Reducing the Contamination Rate and the Unnecessary Requesting of Blood Culture Test through Quality Improvement Project

2021 ◽  
Vol 30 (1) ◽  
pp. 87-91
Author(s):  
Tamer Mohamed ◽  
Ashraf A Askar ◽  
Jamila Chahed
Keyword(s):  
Quality Improvement ◽  
Blood Culture ◽  
Armed Forces ◽  
Blood Cultures ◽  
Quality Improvement Project ◽  
Contamination Rate ◽  
Improvement Project ◽  
Culture Test ◽  
Negative Results ◽  
Before And After

Background: Blood stream infections are major leading causes of morbidity and mortality in hospitalized patients. Increasing the awareness of the clinicians and nurses about the proper protocol of blood culture test is very important in reducing the contamination rate and the unnecessary requesting of blood culture. Objectives: to reduce the contamination rate and the unnecessary requesting of blood culture from different departments through implementation of hospital wide Quality Improvement Project (QIP). Methodology: Blood cultures were tested in the Microbiology Laboratory of Najran Armed Forces hospital, Saudi Arabia, in the period from June 2019 to July 2020 and their results were compared before and after the implementation of the QIP. Results: The comparison between the blood cultures results before and after QIP implementation showed statistically significant (19.6%) reduction in the contamination rate, (14%) reduction in the total number of blood culture requests and (11.6%) reduction in the negative results rate. Conclusion: The reduction in the total number, negative results and contamination rate of blood culture test after QIP implementation were considered as performance indicators that the recommendations of QIP were effective and implemented strictly.

101 Use of Blood Cultures to Detect Bacteraemia in Surgical Patients: A Prospective, Closed Loop Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Osborne
Keyword(s):  
Quality Improvement ◽  
Blood Culture ◽  
Early Recognition ◽  
Blood Cultures ◽  
Quality Improvement Project ◽  
Surgical Patients ◽  
Post Intervention ◽  
Improvement Project ◽  
Continued Education ◽  
Threatening Condition

Abstract Introduction Sepsis is a complex, life-threatening condition, posing a significant burden to both NHS resources and society in general. Bacteraemia is a common presentation in surgical pathology and requires prompt investigation and treatment. Blood cultures remain the gold standard for detecting bacteraemia and providing targeted antibiotic therapy. We aimed to improve the overall use of blood cultures in pyrexial surgical patients. Method A three-loop, prospective quality improvement project was performed. Patients identified as being pyrexial were reviewed to determine when it was recorded and whether blood cultures were taken. Following a departmental presentation, two further audit cycles were performed at two months and seven months post-intervention to determine long-term response. Result A total of 56 patients were included over the three audit cycles. Blood culture adherence improved from 58.7% at baseline to 65% at 7 months. Most notably, out-of-hours compliance improved from 44.4% to 66.6%. 2-month compliance was 85%, however, this comprised of only 7 patients. Conclusions Early recognition and management of sepsis remains a key area of improvement. Whilst overall and out-of-hour blood culture compliance improved, continued education is needed to further increase this.

scholarly journals Reducing Blood Culture Contamination; a Quality Improvement Project in Emergency Department

2020 ◽  
Vol 41 (S1) ◽  
pp. s368-s369
Author(s):  
Itisha Gupta ◽  
Jane Codd
Keyword(s):  
Blood Culture ◽  
Positive Culture ◽  
Blood Cultures ◽  
Patient Treatment ◽  
Contamination Rate ◽  
Negative Consequences ◽  
Total Blood ◽  
Improvement Project ◽  
Competency Training ◽  
The Impact

Background: Blood culture is an important investigation in diagnosing sepsis. Positive culture helps to tailor therapy and is crucial in antimicrobial stewardship (AMS). However, positive blood culture does not always denote a bloodstream infection. Sometimes, false-positive results occur because of contamination from organisms outside the bloodstream, leading to significant negative consequences to patient treatment decisions and financial implications. Rates of blood culture contamination vary widely (0.6%–6%) between organizations, and although it is very difficult to eliminate contamination, it can be minimized. Our hospital group has multiple sites including emergency departments (EDs). We have been intermittently monitoring blood culture contamination rates since 2008, which decreased from 6.8% to 4.8% in 2009 but remained static when audited in 2010, 2012, and 2015. Objectives: To reduce our blood culture contamination rate further by targeting 2 busy EDs and by introducing continuous surveillance of blood culture contamination across 3 hospitals beginning in April 2016. Methods: In 2015, for the first time, blood culture contamination rates for both EDs, based in 2 different hospitals, were calculated. The ED results were communicated to the healthcare workers (HCWs), who agreed to establish a continuous surveillance of blood culture contamination and to participate in a reduction plan. Competency training was conducted according to training needs analysis. For example, phlebotomists were trained to ensure the use of the appropriate blood culture kit and educational sessions were tailored to staff groups. The blood culture contamination rate was monitored from April 2016 to March 2019 for 3 hospitals and both EDs to determine the impact of various measures introduced during this time. Results: In 2015, contamination rate of the 3 hospitals was 4.07%, and 10.2% of total blood cultures flagged positive. Also, 25% of blood cultures were requested from Eds, but these samples comprised 54% of the total contamination. The contamination rates for EDs A and B were 7.4% and 10.6%, respectively, which were significantly higher than the overall rate. From April 16 to March 19, there was 22% increase in total blood cultures performed. Results were analyzed quarterly. In total, 8,525 blood culture sets were received in January–March 2019; of these, the EDs contributed 2,799 sets (32.8%). The total blood culture contamination rate in January–March 2019 decreased to 3.1%. Both EDs A and B showed decreases in their contamination rates to 5.5% and 7.4%, respectively, in 2018–2019. The quarterly decreases were 5.2% and 4.9% in January–March 2019. Conclusions: The emphasis on the sepsis pathway probably led to year-on-year increases in total blood culture sets. Both ED blood culture contamination rates decreased. Consistent efforts in education, training, ensuring competency to various HCW groups, and provision of adequate blood culture kits are important for sustaining these improvements.Funding: NoneDisclosures: None

