Effectiveness of practices to reduce blood culture contamination: a Laboratory Medicine Best Practices systematic review and meta-analysis.
OBJECTIVE
This article is a systematic review of the effectiveness of three practices for reducing blood culture contamination rates: venipuncture, phlebotomy teams, and prepackaged preparation/collection (prep) kits.


METHODS
The CDC-funded Laboratory Medicine Best Practices Initiative systematic review methods for quality improvement practices were used.


RESULTS
Studies included as evidence were: 9 venipuncture (vs. versus intravenous catheter), 5 phlebotomy team; and 7 prep kit. All studies for venipuncture and phlebotomy teams favored these practices, with meta-analysis mean odds ratios for venipuncture of 2.69 and phlebotomy teams of 2.58. For prep kits 6 studies' effect sizes were not statistically significantly different from no effect (meta-analysis mean odds ratio 1.12).


CONCLUSIONS
Venipuncture and the use of phlebotomy teams are effective practices for reducing blood culture contamination rates in diverse hospital settings and are recommended as evidence-based "best practices" with high overall strength of evidence and substantial effect size ratings. No recommendation is made for or against prep kits based on uncertain improvement.
Battelle Centers for Public Health Research and Evaluation, Century Plaza 1, 2987 Clairmont Road, NE-Suite 450, Atlanta, GA 30329-4448, USA. snydersu@battelle.org
Susan R
SR
Snyder
Alessandra M
AM
Favoretto
Rich Ann
RA
Baetz
James H
JH
Derzon
Bereneice M
BM
Madison
Diana
D
Mass
Colleen S
CS
Shaw
Christopher D
CD
Layfield
Robert H
RH
Christenson
Edward B
EB
Liebow
D001419:Bacteria / Q000302:isolation & purification*; D001769:Blood / Q000382:microbiology*; D018929:Cell Culture Techniques / Q000592:standards; D002487:Centers for Disease Control and Prevention, U.S.; D003951:Diagnostic Errors / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control; D005189:False Positive Reactions; D006801:Humans; D016017:Odds Ratio; D018962:Phlebotomy / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D015397:Program Evaluation / Q000379:methods*; D058996:Quality Improvement / Q000592:standards; D011933:Reagent Kits, Diagnostic / Q000592:standards; D014481:United States
D011933:Reagent Kits, Diagnostic