2013 Sep;39(5):459-64. doi: 10.1016/j.jen.2012.03.006. The commitment from our team was considered the most valuable asset and strategy. Rates of blood culture contamination can be as high as 6%2. Purpose: Magnolia Medical Technologies, Inc., inventors of Steripath, the only FDA 510(k)-cleared device platform specifically indicated to reduce blood culture contamination for sepsis testing accuracy . The task force included an emergency physician cham- pion, an ED nurse champion, the chief hospital epidemi- ologist, ED administrators, ED nursing leadership, microbiology laboratory personnel, and infection control personnel. Go to: Baseline measurement Same-site collection rates decreased from 15.13% to 4.14%. Based on the . In addition, few studies describe interventions to reduce peripheral blood culture contamination rates in this population. Reducing the Rate of Blood Culture Contamination in the Emergency Department of a University Teaching Hospital. From January 1, 2015 to December 31, 2015, the contamination rate of blood culture in our emergency department was 5.63%, which exceeded the maximum of 3% suggested by the American Society for Microbiology and the clinical laboratory at our hospital. 10 Hall, K. K., & Lyman, J. 1, Issue. Of note, none of the three antiseptic agents was associated with a lower blood culture contamination rate when assessed by univariate and multivariate analysis and in subgroup analysis among older . Local problem: Blood culture contamination rates trailed the national threshold of less than 3% in one southeastern US emergency department (ED). Blood culture contamination is a common problem in the emergency department (ED) that leads to unnecessary patient morbidity and health care costs. The study objective was to develop and evaluate the effectiveness of a quality improvement (QI) intervention for reducing blood culture contamination in an ED. Wednesday, February 5, 2014. . contamination rates in the emergency department. The total blood culture contamination rate in January-March 2019 decreased to 3.1%. This represents a 44% decrease moving from 1.82% to 1.01% in hospital-wide BC contamination rates and an annualized cost avoidance of approximately $614,000. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. Conclusions: The interventions effectively reduced blood culture contamination rates and same-site blood culture collections in the ED, enhancing the quality of care for patients with BSIs. 1, Hospital A). It is therefore important to identify risk factors associated with blood culture contamination in EDs. 2013;131(1):e292-7. This can delay early targeted treatment and be detrimental to patient care. Blood-culture results may affect clinical decision making. Objectives: To reduce the contamination rate of blood cultures taken in the Accident and Emergency (A&E) department. Journal of Emergency Nursing, 44(6): 570-575. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. The aim of this review is to identify effective . Discussion: The total hospital BC contamination rate never rose above the 3% benchmark, which illustrates the importance of tracking ED-specific data. the blood culture is an essential tool for diagnosing bloodstream infections and guiding antibiotic therapy. In 2015, Houston Methodist Willowbrook Emergency Department blood culture contamination rate was 6.23% due to lack of training and inconsistent technique. Blood culture contamination in emergency departments (ED) that experience a high volume of patients has negative impacts on optimal patient care. Conclusions: The interventions effectively reduced blood culture contamination rates and same-site blood culture collections in the ED, enhancing the quality of care for patients with BSIs. Reducing false-positive peripheral blood cultures in a pediatric emergency department. Yes, according to literature, 20% to 50% are likely false positives. Blood culture contamination rates should not exceed the recommended 3% of all blood culture collections according to the American Society for Microbiology (ASM) and the Clinical Laboratory Standards Institute (CLSI).. Hospital leaders need to be aware of the national movement toward a new blood culture contamination benchmark of 1%. 1 however, false positive blood cultures due to specimen contamination with skin bacteria are a common problem that leads to unnecessary patient morbidity, increased hospital costs, and health care system inefficiencies. Perhaps the most striking result is that 97% of positive cultures represented true positives with the diversion device, compared to 81% without the diversion device. The commitment from our team was considered the most valuable asset and strategy. Pediatrics. All PDSA cycle data on the project measures were extracted from the lab information system to be analyzed and presented on run and control charts. To promote proper technique related to blood culture specimen collection in an effort to reduce contamination, educational interventions have been examined. Discussion The ED BC contamination rate spike occurred over a 3-month period during which the emergency department was transitioning into a new facility on the same campus. 