Implementation of multiple strategies to reduce blood culture contamination

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Abstract Summary
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Authors (including presenting author) :
Radley Ching(1), Lee WM(1), Li SM(1), Cheung WS(1), Cheng WM(1), Yuen YT(1), Wong PY(1)
Affiliation :
(1) Infection Control Team, Princess Margaret Hospital, Kowloon West Cluster, HKSAR
Introduction :
Contaminated blood culture result or false-positive blood culture result may cause delay in diagnosis of patient and administration of appropriate treatment. In Princess Margaret Hospital, blood culture is collected by doctors and phlebotomists. It was found that the number of blood culture contamination significant increased in 2Q 2018 as compared with 1Q 2018 and the major contaminated results were collected by phlebotomist. In view of the situation, Infection Control team performed analysis and identified the possible contributing factors, then implemented a series of strategies aiming at reduction of the contaminated rate.
Objectives :
1. To reduce blood culture contamination rate 26% in 3Q 2018 in compare with 2Q 2018. 2. Reinforced phlebotomist on proper blood culture taking procedure and technique. 3. Benefit patient with quality of care through ensuring accuracy of blood culture technique and result.
Methodology :
1. Fostered the concept of phlebotomists on knowledge and proper blood culture taking procedure. 2. Reviewed the existing training practice for new recruited phlebotomists and blood culture collection practice. 3. Established hands-on training session on blood culture taking with video demonstration, return demonstration in a mimic bedside situation under ICN observation and immediate feedback. 4. Established effective monitoring system through real-time internal communication by email. Whenever contaminated result was detected, ICN will send email to phlebotomist team head for investigation. If a phlebotomist committed blood culture contamination for three times accumulatively, the phlebotomist should underwent re-assessment. 5. Established skills assessment tool (form) for peripheral blood culture collection as performance evaluation of phlebotomist.
Result & Outcome :
The blood culture contamination rate of 3Q 2018 (n=16) decreased 26 % in comparing with the rate of 2Q 2018 (n=27). The effectiveness of improvement strategies is significant.

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