title: Eliminating Blood Culture False Positives: Harnessing the Power of Nursing Shared Governance.
abstract: Our emergency department struggled with unacceptable blood culture contamination rates for several years. The objective of this project was to create a self-governing culture within nursing that would generate and sustain the achievement of monthly blood culture contamination rates below the national benchmark of 3% and the hospital laboratory acceptable threshold of 2.3%.
  
  
  METHODS
  The ED shared governance council partnered with the laboratory team to review the monthly epidemiology reports for all adult and pediatric ED patients having blood cultures performed from January 2010 through December 2015. A written competency assessment test completed by ED personnel performing phlebotomy showed opportunity for improvement. After a review of the literature, a blood culture collection education tool was created and implemented. The final step was to design a monthly monitoring and peer-review process to perform ongoing causal analysis with those individuals who were linked with contaminated specimens.
  
  
  RESULTS
  The evidence shows that the new process decreased the blood culture contamination rate from a baseline rate of 5.37% to 1.76%.
  
  
  CONCLUSIONS
  The chief recommendation is to engage staff through clinical leadership. This quality-improvement project translates to improved patient care and a reduction in unnecessary treatment and costs.
authors.affiliation: Barrington, IL. Electronic address: dawn.moeller@advocatehealth.com.
authors.forename: Dawn
authors.initials: D
authors.lastname: Moeller
mesh_terms: D000071997:Blood Culture / Q000379:methods*; D001800:Blood Specimen Collection / Q000379:methods; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D004866:Equipment Contamination / Q000517:prevention & control; D005189:False Positive Reactions; D006801:Humans; D018962:Phlebotomy / Q000379:methods; D058996:Quality Improvement
keywords: Blood culture; Contaminated specimens; Nursing shared governance; Peer review; Quality improvement