1 Unfortunately, blood culture contamination is common, leading to increased morbidity and overall cost burden. Modification of Blood Test Draw Order to Reduce Blood Culture Contamination.Clin Infect Dis. One method shown to be effective in reducing contamination is initial blood specimen diversion during collection. Methods that should be employed to decreased blood culture contamination include the following: Patient selection: Blood cultures should only be . Conclusions The interventions effectively reduced blood culture contamination rates and same-site blood culture collections in the ED, enhancing the quality of care for patients with BSIs. Practical steps to lower blood culture contamination rates in the emergency department. A Quality Improvement team was created to try to reduce contamination rates to the recommended target. (2018). Clinical Microbiology Reviews, 19(4), 788-802. 1, Issue. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. OBJECTIVES Blood culture contamination is a common problem in the emergency department . Interventions Interventions to reduce blood culture contamination, including prep kits . Blood culture contamination can lead to overuse and misuse of antibiotics. Pediatrics, 131(1), e292-e297. 3% blood culture contamination rate in an Emergency Department Cultures / month: Contamination Rate: Patients impacted by false positives / month: . Bell, M., et al. 1 Contamination of blood cultures contribute to unnecessary return visits, diagnostic studies, and . Updated review of blood culture contamination. The study objective was to develop and . Blood culture is an essential and commonly used diagnostic tool in pediatrics, because it is the gold standard test used to detect bacteremia in patients suspected of having serious infections. . Impact of novel blood culture collection bundle to reduce blood culture contamination rates: An important continuous quality improvement indicator of . Compared with 2008, BCC rates for the ED showed steady reduction from 5.52 to 1.42% in 2011 and leveled out consistently below 1.6%. August 25, 2021. 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. Objectives Blood culture contamination is a common problem in the emergency department (ED) that leads to unnecessary patient morbidity and health care costs. 10 Hall, K. K., & Lyman, J. Given the negative impact this could have on patient outcomes, a quality improvement project was developed in order to ensure delivery of the highest quality of care. Why Do We Care? 2019 Wolters Kluwer Health, Inc. The associated cost of contamination per blood culture is estimated to range between $2844 . Blood cultures are commonly ordered in the emergency department (ED) setting to evaluate for bacteremia. 2 - 8 patients who Baseline measurement (2006). Methodology/Principal Findings A prospectively observational study in a university-affiliated hospital were conducted between August . Design: This was a quality initiative for our department to reduce blood culture contaminations in the emergency department. MeSH terms Blood Culture* Hall RT, Domenico HJ, Self WH, Hain PD. Updated review of blood culture contamination. blood culture contamination in the emergency department: Sterile collection kits and phlebotomy teams. Blood culture contamination carries risks for patients, such as unnecessary antimicrobial therapy and other additional hazards and costs. After reviewing the literature, it was clear that a procedure that is feasible in the fast paced Emergency Department and ensures maximum efficacy of the chlorhexidine for site prep is essential. Developing a plan that is evidence-based and feasible in the fast paced Emergency Department can . They found that after the diversion protocol was introduced, the contamination rate in the emergency department dropped from 2.92 percent to 1.95 percent, while the inpatient contamination rate dropped from 1.82 percent to 1.31 percent. With Magnolia Medical's Steripath Gen2 Initial Specimen Diversion Device (ISDD), hospitals now have an extra layer of contamination protection. 