Effectiveness of multimodal intervention to improve blood culture collection in the emergency department

• Published in: Journal of global infectious diseases Vol. 14; no. 1; pp. 10 - 16
• Main Authors: Shaji, Rosemary, Madigubba, Haritha, Priyadarshi, Ketan, Anandh, P, Nathan, Balamurugan, Vivekanandan, M, Sastry, Apurba
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2022; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: a quality improvement; Blood; blood cultures; blood stream infection; contamination; emergency department; Emergency service; Hospitals; Medical examination; Original; phlebotomist; Canada; A quality improvement; phlebotomist; emergency department; blood cultures; blood stream infection; contamination
• ISSN: 0974-777X; 0974-8245
• DOI: 10.4103/jgid.jgid_138_21

Introduction: The blood culture (BC) contamination was a significant problem in our hospital, especially in the emergency department (ED). The study, therefore, was undertaken to improve the BC collection in the ED. Methods: The study was conducted for 1 year divided into two phases of 6 months each: Preintervention phase and intervention phase (regular and phlebotomist groups). The interventions comprised implementing standard protocol for BC collection and conducting educational sessions. In preintervention and regular groups, the BCs were collected by interns and technicians, while dedicated phlebotomist did so in the phlebotomist group. Data were analyzed and interpreted for the contamination rate as well as compliance in adequate filling of the requisition form. Statistical Package for the Social Sciences (SPSS) version 22. A value of P < 0.005 was considered statistically significant, and P < 0.01 was considered statistically significant. Results: In the preintervention group, 13.7% of specimens were reported as contaminated which was reduced to 4.2% and 3.2% in the regular and phlebotomist group, respectively, after intervention. Compliance of health-care workers to various elements of BC collection protocol was also found to be significantly improved in the intervention phase compared to the preintervention phase (P < 0.001). Conclusions: Implementation of this multimodal intervention resulted in a drastic reduction in BC contamination and improvement in compliance to BC collection protocol and filling of various parameters in the BC requisition form, thus improving the overall effectiveness of BC testing. It was also noted that the contamination rate was further reduced by implementing dedicated phlebotomist.