The Rational Ordering of Blood Cultures in the Emergency Department

Abstract

A large number of patients with febrile illness are evaluated in emergency departments. Blood cultures are often obtained on such patients without reference to established guidelines. As a result of such practice, unnecessary blood cultures are being ordered with negative financial impact on both hospitals and pa tients. Generally speaking, as the number of blood cul tures obtained increases so does the number of false positive results. Follow-up on these results directly impacts on patient care as these patients are often subjected to call backs, additional work up, and ad mission to the hospital. This study reviews the manner in which blood cul tures were ordered before and after the introduction of general guidelines for their use. It outlines a proc ess whereby excessive ordering of blood cultures can be eliminated and suggests that this approach may be effective in limiting inappropriate use of other labo ratory and diagnostic studies.