A multi-pronged approach to improve blood culture diagnostics in different clinical departments: a single-centre experience

Abstract

Purpose Blood culture (BC) diagnostics are infuenced by many factors. We performed a targeted interdisciplinary analysis to analyse efects of various measures on BC diagnostics performance. Methods A diagnostic stewardship initiative was conducted at two intervention and two control wards in a German tertiary level hospital. The initiative comprised staf training on the correct indications and sampling for BC, implementation of information cards, labels to identify the collection site, regular BC bottle feedback including the number of bottles, flling volumes and identifed pathogens; and the use of a specifc sampling device (BD Vacutainer®). Before and after the interventions, two three-month measurement periods were performed, as well as a one-month follow-up period to assess the sustainability of the conducted measures. Results In total, 9362 BC bottles from 787 patients were included in the analysis. The number of BCs obtained from peripheral venous puncture could be increased at both intervention wards (44.0 vs. 22.2%, 58.3 vs. 34.4%), while arterial sampling could be reduced (30.6 vs. 4.9%). A total of 134 staf members were fully trained. The intervention led to a considerable increase in BC knowledge (from 62.4 to 79.8% correct answers) with diferences between the individual professional groups. Relevant reduced contamination rates could be detected at both intervention wards. Conclusions As knowledge on the correct BC sampling and strategies to reduce contamination varies considerably between clinical departments and healthcare professionals, a targeted training should be adapted to the specifc needs of the individual professional groups. An additional flling device is not necessary.