5.00
Hdl Handle:
http://hdl.handle.net/10755/344158
Category:
Abstract
Type:
Poster
Title:
Contaminated Blood Cultures: Avoiding Unnecessary Cost & Improving Outcomes
Author(s):
Glidden, Michele; Coke Kirby,Tiffany; Ingle, Greg; Wornhoff, Brandee
Lead Author STTI Affiliation:
Non-member
Author Details:
Michele Glidden, RN, CEN, mlglidd@hendricks.org; Tiffany Coke Kirby, RN; Greg Ingle, BA, BSN, RN; Brandee Wornhoff, MSN, RN, CNS-BC
Abstract:
Evidence-based Practice Abstracts Purpose: Does standardization of the process of specimen collection improve contamination rates as compared with previous practices among Emergency Department patients with suspected infection requiring blood cultures? Design: In 2011, the percent of contaminated blood cultures was trending upward dangerously near exceeding the national benchmark of <3%. Using the Iowa Model for Evidence-based Practice a problem-focused trigger was identified. All the potential etiologies for the upward trend were examined and a process improvement project was undertaken regarding this quality measure. Setting: This process improvement was undertaken in a 23 bed suburban emergency department seeing approximately 30,000 visits per year staffed by 8 physicians, 3 physician assistants, 40 RN’s, 7 EMT-P’s and 16 unlicensed personnel. Participants/Subjects: The participants originated from a convenience sample of Emergency Department staff members who perform blood culture specimen collection. No other inclusion/exclusion criteria were used with this inquiry. Methods: A written open-ended baseline survey about blood culture drawing practices was administered to the participants. After the results were compiled and reviewed, it was determined there were a multitude of practices for obtaining blood cultures within the Emergency Department. An educational poster intervention addressing best practices, standardization, and the quality measure was circulated and participation was validated. In addition, laboratory quality assurance data was collected and reviewed throughout. Results/Outcomes: The baseline, open-ended survey results indicated variability likely contributing to contamination. These included a tendency by staff members to tie up IV supplies, blood tubes and blood culture bottles in a protective plastic sheet kit. These homemade kits were being made up and left on the counter in the med-prep room, and/or out on desks possibly for hours before use. Blood culture bottles were also likely being contaminated when placed on a patient’s bed prior to being drawn. There was also a discrepancy with too little or too much blood being instilled into the culture bottles. The blood culture contamination rate from the lab quality assurance data for the Emergency Department was as high as 2.7% in the 3rd quarter of 2011. After the educational intervention to standardize the process of specimen collection at the end of the 4th quarter 2011, the contamination rates dropped dramatically starting in January 2012 to 1.5%. Rates have shown sustained improvement to date, with a notable contamination rate of 0% achieved in October 2012. According to several published sources, blood cultures carry an associated cost of approximately $8,000. With 113 contaminates occurring in 2011, the cost to the facility was approximately $904,000. After education and standardization of specimen collection, the rate dropped to 52 contaminates in 2012, incurring a cost of approximately $416,000. In terms of overall outcome, the costs avoided by this process improvement project totaled approximately $488,000. Implications: There is wide-spread satisfaction about the associated benefits this project has on patients. Appropriate antibiotics are expected to be selected and hospital length-of-stay may decrease. The ongoing goal is to sustain the improvement and consider targeting and sustaining a higher performing benchmark.
Keywords:
Contaminated Blood Cultures
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleContaminated Blood Cultures: Avoiding Unnecessary Cost & Improving Outcomesen_GB
dc.contributor.authorGlidden, Micheleen_GB
dc.contributor.authorCoke Kirby,Tiffanyen_GB
dc.contributor.authorIngle, Gregen_GB
dc.contributor.authorWornhoff, Brandeeen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsMichele Glidden, RN, CEN, mlglidd@hendricks.org; Tiffany Coke Kirby, RN; Greg Ingle, BA, BSN, RN; Brandee Wornhoff, MSN, RN, CNS-BCen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344158-
dc.description.abstractEvidence-based Practice Abstracts Purpose: Does standardization of the process of specimen collection improve contamination rates as compared with previous practices among Emergency Department patients with suspected infection requiring blood cultures? Design: In 2011, the percent of contaminated blood cultures was trending upward dangerously near exceeding the national benchmark of <3%. Using the Iowa Model for Evidence-based Practice a problem-focused trigger was identified. All the potential etiologies for the upward trend were examined and a process improvement project was undertaken regarding this quality measure. Setting: This process improvement was undertaken in a 23 bed suburban emergency department seeing approximately 30,000 visits per year staffed by 8 physicians, 3 physician assistants, 40 RN’s, 7 EMT-P’s and 16 unlicensed personnel. Participants/Subjects: The participants originated from a convenience sample of Emergency Department staff members who perform blood culture specimen collection. No other inclusion/exclusion criteria were used with this inquiry. Methods: A written open-ended baseline survey about blood culture drawing practices was administered to the participants. After the results were compiled and reviewed, it was determined there were a multitude of practices for obtaining blood cultures within the Emergency Department. An educational poster intervention addressing best practices, standardization, and the quality measure was circulated and participation was validated. In addition, laboratory quality assurance data was collected and reviewed throughout. Results/Outcomes: The baseline, open-ended survey results indicated variability likely contributing to contamination. These included a tendency by staff members to tie up IV supplies, blood tubes and blood culture bottles in a protective plastic sheet kit. These homemade kits were being made up and left on the counter in the med-prep room, and/or out on desks possibly for hours before use. Blood culture bottles were also likely being contaminated when placed on a patient’s bed prior to being drawn. There was also a discrepancy with too little or too much blood being instilled into the culture bottles. The blood culture contamination rate from the lab quality assurance data for the Emergency Department was as high as 2.7% in the 3rd quarter of 2011. After the educational intervention to standardize the process of specimen collection at the end of the 4th quarter 2011, the contamination rates dropped dramatically starting in January 2012 to 1.5%. Rates have shown sustained improvement to date, with a notable contamination rate of 0% achieved in October 2012. According to several published sources, blood cultures carry an associated cost of approximately $8,000. With 113 contaminates occurring in 2011, the cost to the facility was approximately $904,000. After education and standardization of specimen collection, the rate dropped to 52 contaminates in 2012, incurring a cost of approximately $416,000. In terms of overall outcome, the costs avoided by this process improvement project totaled approximately $488,000. Implications: There is wide-spread satisfaction about the associated benefits this project has on patients. Appropriate antibiotics are expected to be selected and hospital length-of-stay may decrease. The ongoing goal is to sustain the improvement and consider targeting and sustaining a higher performing benchmark.en_GB
dc.subjectContaminated Blood Culturesen_GB
dc.date.available2015-02-04T11:27:32Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:32Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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