Trends in Blood Culture Contamination: A College of American Pathologists Q-Tracks Study of 356 Institutions

2005 ◽  
Vol 129 (10) ◽  
pp. 1222-1225 ◽  
Author(s):  
Leonas G. Bekeris ◽  
Joseph A. Tworek ◽  
Molly K. Walsh ◽  
Paul N. Valenstein
Keyword(s):  
Blood Culture ◽  
Monitoring Program ◽  
Mixed Linear Model ◽  
Cost Of Care ◽  
Contamination Rate ◽  
Blood Collection ◽  
Patient Centered ◽  
Data Set ◽  
Sustained Reduction ◽  
Definition Of

Abstract Context.—Blood culture contamination extends hospital stays and increases the cost of care. Objectives.—To measure blood culture contamination rates in a large number of institutions over time and to elucidate practice patterns and demographic factors associated with sustained reduction in contamination rates. Design.—Longitudinal cohort study of 356 clinical laboratories that provided quarterly data about blood culture results, using a uniform definition of contamination. Mixed linear model analysis of the 1999 through 2003 data set. Results.—Blood culture contamination was significantly higher in institutions that used nonlaboratory personnel to collect blood (P = .03) and significantly lower in facilities that used a dedicated phlebotomy team (P < .001). Higher volume of blood collection was significantly associated with lower contamination rates (P < .001). Continued participation in the Q-Tracks monitoring program was associated with significant and progressive reduction in contamination rates. By the fifth year of participation, the median institution had reduced its blood culture contamination rate by 0.67% (P < .001). Conclusions.—Institutions that use decentralized patient-centered personnel rather than dedicated phlebotomy teams to collect blood cultures experience significantly higher contamination rates. Long-term monitoring of contamination is associated with sustained improvement in performance.

Assessment Monitoring of Laboratory Critical Values: A College of American Pathologists Q-Tracks Study of 180 Institutions

2007 ◽  
Vol 131 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Elizabeth A. Wagar ◽  
Ana K. Stankovic ◽  
David S. Wilkinson ◽  
Molly Walsh ◽  
Rhona J. Souers
Keyword(s):  
Health Care Providers ◽  
Monitoring Program ◽  
Mixed Linear Model ◽  
Critical Value ◽  
Critical Values ◽  
Care Providers ◽  
Critical Range ◽  
Clinical Laboratories ◽  
Definition Of ◽  
Value Reporting

Abstract Context.—Critical laboratory value reporting is a highly visible and essential key activity for clinical laboratories. Objective.—To measure critical laboratory value reporting in multiple institutions over time and to examine the practice patterns and demographic factors associated with sustained improvement in critical value reporting. Design.—A longitudinal cohort study of 180 clinical laboratories that provided quarterly critical values reporting data for 2 to 16 quarters was conducted using a uniform definition of successful caregiver notification. Mixed linear model analysis of the 2001 through 2004 dataset was performed. Results.—A decrease in total and inpatient rates of undocumented critical values per 1000 results was associated with (1) the American Association of Blood Banks inspection within the past 2 years (P = .01, for both total and inpatient rates); (2) unit secretary/clerical staff not authorized to accept inpatient critical value notification (P = .004 [total] and .001 [inpatient]); and (3) the mandatory practice of requiring notification of health care providers when handling inpatients known to have results repeatedly in the critical range (P = .01, for both total and inpatient rates). Continued participation in the Q-Tracks monitoring program was associated with significant and progressive improvement in total, inpatient, and outpatient critical value reporting (P = .02, .01, and .003, respectively). Conclusions.—Critical value reporting improved as the duration of participation in the Q-Tracks monitoring program increased. Improved total and inpatient critical value reporting was associated with factors that may be markers for institutions with priorities of quality management and enhanced communication with responsible caregivers.

scholarly journals Regression Discontinuity of Blood Culture Contamination Rate After Changing of Disinfectants: Retrospective Observational Study

2021 ◽  
Author(s):  
Koshi Ota ◽  
Daisuke Nishioka ◽  
Yuri Ito ◽  
Emi Hamada ◽  
Naomi Mori ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Observational Study ◽  
Regression Discontinuity ◽  
Blood Cultures ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Contamination Rate ◽  
Blood Collection ◽  
Contaminated Blood

