Journal
QUALITY MANAGEMENT IN HEALTH CARE
Volume 32, Issue 1, Pages 40-45Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QMH.0000000000000381
Keywords
antimicrobial stewardship; blood culture contamination; infection control; ISO 9001; 2015; microbiology; quality improvement
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Blood culture contamination rates were successfully reduced through the implementation of a process-driven quality improvement program. Multiple methods were used, including reeducation and ongoing coaching of staff, reorganizing blood culture supplies, and adding multiple layers of supervision. Results showed a significant negative correlation between contamination rate and cumulative cost difference, indicating potential cost savings. The estimated value added to the institution through this initiative was approximately $215,743 to $228,543.
Background and Objectives:Blood cultures are vital diagnostic tests that detect harmful pathogens in a patient's bloodstream. In this study, we implemented a process-driven quality improvement program to reduce blood culture contamination rates. Methods:St Joseph Health (SJH) utilized the ISO 9001:2015 Internal Audit tool, failure mode effect analyses, and the Centers for Disease Control and Prevention's Hierarchy of Controls to identify opportunities for improvement and design effective corrective and preventive action plans. These actions included reeducation and ongoing coaching of staff on the blood culture collection process, reorganizing blood culture supplies on the nursing units, and adding multiple layers of supervision. Results:A statistically significant relationship was identified between 2 variables (contamination rate and cumulative cost difference). The 2 variables had a negative association, demonstrating that as the contamination rate decreased, the cumulative cost difference increased, indicating potential cost savings. Conclusion:The estimated value added to the institution through this initiative was approximately $215 743 to $228 543 in potential cost savings. SJH significantly reduced the number of blood culture contaminations in the critical care division, evidenced by a controlled 6-month mean below 1%. Review of the 6-month mean as a reference point demonstrated the sustainability of the implemented corrective and preventive measures.
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