The effect of a quality improvement programme reducing blood culture contamination on the detection of bloodstream infection in an emergency department.
| Autor: | Robertson P; Department of Microbiology, Glasgow Royal Infirmary, UK., Russell A; Emergency Department, Monklands Hospital, UK., Inverarity DJ; Department of Microbiology, Monklands Hospital, UK. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of infection prevention [J Infect Prev] 2015 Mar; Vol. 16 (2), pp. 82-87. Date of Electronic Publication: 2014 Dec 10. |
| DOI: | 10.1177/1757177414561107 |
| Abstrakt: | Background: Contaminated blood cultures (BC) generate avoidable costs and prolong hospital stays. To measure our hospital's performance against the recommended standard of <3% BC contamination, we performed a prospective study. Methods: We prospectively determined the frequency of contaminated and genuinely positive BC hospital-wide over seven months. Results: Overall, 73 of 1,829 blood cultures reviewed were contaminated (4.0%). However, distribution of contamination was not uniform. Finding a consistently higher incidence of contamination (11.7%) in our emergency department (ED) than elsewhere in the hospital (2.5%), we adopted a collaborative quality improvement strategy targeted to the ED. A combination of education, modified BC packs and regular feedback of BC results was associated with a significant reduction in contamination (7.4%, p =0.01) over the next six months. Our data suggests that contaminated BC were more likely to have been taken during regular day time hours (odds ratio (OR) 2.7, p =0.012), rather than overnight and were not associated with influxes of new junior medical staff. We found no evidence that the incidence of true bloodstream infection (12.8%) diagnosed by our ED was adversely affected by our intervention (10.7%, p =0.35). Conclusions: Using a simple and inexpensive collaborative intervention we reduced BC contamination without adversely affecting the detection of genuine BSI. Competing Interests: Conflict of interest: The authors declare that there is no conflict of interest. |
| Databáze: | MEDLINE |
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