Abstract Background: Blood cultures are indispensable for detecting life-threatening bacteremia. Little is known about associations between contamination rates and topical disinfectants for blood collection in adults.Objective: We sought to determine whether a change in topical disinfectants was associated with the rates of contaminated blood cultures in the emergency department of a single institution.Methods: This single-center, retrospective observational study of consecutive patients aged 20 years or older was conducted in the emergency department (ED) of a university hospital in Japan between August 1, 2018 and September 30, 2020. Pairs of blood samples were collected for aerobic and anaerobic culture from the patients in the ED. Physicians selected topical disinfectants according to their personal preference before September 1, 2019; alcohol/chlorhexidine gluconate (ACHX) was mandatory thereafter, unless the patient was allergic to alcohol. Regression discontinuity analysis was used to detect the effect of the mandatory usage of ACHX on rates of contaminated blood cultures.Results: We collected 2,141 blood culture samples from 1097 patients and found 164 (7.7%) potentially contaminated blood cultures. Among these, 445 (20.8%) were true bacteremia and 1,532 (71.6%) were true negatives. Puncture site disinfection was performed with ACHX for 1,345 (62.8%) cases and with povidone-iodine (PVI) for 767 (35.8%) cases. The regression discontinuity analysis showed that mandatory ACHX usage significantly reduced the blood culture contamination rate by 9.6% (95% confidence interval (CI): 5.0%–14.2%, P <0.001).Conclusion: Rates of contaminated blood cultures were significantly lower when ACHX was used as the topical disinfectant.

Psychiatric case registers for monitoring service utilisation and evaluating its costs

1997 ◽  
Vol 6 (S1) ◽  
pp. 177-198 ◽  
Author(s):  
Francesco Amaddeo ◽  
Paola Bonizzato ◽  
Michele Tansella
Keyword(s):  
Information Systems ◽  
Social Services ◽  
Medical Information ◽  
Service Utilisation ◽  
Patient Centered ◽  
Data Set ◽  
Case Register ◽  
Psychiatric Case Register ◽  
Psychiatric Case ◽  
Definition Of

Psychiatric case registers are systematic health information systems of a geographically delimited area that record the contacts with designated medical and social services of patients or clients from the area. The information is stored in a linked and cumulative file so that the care of any individual or group can be followed over time, no matter how complex the pattern of service attendance (Wing, 1989). They represent the evolution of older systems for recording data of clinical relevance, such as disease registers to which hospitals and physicians used to report all cases of a certain diagnosis and hospital-based registers, which in general are based on aggregate data concerning patients who received care by a particular hospital or clinic (Häfner & an der Heiden, 1986).Bennett & Trute (1983) pointed out that the term “information” has substantially wider connotations than the term “data”. In order to become “information”, data have to be placed within a framework and interpreted. This is true for all medical information systems, including those that collect limited data set, such as those about births, deaths, admissions to hospital, etc. (Wing, 1986).A WHO Working Group held in Mannheim provided an agreed definition of a Psychiatric Case Register (PCR) which resulted in the following: “a Psychiatric Case Register is a patient-centered longitudinal record of contacts with a defined set of psychiatric services, originating from a defined population” (WHO, 1983).

scholarly journals Regression discontinuity of blood culture contamination rate after changing of disinfectants: retrospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Koshi Ota ◽  
Daisuke Nishioka ◽  
Yuri Ito ◽  
Emi Hamada ◽  
Naomi Mori ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blood Culture ◽  
Observational Study ◽  
Regression Discontinuity ◽  
Blood Cultures ◽  
University Hospital ◽  
Retrospective Observational Study ◽  
Contamination Rate ◽  
Blood Collection ◽  
Contaminated Blood

AbstractBlood cultures are indispensable for detecting life-threatening bacteremia. Little is known about associations between contamination rates and topical disinfectants for blood collection in adults. We sought to determine whether a change in topical disinfectants was associated with the rates of contaminated blood cultures in the emergency department of a single institution. This single-center, retrospective observational study of consecutive patients aged 20 years or older was conducted in the emergency department (ED) of a university hospital in Japan between August 1, 2018 and September 30, 2020. Pairs of blood samples were collected for aerobic and anaerobic culture from the patients in the ED. Physicians selected topical disinfectants according to their personal preference before September 1, 2019; alcohol/chlorhexidine gluconate (ACHX) was mandatory thereafter, unless the patient was allergic to alcohol. Regression discontinuity analysis was used to detect the effect of the mandatory usage of ACHX on rates of contaminated blood cultures. We collected 2141 blood culture samples from 1097 patients and found 164 (7.7%) potentially contaminated blood cultures. Among these, 445 (20.8%) were true bacteremia and 1532 (71.6%) were true negatives. Puncture site disinfection was performed with ACHX for 1345 (62.8%) cases and with povidone-iodine (PVI) for 767 (35.8%) cases. The regression discontinuity analysis showed that mandatory ACHX usage was significantly associated with lower rates of contaminated blood cultures by 9.6% (95% confidence interval (CI): 5.0%–14.2%, P < 0.001). Rates of contaminated blood cultures were significantly lower when ACHX was used as the topical disinfectant.

