scholarly journals Evaluation of an intervention to decrease false positive blood culture contamination rates in Emergency Department

2016 ◽  
Vol 2016 (2) ◽  
pp. 89
Author(s):  
Parvathy Venugopal
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive

scholarly journals Blood Culture Contamination in a Community Hospital- less than 2% is achievable

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S127-S127
Author(s):  
R Bedi ◽  
J Atkinson
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Antimicrobial Therapy ◽  
False Positive ◽  
Community Hospital ◽  
Blood Cultures ◽  
Proper Order ◽  
Multiple Devices ◽  
American Society

Abstract Introduction/Objective Blood cultures are commonly obtained to evaluate the presence of bacteria or fungal infection in a patient’s bloodstream. The presence of living microorganisms circulating in the bloodstream is of substantial prognostic and diagnostic importance. A positive blood culture indicates a reason for the patient’s illness and provides the etiological agent for antimicrobial therapy. Collection of blood culture is an exact process that requires time, the proper order of draw, and following of correct protocol. The busy Emergency department that requires multiple demands for nurse’s time, turnover of staff, rushing from one task to another can result in the improper collection and false-positive blood cultures. The national benchmark is set at 3% by the American Society of Clinical Microbiology (ASM) and The Clinical and Laboratory Standard Institute (CLSI). False-positive blood culture results in increased length of stay and unnecessary antimicrobial therapy, resulting in an increased cost burden to the hospital of about $5000 per patient. Methods/Case Report At our 150-bed community hospital, 26 beds Emergency Department, we have come a long way in reduction of our blood culture contamination rates from upwards of 4% to less than 2%, far lower than the national benchmark. Results (if a Case Study enter NA) NA Conclusion There are multiple devices available from various manufacturers claiming to reduce blood culture contamination. These devices do reduce blood culture (BC) contamination but at an added cost of the device. The rate of BC can be reduced and less than 3% is achievable by materials available in the laboratory. We have achieved this by providing training to every new staff by demonstration and direct observation, providing everything required for collection in a kit, using proper technique, the inclusion of diversion method that involves the aseptic collection of a clear tube before collecting blood cultures, and following up monthly on any false positive blood cultures.

scholarly journals LO47: Use of C-reactive protein can safely decrease the number of emergency department patients with sepsis who require blood cultures

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S44
Author(s):  
R. Stenstrom ◽  
J. Choi ◽  
E. Grafstein ◽  
T. Kawano ◽  
D. Sweet ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Blood Cultures ◽  
Low Risk ◽  
Reactive Protein ◽  
Emergency Department Patients ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

Introduction: Sepsis protocols call for the acquisition of blood cultures in septic emergency department (ED) patients.However, the criteria for blood cultures are vague, they are costly, only positive 8-12% of the time, with up to half of these being false positives. The objective of this study was to establish if positive blood cultures could be excluded in low-risk sepsis patients with levels of CRP below 20 ml/L. Methods: This was a multicenter prospective cohort study of 765 ED patients at St Paul’s and Mount St Joseph’s hospitals in Vancouver with sepsis (2 or more SIRS criteria and infection) and none of: immuncompromised, injection drug use, indwelling vascular device or septic shock (SBP<90 mmhg). Consecutive patients with sepsis had CRP and blood cultures obtained at the same time.OUTCOMES. True positive blood cultures, false positive blood cultures, positive blood cultures that changed patient management. True and false positive blood cultures were based on Infectious Disease Society of America Guidelines, and change in management was defined as change in type or length of antibiotic therapy and was blindly adjudicated by a medical microbiologist. Results: 765 ED patients with sepsis met inclusion criteria. Mean age was 48.3 years and 57% were male. Blood cultures were positive in 99/765 (12.9%) subjects, of which 19 were false positive (19.2%). CRP was >20 mg/L in 595/765 (77.8%) of patients. Of 170 subjects with a CRP<20 mg/L, 3 had a positive blood culture (1.8%; 95% CI 0.1%- 5%). Management was not changed in any patient with a positive blood culture and CRP level<20 mg/L. Of 19 subjects with a false positive blood culture, CRP was <20 mg/L for 6 (31.6%). Conclusion: In this cohort of low-risk sepsis patients, based on a CRP of <20 mg/L, acquisition of blood cultures could be safely avoided in 22.2% of patients, at significant savings to the health care system.