EP.TU.653Improving surgical admission clerking by introducing a standardized clerking proforma: a quality improvement project

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Georgios Geropoulos ◽  
Clio Kennedy ◽  
Stanley Tang ◽  
Ahmed Elhamshary ◽  
Sara Rakhshani-Moghadam ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Care Providers ◽  
Quality Improvement Project ◽  
Surgical Patient ◽  
Care Providers ◽  
Allied Health Professionals ◽  
Improvement Project ◽  
Operative Care ◽  
Detailed Medical History ◽  
Before And After

Abstract Aims When clerking new admissions several critical actions must be performed in a timely and accurate way. These include reviewing referral letters, obtaining a detailed medical history and documenting the patient’s plan. This is of paramount importance, especially in high volume surgical hospitals. The aim of this quality improvement project is to evaluate a standardized electronic proforma for surgical patient clerking in an attempt to minimize missing information that can compromise peri-operative care. Methods A short questionnaire assessing the clerking process was handed out to doctors and allied health professionals. It was completed before and after the introduction of the clerking proforma. Proportion confidence intervals (95% CI) compared for each answer before and after the proforma releasing. Results Domains with a statistically significant improvement were the admission reason, management, treatment escalation and venous thromboprophylaxis plan in patients on long term anticoagulation. After introduction of the proforma, feedback still implied that the social history needed to be more extensive. Further edits to the proforma in a second cycle include prompts regarding baseline function and ADLs, as well as existing packages of care. Conclusions Overall, the introduction of the surgical patient clerking proforma lead to an improvement of the quality of the clerking as assessed by standardized questionnaires. It is noteworthy that a complete clerking is correlated with more effective handover between health care providers, less medical errors, less treatment delays and improved patient outcomes.

CODE FAST: a quality improvement initiative to reduce door-to-needle times

2015 ◽  
Vol 8 (7) ◽  
pp. 661-664 ◽  
Author(s):  
Leslie Busby ◽  
Kumiko Owada ◽  
Samish Dhungana ◽  
Susan Zimmermann ◽  
Victoria Coppola ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Univariate Analysis ◽  
Substantial Reduction ◽  
Heart Association ◽  
Time Of Day ◽  
Quality Improvement Project ◽  
Quality Improvement Initiative ◽  
Improvement Project ◽  
Process Improvements ◽  
Before And After

BackgroundRapid delivery of IV tissue plasminogen activator (tPA) in qualifying patients leads to better clinical outcomes. The American Heart Association has reduced target door-to-needle (DTN) times from 60 to 45 min in the hopes of continued process improvements across institutions.ObjectiveTo start a quality improvement project called CODE FAST in order to reduce DTN times at our institution.Materials and methodsWe retrospectively reviewed data from our internally maintained database of patients treated with intravenous tPA before and after implementation of the CODE FAST protocol. We assessed demographic information, time of day and times of arrival to first image and delivery of tPA in patients from February 2014 to February 2015. Outcomes were assessed based on discharge to home. Univariate analysis was performed to assess for improvement in DTN times before and after implementation of the protocol.ResultsA total of 93 patients (41 pre-CODE FAST and 52 post-CODE FAST) received IV tPA during the study period. Patients were equally matched between the two groups except that in the pre-CODE FAST era patients receiving tPA were younger and more likely to be men. There was a substantial reduction in door-to-imaging time from a median of 16 to 8 min (p<0.0001) and DTN time with a reduction in the median from 62 to 25 min (p<0.0001). In logistic regression modeling, there was a trend towards more discharges to home in patients treated during the CODE FAST era.ConclusionsWe present a quality improvement project that has been overwhelmingly successful in reducing DTN time to <30 min. The template we present may be helpful to other institutions looking to reduce their DTN times and may also reduce costs as we note a trend towards more discharges to home.

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