PC1219: Blood Culture Contamination: Yes, Together We Can Decrease Them

Purpose/Objectives:

Introduction: Blood culture contamination [BCC] occurs due to injection of bacterial skin flora during blood collection resulting in false positive blood cultures. It is associated with longer hospital stay, excessive antibiotics use, and potential adverse effect of antibiotics [e.g. Vancomycin use]. Our hospital records showed high BCC among pediatric patients [3.4%] above national benchmark [3%]. Purpose of this Quality Improvement [QI] was to decrease BCC in our hospital. High BCC was presumed to be related to decreased time for cleaning site, touching venipuncture site after cleaning, and obtaining sample from non-peripheral sticks [like arterial catheter, preplaced Intravenous Line unless clinically indicated].

Design/Methods: Method: BCC was defined as any blood culture positive to skin flora during 1/1/2019 to 12/31/2019. Standardized checklist was made to ensure proper blood culture site cleaning, drying, applying tourniquet, making aseptic field using sterile towel, using sterile gloves, prompt delivery of samples to laboratory. The procedure was supervised by second observer using a checklist. Training to Emergency Department personnel and laboratory phlebotomist were provided initially and periodically. Data from January to July was before intervention and August to December was after standardized checklist intervention.

Results:

Results: Total BCC decreased from 3.4 % [99/2940] to 2.2% [52/2406] after intervention [p 0.004 < 0.05]. Decrease in BCC was more pronounced among Blood drawn by Laboratory Phlebotomist [49/1582] 2.6 % to [19/1485] 1.3% with intervention [ p-value 0.0003 < 0.05]. BCC by Emergency Department Personnel also decreased from 49/ 1097 [4.5%] to 33/921 [3.6%] with intervention [p-value 0.15 > 0.05] but did not reach statistical significance.

Conclusion/Discussion:

Conclusion: Systematic approach helped us decrease BCC below national benchmark and prevent potential morbidities.