A Strategy for Design of Marine Pollution Monitoring Studies

1986 ◽  
Vol 18 (4-5) ◽  
pp. 15-26 ◽  
Author(s):  
D. A. Segar ◽  
E. Stamman
Keyword(s):  
Information Needs ◽  
Marine Pollution ◽  
Monitoring Program ◽  
Pollution Monitoring ◽  
Systematic Evaluation ◽  
Management Information ◽  
Different Types ◽  
Management Context ◽  
Definition Of ◽  
Scientific Testing

Most historical marine pollution monitoring has proven useless in a management context. A strategy for development of effective marine pollution monitoring programs is outlined. This strategy is based on the following steps: 1) systematic evaluation of the management information needs, 2) identification of the hypothetical impacts associated with those management concerns, and 3) investigation of the feasibility of monitoring those effects such that the existence, or absence, of a specified level of effects can be established in a statistically-valid manner. There are two fundamentally different types of monitoring program: site-specific and regional. These two types of program differ markedly in scope and approach when designed through application of this strategy. The strategy requires development of null hypotheses which address management concerns and which are amenable to scientific testing. In order for the program to be successful, the null hypotheses selected for inclusion in a marine pollution monitoring program must address levels of effect which are predefined to be environmentally significant. The definition of environmentally significant effect levels is a difficult process which must be primarily the responsibility of the managerial community.

scholarly journals Has the Credibility of the Social Sciences Been Credibly Destroyed? Reanalyzing the “Many Analysts, One Data Set” Project

2021 ◽  
Vol 7 ◽  
pp. 237802312110244
Author(s):  
Katrin Auspurg ◽  
Josef Brüderl
Keyword(s):  
Social Sciences ◽  
Causal Reasoning ◽  
Research Question ◽  
Social Science Research ◽  
Science Research ◽  
Skin Tone ◽  
Data Set ◽  
The Social ◽  
The Many ◽  
Definition Of

In 2018, Silberzahn, Uhlmann, Nosek, and colleagues published an article in which 29 teams analyzed the same research question with the same data: Are soccer referees more likely to give red cards to players with dark skin tone than light skin tone? The results obtained by the teams differed extensively. Many concluded from this widely noted exercise that the social sciences are not rigorous enough to provide definitive answers. In this article, we investigate why results diverged so much. We argue that the main reason was an unclear research question: Teams differed in their interpretation of the research question and therefore used diverse research designs and model specifications. We show by reanalyzing the data that with a clear research question, a precise definition of the parameter of interest, and theory-guided causal reasoning, results vary only within a narrow range. The broad conclusion of our reanalysis is that social science research needs to be more precise in its “estimands” to become credible.

scholarly journals Increased blood culture contamination rate during COVID-19 outbreak in intensive care unit: A brief report from a single-centre

2021 ◽  
pp. 175114372110121
Author(s):  
Emanuele Russo ◽  
Giuliano Bolondi ◽  
Emiliano Gamberini ◽  
Domenico Pietro Santonastaso ◽  
Alessandro Circelli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Contamination Rate ◽  
Single Centre

scholarly journals Current Evidence and Future Perspectives on the Effective Practice of Patient-Centered Laboratory Medicine

2015 ◽  
Vol 61 (4) ◽  
pp. 589-599 ◽  
Author(s):  
Mike J Hallworth ◽  
Paul L Epner ◽  
Christoph Ebert ◽  
Corinne R Fantz ◽  
Sherry A Faye ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Clinical Effectiveness ◽  
Laboratory Medicine ◽  
Current Evidence ◽  
Patient Centered ◽  
Definition Of ◽  
Current Utilization ◽  
Measures Of Effectiveness ◽  
The Impact ◽  
Primary Measure

AbstractBACKGROUNDSystematic evidence of the contribution made by laboratory medicine to patient outcomes and the overall process of healthcare is difficult to find. An understanding of the value of laboratory medicine, how it can be determined, and the various factors that influence it is vital to ensuring that the service is provided and used optimally.CONTENTThis review summarizes existing evidence supporting the impact of laboratory medicine in healthcare and indicates the gaps in our understanding. It also identifies deficiencies in current utilization, suggests potential solutions, and offers a vision of a future in which laboratory medicine is used optimally to support patient care.SUMMARYTo maximize the value of laboratory medicine, work is required in 5 areas: (a) improved utilization of existing and new tests; (b) definition of new roles for laboratory professionals that are focused on optimizing patient outcomes by adding value at all points of the diagnostic brain-to-brain cycle; (c) development of standardized protocols for prospective patient-centered studies of biomarker clinical effectiveness or extraanalytical process effectiveness; (d) benchmarking of existing and new tests in specified situations with commonly accepted measures of effectiveness; (e) agreed definition and validation of effectiveness measures and use of checklists for articles submitted for publication. Progress in these areas is essential if we are to demonstrate and enhance the value of laboratory medicine and prevent valuable information being lost in meaningless data. This requires effective collaboration with clinicians, and a determination to accept patient outcome and patient experience as the primary measure of laboratory effectiveness.

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