Date of Award

Summer 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Departments (Collect)

Nursing

Program or Major

Direct Entry Master's of Nursing

Degree Name

Master of Science

First Advisor

Elizabeth Evans

Second Advisor

Pamela Kallmerten

Abstract

Background: A critical access hospital in New England experienced an increase in blood culture contamination rates within the Emergency Department (ED). There was a disconnect between the current standardized collection protocol within the ED and the action of staff collecting which has led to an increase of blood contamination (BCC) rates.

Local Problem: The disconnect between the current collection standard and staff collecting caused the Emergency Department to rise above 3.0% in blood cultures contaminations. This rise in contamination rates contributes to longer patients stays and unnecessary treatments.

Methods: Using the Plan-Do-Study-Act model, an educational flyer was implemented to remind and encourage staff to use a waste tube during blood culture collections. Data was collected using pre- and post- surveys to understand staff’s knowledge of proper blood culture collection, their willingness to adapt to the use of a waste tube, and post-intervention, find out if staff was influenced to use a waste tube.

Interventions: A pre-survey was emailed to staff to collect data on their knowledge of the blood culture collection process. An educational flyer with the facilities current collection procedure and an SBAR of the importance of a waste tube was created and hung around the department. During the observation phase, the project lead observed random times of staff collecting blood cultures. The flyer was to help decrease the blood culture contamination rates to below 3.0% by July 2024. A post-survey was emailed to staff to find out if they were influenced by the flyer to use a waste tube.

Results: The intervention proved ineffective with blood culture contamination rate increasing from 3.3% to 4.4%. There was a correlation between staff not using a waste tube and an increase in blood culture contamination rate (r=-1). The intervention influenced some staff to use a waste tube. During the observation phase, staff were observed using a waste tube 100% of the time.

Conclusion: While the intervention did not prove effective, it created awareness of the importance of using a waste tube. The intervention highlights the importance of using a waste tube and what happens when not used every time. Although the intervention was not successful, it was a good beginning step to decreasing blood culture contamination rates.

Key words: emergency room, blood cultures, contaminations, preventions, quality improvement, and sepsis.

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