Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Document Type

Presentation

Abstract

Introduction: Blood cultures (BCs) are a vital diagnostic tool for sepsis in patients with a suspected infection. Emergency departments are the primary place where BCs are drawn, but the BC contamination rates in emergency departments are the highest and most varied in healthcare. This project’s goal was to decrease the BC contamination rate below 3% (the national benchmark for BC contamination) in an ED in the Southeastern region through the implementation of a blood culture collection toolkit.

Methods: The best practices for reducing the BC contamination rate in the emergency department was determined through a thorough literature review. A cost-effective, evidence-based plan was formed to utilize emergency department resources more effectively to decrease the BC contamination rate. The BC toolkit consisted of nursing education on proper BC collection, monthly aggregate level feedback in the ED, and packaged BC collection kit.

Results: The monthly contamination rates were 3.6%, 1,7%, and 2.1% respectively during the 3-month implementation of the project. This emergency department had not had two consecutive months with contamination rates less than 3% in 3 years prior to this project. When compared to the corresponding 3 months from the previous year, there was a statistically significant decrease in the BC contamination rates during implementation. There was a clinically significant decrease in the BC contamination rates when compared to the 3 months immediately before implementation.

Discussion: As evidenced by the results of this project, emergency departments can decrease BC contamination rates to meet the national benchmark of 3% through a well-structured strategy. Further, this can be accomplished at no additional cost to the emergency department. The cost-effective nature of this project combined with a strong sense of teamwork will lead to sustainable change in emergency departments to consistently improve the quality of care given to patients.

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