scholarly journals Risk of bacteremia in patients presenting with shaking chills and vomiting - a prospective cohort study

2020 ◽  
Vol 148 ◽  
Author(s):  
M. Holmqvist ◽  
M. Inghammar ◽  
L. I. Påhlman ◽  
J. Boyd ◽  
P. Åkesson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Vital Sign ◽  
Bacterial Infections ◽  
Altered Mental Status ◽  
Negative Blood Culture ◽  
Multivariate Logistic Regression ◽  
Prospective Multicenter Study

Abstract Chills and vomiting have traditionally been associated with severe bacterial infections and bacteremia. However, few modern studies have in a prospective way evaluated the association of these signs with bacteremia, which is the aim of this prospective, multicenter study. Patients presenting to the emergency department with at least one affected vital sign (increased respiratory rate, increased heart rate, altered mental status, decreased blood pressure or decreased oxygen saturation) were included. A total of 479 patients were prospectively enrolled. Blood cultures were obtained from 197 patients. Of the 32 patients with a positive blood culture 11 patients (34%) had experienced shaking chills compared with 23 (14%) of the 165 patients with a negative blood culture, P = 0.009. A logistic regression was fitted to show the estimated odds ratio (OR) for a positive blood culture according to shaking chills. In a univariate model shaking chills had an OR of 3.23 (95% CI 1.35–7.52) and in a multivariate model the OR was 5.9 (95% CI 2.05–17.17) for those without prior antibiotics adjusted for age, sex, and prior antibiotics. The presence of vomiting was also addressed, but neither a univariate nor a multivariate logistic regression showed any association between vomiting and bacteremia. In conclusion, among patients at the emergency department with at least one affected vital sign, shaking chills but not vomiting were associated with bacteremia.

False-positive blood culture results in patients with hematologic malignancies

2019 ◽  
Vol 25 (5) ◽  
pp. 404-406
Author(s):  
Yasuhiro Ebihara ◽  
Kiyoko Kobayashi ◽  
Noriyuki Watanabe ◽  
Yoshitada Taji ◽  
Tomoya Maeda ◽  
...  
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Hematologic Malignancies

Implementation of the Theory of Planned Behavior to Promote Compliance with a Chlorhexidine Gluconate Protocol

2017 ◽  
Vol 22 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Christina Ryan
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Theory Of Planned Behavior ◽  
Medical Treatment ◽  
Patient Care ◽  
Planned Behavior ◽  
False Positive ◽  
Chlorhexidine Gluconate ◽  
Blood Cultures

Abstract Introduction: Blood cultures are critical values for identifying the source of an infection in patients seeking medical treatment for an acute illness. False-positive cultures can negatively influence patient care when physicians use inaccurate information to prescribe treatment. Inaccurate prescribed treatment negatively influences the quality of patient care related to prolonged medical treatment and hospital stay and unnecessary repetition of diagnostic tests. Purpose: The purpose of this project was to determine if blood culture contamination rates would be decreased if improved availability of CHG products was provided in all emergency department patient care areas would reduce the contamination rates of blood cultures. Methodology: The Theory of Planned Behavior provided the theoretical framework for this descriptive correlational project to examine barriers to following the procedural guidelines to cleanse venipuncture sites with a chlorhexidine gluconate (CHG) product before venipuncture Alcohol preparation pads were removed from the emergency department and a CHG product packaged similar to the alcohol preparation pads was placed in the department procedure trays and bedside carts. Results: During the first 2 weeks of the pilot project, blood culture contamination rates were reduced from 4.5% to 1.5%. The following month, rates remained low at 1.9%. Conclusion: Placement of CHG products at the bedside will improve patient safety and quality of care by reducing the incidence of inaccurate diagnosis and treatment based on false-positive blood cultures.

scholarly journals Financial and Clinical Impact of False‐Positive Blood Culture Results

2001 ◽  
Vol 33 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Mark L. Waltzman ◽  
Marvin Harper
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
False Positive ◽  
Clinical Impact
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