Hospital Food Safety and Regulatory Surveillance: Ensuring a Successful Survey

Abstract

ISSUE: Blood cultures are an important diagnostic tool used for the diagnosis of bloodstream infection and help provide source and organism information for appropriate treatment. Contaminated blood cultures can increase adverse events and costs due to unnecessary admission to hospital, increased length of stay, unwarranted antibiotics, treatment side effects, and potential for antimicrobial resistance. Blood cultures collected from our Emergency Department (ED) had unacceptable contamination rates of 5 percent (%) to 9 percent (%). PROJECT: Current practice for blood culture collection was examined by multi-disciplinary team of experts from Infection Prevention, Medical Laboratory, and Emergency Department. A change in practice was implemented to collect blood cultures from separate individual peripheral venipunctures. A 3.15% chlorhexidine/70% alcohol (Prevantics ) swabstick antiseptic was selected for skin antisepsis prior to collection to replace the former 2% chlorhexidine/70% alcohol (Chloraprep FREPP ) product. Nursing staff and phlebotomists were trained to scrub the patient’s skin using a back/ forth friction scrub for thirty (30) seconds, followed by thirty (30) seconds dry time prior to performing venipuncture. RESULTS: The blood culture contamination rate decreased from 9.73% to 1.19% which represents an 87.8% decrease in the Emergency Department’s blood culture contamination rate. The hospital’s total blood culture contamination rates remain below the 2% goal in all peripheral blood cultures throughout the facility after hospital wide implementation of new skin antiseptic product and collection practice changes. LESSON LEARNED: Following best practice for blood culture collection can decrease blood culture contamination. Using an effective and easy to use antiseptic for skin antisepsis prior to independent peripheral site blood culture collection proved to be best practice in our facility.