Quality improvement of blood cultures by educational intervention

Abstract

Background: Blood culture is the most valuable test in diagnosis of bloodstream infection. Periodic monitoring and intervention of blood culture practice is important on quality improvement of blood culture. We provided an educational intervention program on phlebotomists and evaluated the impact on blood cultures. Methods & Materials: We analyzed 18,651 blood culture bottles obtained between November 2018 and June 2019. Educational intervention was provided for the phlebotomists to improve quality of blood cultures since March 2019. We divided the study period as “baseline period” and “intervention period” according to educational intervention. We evaluated true positive rate, contamination rate, blood volume, time to detection, and turnaround time of organism identification. Results: In baseline period, the true positive rate was 7.9% and contamination rate was 0.5%. After intervention, the positive rate decreased to 6.1% and contamination rate was 0.7%. The blood volume was significantly increased from 5.4 mL to 7.3 mL (P < 0.0001) after intervention. Similarly, the proportion of optimal blood volume (8–12 mL) increased from 9.1% to 39.4% (P < 0.0001). Time to detection (TTD) and turnaround time (TAT) of organism identification was improved from 14.9 h to 13.1 h (P = 0.0478) and 82.4 h and 73.5 h (P = 0.0482), respectively. Conclusion: Educational intervention of phlebotomy team could influence the quality of blood cultures, especially blood volume. Accordingly, improved blood volume shortened TTD and TAT of identification. Therefore, educational intervention is a key element in quality improvement of blood cultures.