2-7 These contaminated blood cultures have significant negative consequences for individual patients . In the past, a blood culture contamination rate of less than 3% was deemed acceptable. Conclusions: Venipuncture and the use of phlebotomy teams are effective practices for reducing blood cul- ture contamination rates in diverse hospital settings and are recommended as evidence-based "best practices" with high overall strength of evidence and substantial effect size ratings. Journal of Emergency Nursing, 39(5), 459- 464. This represents a 44% decrease moving from 1.82% to 1.01% in hospital-wide BC contamination rates and an annualized cost avoidance of approximately $614,000. Fig. conducted from the perspective of a hospital leadership team selecting a blood culture collection strategy for an adult emergency department (ED) with 8,000 cultures drawn annually. Current evidence suggests that the emergency department (ED) often has blood culture contamination (BCC) rates above the recommended 3%, contributing to increased hospital length of stay, unnecessary or inappropriate antimicrobial treatment, and increased economic burden. Bates DW, Goldman L, Lee TH. 2013;131(1):e292-7. A. Results: Over a 6-month period, a reduction in the BCC rate at the emergency department (ED) of the University Hospital reached 1.5% compared with the baseline at 4.0%. Discussion: The results show that reducing blood culture contamination rates through the use of a structured plan and teamwork is feasible in the fast-paced emergency department. 1, p. OBJECTIVES: Blood culture contamination is a common problem in the emergency department (ED) that leads to unnecessary patient morbidity and health care costs. A financial measure estimated the savings in charges between the observed and expected contaminants in PDSA3. Objectives Blood culture contamination is a common problem in the emergency department (ED) that leads to unnecessary patient morbidity and health care costs. Steripath, the only FDA 510 (k)-cleared device indicated to reduce blood culture contamination, is engineered to deliver sustained contamination rates of under 1.0% in the emergency department . 1, Issue. BACKGROUND AND OBJECTIVE:. 1, p. Global Journal on Quality and Safety in Healthcare, Vol. EDs' positive BC rates have been shown to range from 3.4%-7.9% with contamination rates 0.6-7.9%. Blood culture contamination is a common problem in the emergency department (ED) that leads to unnecessary patient morbidity and health care costs. Confidential . Blood cultures are commonly performed in the emergency department (ED) due to the important diagnostic and prognostic information they can provide to clinicians. From January 2013 to November 2014 inclusive, the contamination rate was 4.74% in our Emergency Department, responsible for initial management and investigation of over 40 cases of sepsis per month. Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings. A Quality Improvement team was created to try to reduce contamination rates to the recommended target. Reducing the Rate of Blood Culture Contamination in the Emergency Department of a University Teaching Hospital. The study, therefore, was undertaken to improve the BC collection in the ED. Infect . . There was a significant increase in our monthly blood culture contamination rates, over a 3 month period of time, which exceeded a recommended standard of <3%, as high as 4.35%. 1 However, false positive blood cultures due to specimen contamination with skin bacteria are a common problem that leads to unnecessary patient morbidity, increased hospital costs, and health care system inefficiencies. Article Google Scholar Harding AD, Bollinger S. Reducing blood culture contamination rates in the emergency department. The blood culture is an essential tool in clinical medicine for detecting bacteremia and guiding antibiotic therapy. . A QI assessment of ED blood culture contamination led to development of a targeted intervention to convert the process of blood culture collection from a clean to a fully sterile procedure, which led to an immediate and sustained reduction of contamination in an ED with a high baseline contamination rate. The use of the diversion device reduced the rate of blood culture contamination from 1.78% to 0.22%, without reducing the sensitivity for detection of true bacteremia and candidemia. Clinical Microbiology Reviews, 19(4), 788-802. 1 Current literature 26 27 Faced with these contamination rates clinicians cannot be sufficiently confident in initial positive BC results to alter patient management. Journal of Emergency Nursing, 39(5), 459-464. Global Journal on Quality and Safety in Healthcare, Vol. Marini, M. (2013, September). Same-site and single-set collection issues were . EDs with high blood culture contamination rates should strongly consider evidence-based strategies to reduce contamination . Same-site collection rates decreased from 15.13% to 4.14%. Blood culture contamination rates decreased from 3.39% to 2.6%. Contaminated blood cultures add an exorbitant financial . 1, p. . Journal of Emergency Nursing, 39(5), 440-456. Steripath is a pre-assembled, sterile blood culture system designed to divert and sequester the initial 1.5 to 2.0 mL of blood prior to culture bottle inoculation.Credit: Magnolia Medical Tech. 2019; 2Data on file;; 3Tompkins . This represents a 44% decrease moving from 1.82% to 1.01% in hospital-wide BC contamination rates and an annualized cost avoidance of approximately $614,000.