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Lee, Kim, and Kim: Educational Intervention to Improve Blood Culture Indicators in a Secondary-Care Hospital
Original Article

Ann Clin Microbiol 2021;24(1):1-9.

Published online: 30 March 2021

DOI: https://doi.org/10.5145/ACM.2021.24.1.1

Educational Intervention to Improve Blood Culture Indicators in a Secondary-Care Hospital

Seungjun Lee1, Seong Chun Kim2, Sunjoo Kim1, 3, *

1Department of Laboratory Medicine, Gyeongsang National University Changwon Hospital, Korea

2Departments of Emergency Medicine, Gyeongsang National University College of Medicine, Jinju, Korea

3Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea

Corresponding author: Sunjoo Kim E-mail: sjkim8239@hanmail.net

Received 23 March 2020       Revised 27 April 2020       Accepted 28 April 2020

© Korean Society of Clinical Microbiology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/.

Abstract

Background: Blood culture is essential for diagnosis of sepsis. However, usually the available blood volume is not sufficient to meet the guidelines. Thus, periodic monitoring and feedback are essential to improve the quality of blood cultures. Methods: We analyzed blood cultures requested between November 2018 and June 2019, and provided educational intervention and coaching for phlebotomists at the end of February 2019. Then, we evaluated the impact of education on blood cultures in a secondary­­­­­‑­care hospital. Blood volume, positive rate, contamination rate, and time to detection (TTD) were compared between the pre- (November 2018 to February, 2019) and post-intervention periods (March to June, 2019). Results: The average blood volume increased significantly from 5.4 mL to 7.1 mL (P < 0.0001) (35.2%) after intervention. Accordingly, the proportion of optimal blood volume (8–12 mL) increased from 9.1% to 37.8% (P < 0.0001). Before the intervention, the positivity rate was 9.6% and the contamination rate was 0.5%, whereas after the intervention, the positivity rate decreased to 9.1% and the contamination rate increased to 1.1%. TTD improved from 14.7 hours to 13.1 hours (P = 0.0420). Conclusion: The educational intervention of the phlebotomy team improved the quality of blood cultures, especially blood volumes and TTD. However, the positivity rate did not increase, suggesting that it is affected not only by the blood volumes but also by the severity of the underlying illnesses of the patient in a secondary-care hospital.

Keywords: Bacteremia, Blood culture, Blood volume, Educational intervention, Quality improvement


CONFLICTS OF INTEREST

No potential conflicts of interest relevant to this article were reported.

REFERENCES

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Table 1
Comparison of indicators of blood cultures between pre- and post- educational intervention period
acm_2401_001-t1.png

Number of bottles weighted by a scale was 1,725 during pre-intervention and 8,492 during post-intervention.*Optimal blood volume is defined as 8 – 12 mL per bottle.Abbreviation: IQR, interquartile range.

Table 2
Comparison of indicators of blood cultures between emergency medical technicians and laboratory technicians
acm_2401_001-t2.png

Abbreviation: ICU, intensive care unit.

Fig. 1.
Fig. 1. Distribution of blood volume in blood culture bottles. The optimal volume (8–12 mL) accounted for (A) 9.1% in pre-interventional period and (B) 37.8% in post-interventional period.
acm_2401_001-f1.png
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