Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings

Hall, Randon; Domenico, Henry J.; Self, Wesley H.; Hain, Paul D.

doi:10.1542/peds.2012-1030

Cited by 84 publications

(75 citation statements)

References 11 publications

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“…Además, se han descrito varios factores que influencian los indicadores como el tipo de personal que toma la muestra, el tipo de servicio y la vía de obtención de la muestra (periférica vs catéter) 22 . En el Reino Unido por ejemplo, en un hospital general universitario de 426 camas, Alahmadi y colaboradores 9 reportan un 4,7% de contaminación en los hemocultivos de pacientes de UCI, mientras que en el estudio de Hall y colaboradores 23 , realizado en el servicio de urgencias de un hospital pediátrico, la contaminación fue del 3,9%, durante la evaluación previa a la implementación de una intervención para la estandarización de la toma de muestras de hemocultivos por vía periférica.…”

Section: Discussionunclassified

Caracterización de los procedimientos para la realización de hemocultivos en pacientes adultos, en instituciones hospitalarias del Área Metropolitana del Valle de Aburrá.

Maldonado

Nagles

Robledo

et al. 2017

Infect

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Cómo citar este artículo: N. Maldonado, et al. Caracterización de los procedimientos para la realización de hemocultivos en pacientes adultos, en instituciones hospitalarias del Área Metropolitana del Valle de Aburrá. Infectio 2018; 22(1): 19-25 Resumen Objetivo: Caracterizar procedimientos para la toma, análisis, reporte y aseguramiento de la calidad en hemocultivos en pacientes adultos, en instituciones hospitalarias. Material y método: Estudio descriptivo en 15 hospitales de Medellín y alrededores. Se empleó un formulario semiestructurado para recolectar la información, se utilizó SPSS ® para el análisis. Resultados: Todas las instituciones tienen protocolos basados en fuentes de autoridad reconocida; con diferencias importantes en procesos pre-analíticos y postanalíticos. Los productos más empleados para la antisepsia fueron gluconato de clorhexidina al 2-4% (66,7%) y alcohol isopropílico o etílico al 70% (20,0%), con discrepancias en los tiempos de acción. El 73,3% emplea guantes estériles y la misma proporción usa sistema abierto (jeringa) para la venopunción. En el 46,6% se toman dos botellas aerobias y una anaerobia por episodio y en 33,3% dos botellas aerobias. El 66,6% lleva un indicador de contaminación, 53,3% de positividad y 26,6% de volumen de sangre. La tasa promedio de hemocultivos contaminados durante el semestre de seguimiento fue 1,61%. Conclusión: Se observa heterogeneidad en los procedimientos, especialmente en fases pre-analítica y post-analítica. En la búsqueda de la excelencia y la seguridad del paciente son necesarios protocolos estandarizados e indicadores para medir y controlar el desempeño de los hemocultivos. AbstractObjective: To characterize the procedures that are performed for the collection, analysis, reporting and quality assurance of blood cultures in adult patients in hospital institutions. Material and Methods: Descriptive study in 15 hospitals of Medellin and its surroundings. A semi-structured collection instrument was used to collect the information provided by each hospital; SPSS® was used for the analysis. Results: All institutions have protocols based on authorized sources; there were important differences in the pre-analytic and post-analytic processes. The products employed for skin antisepsis were 2-4% chlorhexidine gluconate (66.7%) and 70% isopropyl or ethyl alcohol (20.0%), with discrepancies in product action times. 73.3% use sterile gloves and an equal proportion uses an open system (syringe) for venipuncture. Two aerobic and one anaerobic bottles are taken per episode in adult patients in 46.6% of institutions and only two aerobic bottles in 33.3% of them. Indicators of contamination were used by 66.6 % of institutions, of positivity in 53.3% and of blood volume in 26.6%. The average rate of contaminated blood cultures during the follow-up period was 1.61%. Conclusion: Heterogeneity in the procedures was observed especially in the pre-analytic and post-analytical phases. In the pursuit of excellence and patient safety, standardized protocols and the use o...

