Conner, Victoria, BSN, RN

Hynes, Victoria, BS, BSN, RN

Kahr, Alyssa, BSN, RN

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingChanging the Culture of Blood CultureContaminationVictoria Conner BSN, RNLehigh Valley Health Network, Victoria.Conner@lvhn.orgVictoria Hynes BS, BSN, RNLehigh Valley Health Network, Victoria.Hynes@lvhn.orgAlyssa Kahr BSN, RNLehigh Valley Health Network, Alyssa.Kahr@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtConner, V. Hynes, V. Kahr, A. (2018, July 12). Changing the Culture of Blood Culture Contamination. poster presented at: LVHNVizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA.© 2014 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaChanging the Culture of Blood Culture Contamination• February 2018 LVHN CC ED blood culture contamination rate is 4.6%, LVHN hospital wide goal is < 3.0% contamination rate in blood cultures• Blood culture contamination can lead to unnecessary and sometimes incorrect treatment, leading to increased cost for both the hospital and the patient (Gander, 2009)• Reeducation was provided to technical partners and nurses in the Emergency Department • “Bucket rounding” and a Power Point were used throughout all shifts to educate and demonstrate proper techniques and track the staff members who received education– “Bucket rounding” is a common form of education in the Emergency Department. Educators present information to staff while checking understanding of the material. Additionally, staff will receive a snack for their time.• A sample blood culture kit was used during bucket rounding to allow for hands on learning and return demonstration• Education included points such as:o Blood cultures should never be drawn from a preexisting intravenous lineo Technical partners should be the first choice to draw cultures using peripheral phlebotomy o Blood culture draws should be attempted from the opposite arm if an intravenous line is already present, or should be drawn below the site• The initial contamination rate was 4.6% in February 2018 • The goal for the contamination rate post education was to be below the LVHN hospital wide goal of <3.0%• Post education contamination rate for May 2018 was 3.2%• Contamination rates decreased post education• Contamination rates tend to be higher at teaching hospitals, reeducation has been shown to decrease rates of contaminated blood cultures (Bentley, 2016)• Requiring a return demonstration during reeducation resulted in a decrease in contamination rates (Academy of Emergency Medicine, 2009) • Using 70% isopropyl alcohol followed by 10% providine-iodine prior to draw results in lower contamination rates (Wesley, 2014)• Providing regular feedback on contamination rates results in lower contamination rates (Gander, 2009)• Individual follow up from laboratory with specimen collector initiated• Investigation of the inclusion of sterile gloves in blood culture kit to further reduce contamination ratesVictoria Conner, BSN, RN; Victoria Hynes, BS, BSN, RN; Alyssa Kahr, BSN, RN; Moria Shepherd, BSN, RNBACKGROUNDEVIDENCEPROCESS/IMPLEMENTATION OUTCOMES/RESULTSNEXT STEPSREFERENCES• Bentley, James, et al. “A Change of Culture: Reducing Blood Culture Contamination Rates in an Emergency Department.” BMJ Quality Improvement Reports, British Publishing Group, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4915310/• Constance M. Bowen, Reducing blood culture contamination in the emergency department: It takes a team, Journal of Emergency Nursing 2016• Gander, Rita. “Impact of Blood Cultures Drawn by Phelbotomy on Contamination Rates and Health Care Costs in a Hospital Emergency Department.” Journal of Clinical Microbiology, 26 Jan. 2009.• Reducing Blood Culture Contamination in the Emergency Department: An Interrupted Time Series Quality Improvement Study, Acad Emerg Medicine, 30 Jan. 2013.• Wesley H, Cost Anaylsis of Strategies to Reduce Blood Culture Contamination in the Emergency Department: Sterile Collection Kits and Phlebotomy Teams, Infection Control Hospital Epidemiology, 2014 August

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