blood culture contamination rates ranged from 4% to 1.5% each month. Conclusions: Blood culture kits and educational training on proper technique resulted in significant reduction (>60%) in the false positive blood culture rate in the Critical areas of ED-HGH. Studies at other institutions have suggested that reducing the false positive blood culture rate could decrease costs by preventing unnecessary hospitalizations and administration of unnecessary antibiotics, as well as helping to prevent the development of multi-drug resistant organisms. 0000-0003-0866-6512 0000-0002-1057-2438.