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Section: Discussionunclassified

Caracterización de los procedimientos para la realización de hemocultivos en pacientes adultos, en instituciones hospitalarias del Área Metropolitana del Valle de Aburrá.

Maldonado

Nagles

Robledo

et al. 2017

Infect

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“…Developed countries invested very much in programs which intends to reduce the level of contaminations below 3% 8,21 . Because contaminated blood cultures may induce high costs of treatment, this problem should be taken seriously.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

et al. 2015

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BackgroundFalse-positive blood cultures findings may lead to a falsely increased morbidity and increased hospital costs. MethodThe survey was conducted as retrospective -prospective study and included 239 preterm infants (born before 37 weeks of gestation) who were treated in Neonatal Intensive Care Unit (NICU) in Institute for Child and Youth Health Care of Vojvodina during one year (January 1st, 2012 to December 31st, 2012). The retrospective part of the study focused on examination of incidence of neonatal sepsis and determination of risk factors. In the prospective part of the study infants were sub-divided into two groups: Group 1-infants hospitalized in NICU during the first 6 months of the study; blood cultures were taken by the ''clean technique'' and checklists for this procedure were not taken. Group 2-neonates hospitalized in NICU during last 6 months of the study; blood cultures were taken by ''sterile technique'' and checklists for this procedure were taken. ResultsThe main risk factors for sepsis were prelabor rupture of membranes, low gestational age, low birth weight, mechanical ventilation, umbilical venous catheter placement, and abdominal drainage. Staphylococcus aureus and coagulase negative Staphylococcus were the most frequently isolated microorganisms in false-positive blood samples. ConclusionsEducation of employees, use of checklists and sterile sets for blood sampling, permanent control of false positive blood cultures, as well as regular and routine monthly reports are crucial for successful reduction of contamination rates.

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“…Eğitim verilmesinin mali etkilerinin incelendiği bir çalışmada %3,9 (212/5402) olan yalancı pozitif sonuçların eğitim sonrasında %1,6'a (35/2153) gerilediği ve hastanenin bu gelişmeden yılda yaklaşık 250 bin dolar kazancının olduğu hesaplanmıştır [4]. Komplike olmayan selülitli çocuklar için kan kültürü alınmaması gerektiğinin belirtildiği diğer bir çalışmada, selülitin kan kültürü görülmeksizin kolaylıkla tedavi edilebileceği ve az sayıda bakteriyeminin tespit edilmemesi karşılığında ciddi bir mali kayıptan (tahminen yıllık 213 hasta için $42.850 dolar) kurtulunabileceği belirtilmiştir [8].…”

Section: İstatistiksel Analizunclassified

“…Kontamine kan kültürleri gereksiz tetkik, hastanede kalış ve antimikrobiyal tedavi başlanması ile maliyet artışı, antimikrobiyal direnç gelişimi ve antimikrobiyallerin komplikasyonları gibi istenmeyen sonuçlara neden olabilir [4].…”

Section: Introductionunclassified

Indications of Collecting Blood Culture and Necessity of Educations [Kan Kulturu Alma Nedenleri ve Egitimin Gerekliligi]

Şahin¹,

Şahin²,

Çayır³

et al. 2014

Med-Science

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Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings

Cited by 84 publications

References 11 publications

Caracterización de los procedimientos para la realización de hemocultivos en pacientes adultos, en instituciones hospitalarias del Área Metropolitana del Valle de Aburrá.

Caracterización de los procedimientos para la realización de hemocultivos en pacientes adultos, en instituciones hospitalarias del Área Metropolitana del Valle de Aburrá.

Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

Indications of Collecting Blood Culture and Necessity of Educations [Kan Kulturu Alma Nedenleri ve Egitimin Gerekliligi]

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