title: Reducing the blood culture contamination rate in a pediatric emergency department and subsequent cost savings.
abstract: OBJECTIVE
  Blood culture contamination in the pediatric population remains a significant quality and safety issue because false-positive blood cultures lead to unnecessary use of resources and testing. In addition, few studies describe interventions to reduce peripheral blood culture contamination rates in this population. We hypothesized that the introduction of a standardized sterile collection process would reduce the pediatric emergency department's peripheral blood culture contamination rate and unnecessary use of resources.
  
  
  METHODS
  A sterile blood culture collection process was designed by analyzing current practice and identifying areas in which sterile technique could be introduced. To spread the new technique, a web-based educational model was developed and disseminated. Subsequently, all nursing staff members were expected to perform peripheral blood cultures by using the modified sterile technique.
  
  
  RESULTS
  The peripheral blood culture contamination rate was reduced from 3.9% during the baseline period to 1.6% during the intervention period (P < .0001), with yearly estimated savings of ~$250,000 in hospital charges.
  
  
  CONCLUSIONS
  Subsequent to our intervention, there was a significant reduction of the peripheral blood culture contamination rate as well as considerable cost savings to the institution. When performed in a standardized fashion by using sterile technique, blood culture collection with low contamination rates can be performed via the insertion of an intravenous catheter.
authors.affiliation: Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
authors.forename: Randon T
authors.initials: RT
authors.lastname: Hall
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Domenico
authors.forename: Wesley H
authors.initials: WH
authors.lastname: Self
authors.forename: Paul D
authors.initials: PD
authors.lastname: Hain
mesh_terms: D001800:Blood Specimen Collection / Q000191:economics* / Q000379:methods / Q000592:standards; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000592:standards; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings / Q000191:economics* / Q000379:methods / Q000592:standards; D004632:Emergency Medical Services / Q000191:economics* / Q000379:methods / Q000592:standards; D004636:Emergency Service, Hospital / Q000191:economics* / Q000592:standards; D004866:Equipment Contamination / Q000191:economics / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies