Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings

Author:

Hall Randon T.1,Domenico Henry J.2,Self Wesley H.3,Hain Paul D.4

Affiliation:

1. Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee;

2. Departments of Biostatistics and

3. Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and

4. Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas

Abstract

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.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference14 articles.

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4. Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions.;Bekeris;Arch Pathol Lab Med,2005

5. Reducing blood culture contamination in a pediatric emergency department.;Weddle;Pediatr Emerg Care,2011

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