A Quality Improvement Initiative: Reducing Blood Culture Contamination in a Children’s Hospital
| Autor: | Kristin Dowdy, Lisa M. Stempak, Rana E. El Feghaly, William Needham, Kesha Prystupa, Marie Kennedy, Jahnavi Chatterjee, Stephanie Morgan |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Quality management Health Personnel Best practice 030106 microbiology Blood volume 03 medical and health sciences 0302 clinical medicine Phlebotomy 030225 pediatrics medicine Humans Blood culture Nurse education Protocol (science) Blood Specimen Collection medicine.diagnostic_test business.industry Electronic medical record Contamination Hospitals Pediatric medicine.disease Quality Improvement Blood Culture Pediatrics Perinatology and Child Health Medical emergency business |
| Zdroj: | Pediatrics. 142 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2018-0244 |
| Popis: | BACKGROUND AND OBJECTIVE:Blood culture contamination is a safety and quality concern in children’s hospitals; it leads to increased unnecessary testing, admissions, antibiotic exposure, and cost. The standard benchmark for blood culture contamination is 3%. Our aim with the quality improvement project was to reduce the contamination rate at our children’s hospital from a mean of 2.85% to METHODS:After initial unit-specific efforts, we formed a multidisciplinary team, created a process map and a cause-and-effect analysis, sent out surveys to nurses, and created observation sheets used to identify problem areas and record the most common deviations during the collection process. We also standardized the blood culture collection protocol and reemphasized nurse education in person and with online modules. During our project, we noted that nurses were collecting 1 to 3 mL of blood on all children regardless of weight. We developed optimal weight-based blood volumes and, after educating ordering providers, we updated our electronic medical record to reflect appropriate volumes in the order.RESULTS:Despite a steady increase in the number of blood cultures collected at our children’s hospital, we were able to decrease the average contamination rate from 2.85% to 1.54%, saving the hospital an estimated average of $49 998 per month.CONCLUSIONS:By standardizing blood culture collection methods, optimizing blood volume, creating checklists, and reinforcing nurse education, we were able to develop a best practice for pediatric blood culture collection and reduce blood culture contamination to a sustainable low rate at our children’s hospital. |
| Databáze: | OpenAIRE |
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