HH prompt and monitoring systems seem to improve compliance but improvements may be undermined by practitioner irritation and system gaming.

Objectives: To reduce the contamination rate of blood cultures taken in the Accident and Emergency (A&E) department. Methods: The standard blood culture sampling kit was supplemented with an instruction sheet on the optimal method for drawing blood cultures and a large 62% ethyl alcohol impregnated wipe.Results: There was a statistically significant reduction in the number of contaminants (p = 0.03). Conclusions: Simple measures to encourage skin disinfection and appropriate sampling technique will reduce the incidence of contamination of blood cultures in the A&E department.T he usefulness of blood cultures taken in the Accident and Emergency department (A&E) remains open to question. In two A&E based studies only 1.6% of blood cultures taken in one study had an impact on the management of patients 1 and in another only 0.52% potentially had their medical management affected by the positive blood culture results. 2Contamination of blood cultures is also a common problem and false positive results due to contaminants may lead to errors both in clinical interpretation and administration of inappropriate treatment. There are several problems in A&E which may contribute to high contamination rates of blood cultures-these include a rapid turnover of staff, lack of ongoing training, workload, and the nature of the presenting patients. Our study shows the effect that the provision of information on skin decontamination has on the contamination rate in A&E. METHODSThe infection control team, in partnership with the A&E consultant staff, introduced a blood culture sampling kit. This contained BacT/ALERT (Biomerieux, Basingstoke, Hants, UK) sampling bottles but the bottles were placed in a polythene sleeve with enclosed pocket size instructions on how to take blood cultures (fig 1) and a large 62% ethyl alcohol impregnated wipe (Purell, Gojo Industries, Arkon, OH, USA) for cleaning the patient's skin before venepuncture.The medical and nursing staff in A&E were instructed on how to use the blood culture kits but no additional formal training was given on venepuncture. The interventions were timed to occur in the middle of the junior doctors' rotation period to minimise the effect that staff changes may have had on the study.The request form was marked in order to allow the laboratory to identify which blood culture samples had been collected using the kit method. Bacteria were identified using standard microbiological techniques. A blood culture contaminant was defined as a usual skin organism that was isolated from only one set of blood cultures in a patient with no evidence of an infection with that organism. RESULTSIn the month before the intervention 50 sets of blood cultures were taken, 35 (70%) had no bacterial growth, three (6%) were judged to have significant growth, and 12 (24%) were judged to contain contaminants. In the month following the intervention 50 sets of blood cultures were also taken; 37 (74%) had no bacterial growth, nine (18%) were judged to have significant growth, and four (8%) were judged to con...

No abstract

No abstract

No abstract

The NHS strives to create and promote a safe environment for patient care in which risks are minimised. Urinary catheterisation is a common healthcare procedure but it is an invasive intervention that carries the risk of infection. Evidence-based guidelines have been developed to minimise the risks associated with these devices and to allow healthcare professionals to implement best practice at all times. This article looks at evidence-based guidance and technological innovations aimed at reducing infection risks and improving patient outcomes.

Objective: To investigate the contamination of blood pressure cuffs on medical, surgical, paediatric and intensive care areas in a university teaching hospital. Design: A comprehensive, prospective study quantitatively and qualitatively evaluating the bacterial contamination on blood pressure cuffs of 100 sphygmomanometers in use in ten hospital units from June through to July 2007. Setting: A university teaching hospital with medical, surgical, paediatric and intensive care units. Results: The inner sides of the cuffs were found to harbour more organisms (97%) compared to the outer surface (89%). The inside also had a much higher level of contamination, 29% having >100 colony forming units (cfu) compared to only 8% with >100cfu on the outer surface. On average most cuffs were found to have organisms in the 10—100 cfu range. The most heavily contaminated cuffs (>100cfu) were found on the general intensive care unit. Coagulase negative Staphylococcus was the most commonly isolated organism, found in 67% of samples.

he culture of micro-organisms from blood is an essential laboratory test for the diagnosis of bacteraemia. Early positive results provide valuable diagnostic information on which appropriate antimicrobial therapy can be initiated. Like any tests, however, false-positive blood culture results can limit the utility of this important tool. These false-positive results arise due to contamination. Reports from NHS trusts and equipment suppliers suggest these contamination rates could be as high as 10 % ( Department of Health (DH), 2007) . A variety of strategies have been investigated and employed to decrease contamination rates. This article describes the utility of a variety of approaches to reduce the number of false-positive percutaneous blood cultures specifi cally in the adult population. Abstract Tat RUTGERS UNIV on April 13, 2015 bji.sagepub.com Downloaded from