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QUALITY IMPROVEMENT IN ACTION
Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 13-18

Reducing the rate of blood culture contamination in the emergency department of a university teaching hospital


1 Department of Pathology and Laboratory Medicine, College of Medicine, King Khalid University Hospital and King Saud University, Riyadh, KSA
2 Department of Health Systems and Quality Management, College of Public Health and Health Informatics, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, KSA; Department of Primary Care and Public Health, Imperial College London, UK

Correspondence Address:
Salma Alshamrani
Department of Pathology and Laboratory Medicine, College of Medicine, King Khalid University Hospital and King Saud University, Riyadh
KSA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JQSH.JQSH_5_18

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Objective: Blood culture is an important laboratory test to determine bacteremia in Fungemia in patient's blood. Frequent blood culture contamination (BCC) leads to unnecessary treatment, waste of laboratory resources, and false-positive blood culture. The College of American Pathologist Accreditation states that monitoring of BCC rate should be within average 2%–3%. Based on May 2015 to May 2016 data at King Khalid University Hospital, it showed that we had experienced a consistent increase in BCC rate with an average of 4.6%. Emergency department (ED) had the highest contamination rate (5.7%). The aim of this study was to reduce the rate of contamination to <2%. Methods: A multidisciplinary quality team has been formed, (IHI) the institute for healthcare improvement model, used for improvement and other relevant quality tools for testing and implementing the choice of solution. Several plan-do-study-act (PDSA) cycles have been conducted to test the proposed solutions. All PDSA cycle data on the project measures were extracted from the lab information system to be analyzed and presented on run and control charts. Results: Over a 6-month period, a reduction in the BCC rate at the emergency department (ED) of the University Hospital reached 1.5% compared with the baseline at 4.0%. There was a significant reduction in BCC in the adult ED, which reached zero rates. However, BCC in the pediatrics ED was reduced to 1.5%, resulting from changes that were proposed, tested, and implemented during the running period. Essentially, the results of this initiative both met and exceeded the benchmark by 2%–3%. Conclusion: Standardizing work processes based on updated policy and procedures, conducting regular audits, and sending feedback are practical evidence-based strategies that lead to reducing BCC in the ED.


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