Improving blood culture collections in the emergency department

The bugs in bottles project

Grant ID: EMSS-400R30-2018- Williams

Project Summary

The primary aim of this study is to assess the effectiveness of an intervention designed to improve the quality of blood cultures collected in a busy emergency department.

Blood cultures are tests that are frequently ordered by emergency doctors to detect and identify bacteria present in the blood of patients who are unwell. The test requires a sample of blood to be collected from the patient. Like many tests, the quality of the results is related to the quality of the sample collection process.

Several factors may influence the quality of sample collection and increase the chance of sample contamination. These include not collecting enough blood and poor sterility of the collection process. Contamination of blood cultures may result in the patient staying longer in hospital, being prescribed unnecessary antibiotics and increasing the costs of care.

This study will implement a rigorous intervention to reduce contamination rates in blood culture samples collected at the Emergency and Trauma Centre at the Royal Brisbane and Women’s Hospital. The intervention comprises: education to staff that collect blood cultures; the introduction of blood culture collection kits; and regular feedback of quality indicators to the clinicians that collect blood cultures.

If successful, a reduction in blood culture contamination rates and single sets of cultures should be seen, and the average volume of blood cultured should increase. These outcomes may help to reduce patient length of stay, cost of care, with positive effects in anti-microbial stewardship and patient flow.

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Outcomes

This study has shown that a multifaceted intervention aimed at clinicians can increase the adherence to standarised blood culture collection and improve key metrics in the emergency department. The quality of the blood culture collection can significantly impact on the quality of the results obtained.

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Video/Presentations

- Hills A., Ray M., Hughes J.A., Dixon M., Greenslade J., Harper J., Williams J., Turning up the volume on suboptimal blood culture collection practices, International Conference for Emergency Nursing, October 2019, Adelaide. (Oral)

- Hills A., Ray M., Hughes J.A., Dixon M., Duncan, J., Greenslade J., Harper J., Williams J., Patient factors influencing the quality of blood culture collection in the adult emergency department, International Conference for Emergency Nursing, October 2019, Adelaide. (Oral)

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