Introduction: Seizing Control of Blood Culture Contamination Rates (02:06)
Contamination rates are one of the biggest problems laboratories face. Topics will include: blood culture necessity, bacteremia sources, the purpose of multiple sets, contamination costs, realistic goals, and strategies to reduce contamination rates.
Why Order Blood Cultures? (02:04)
Cultures rule in or rule out systematic infections. Sources of septicemia include: colonized intravascular devices and extravascular sources.
Why Multiple Sets? (03:37)
A single set of cultures has little predictive value; see a list of common blood culture contaminants and contamination indicators. Multiple sets may be timed, un-timed, or per fever.
Cost of Contamination (02:57)
Studies indicate that the cost per contaminated culture for inpatients range from $2,889- $8,720; patient stay can increase up to 3.3 days. Outpatient costs result in $152 per false positive culture; 26% of pediatric patients are hospitalized unnecessarily.
Cost Avoidance (03:53)
See a comparison of hospital costs per contaminated culture for emergency department patients and the cost avoidance of a third hospital when keeping contamination rates below 2%. Studies suggest that on average 10% of all blood cultures will be positive; 40% of those represent contaminants. See graphs of savings when reducing rates by one percent.
Your Contamination Rate: What Should We Target? (02:27)
The ASM states that the rate should not exceed 3%; experts recommend a target rate of 2%. See contamination rates in centralized vs. decentralized environments.
Seizing Control (01:04)
Knowledge of proper blood collection technique and the implementation of management strategies reduce the contamination rate.
Seizing Control: Collection Technique (09:38)
Chlorhexidine is the most widely used antiseptic for venipunctures. Hear recommendations for site prep, re-palpating, sterile glove use, stopper cleansing, specimen diversion, SPS tubes, and VADs.
Seizing Control: Management Strategies (02:15)
A CDC evidence review panel found two best practices for blood culture contamination rate reduction: venipuncture instead of a line draw and employing a dedicated phlebotomy team.
Seizing Control: Train (01:29)
Use the "train, track, and treat" methodology to reduce blood culture contamination rates. Train the phlebotomist first and then non-lab blood collection personnel in the six elements of collection technique.
Seizing Control: Track (02:33)
Monitor blood culture contamination rates by individual and department, and communicate the rate. Establish benchmarks for top and bottom performers.
Seizing Control: Treat (00:56)
Positive reinforcement is just as important as feedback. Feed an individual or department when blood culture contamination rates are trending downward.
Seizing Control: Admin. Support (02:54)
Learn tips for winning administration support for the "train, track, and treat" methodology to reduce blood culture contamination rates.
Seizing Control: Sustaining the Gains (01:52)
Keeping down blood culture contamination rates is ongoing and always necessary. Tips include: "train, track, treat;" employ best practices; eradicate other methods; communicate the rate; and employ revocation if necessary.
Rate Summary (01:31)
Review the elements of reducing blood culture contamination rates discussed in this video.
Additional Resources (01:01)
See additional resources on phlebotomy information.
Credits: Seizing Control of Blood Culture Contamination Rates (00:24)
Credits: Seizing Control of Blood Culture Contamination Rates
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