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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Quality Report

Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings

Randon T. Hall, Henry J. Domenico, Wesley H. Self and Paul D. Hain
Pediatrics January 2013, 131 (1) e292-e297; DOI: https://doi.org/10.1542/peds.2012-1030
Randon T. Hall
aDepartment of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, Tennessee;
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Henry J. Domenico
Departments of bBiostatistics and
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Wesley H. Self
cEmergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and
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Paul D. Hain
dDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
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Abstract

BACKGROUND AND OBJECTIVE: Blood culture contamination in the pediatric population remains a significant quality and safety issue because false-positive blood cultures lead to unnecessary use of resources and testing. In addition, few studies describe interventions to reduce peripheral blood culture contamination rates in this population. We hypothesized that the introduction of a standardized sterile collection process would reduce the pediatric emergency department’s peripheral blood culture contamination rate and unnecessary use of resources.

METHODS: A sterile blood culture collection process was designed by analyzing current practice and identifying areas in which sterile technique could be introduced. To spread the new technique, a web-based educational model was developed and disseminated. Subsequently, all nursing staff members were expected to perform peripheral blood cultures by using the modified sterile technique.

RESULTS: The peripheral blood culture contamination rate was reduced from 3.9% during the baseline period to 1.6% during the intervention period (P < .0001), with yearly estimated savings of ∼$250 000 in hospital charges.

CONCLUSIONS: Subsequent to our intervention, there was a significant reduction of the peripheral blood culture contamination rate as well as considerable cost savings to the institution. When performed in a standardized fashion by using sterile technique, blood culture collection with low contamination rates can be performed via the insertion of an intravenous catheter.

KEY WORDS
  • blood culture contamination
  • coagulase-negative staphylococcus
  • pediatric emergency department
  • Abbreviations:
    ED —
    emergency department
    IV —
    intravenous
    • Accepted August 14, 2012.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 1
    1 Jan 2013
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    Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings
    Randon T. Hall, Henry J. Domenico, Wesley H. Self, Paul D. Hain
    Pediatrics Jan 2013, 131 (1) e292-e297; DOI: 10.1542/peds.2012-1030

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    Reducing the Blood Culture Contamination Rate in a Pediatric Emergency Department and Subsequent Cost Savings
    Randon T. Hall, Henry J. Domenico, Wesley H. Self, Paul D. Hain
    Pediatrics Jan 2013, 131 (1) e292-e297; DOI: 10.1542/peds.2012-1030
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    Subjects

    • Hematology/Oncology
      • Hematology/Oncology
    • Emergency Medicine
      • Emergency Medicine

    Keywords

    • blood culture contamination
    • coagulase-negative staphylococcus
    • pediatric emergency department
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