Date of Award

Fall 2024

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

Doctor of Nursing Practice

Degree Name

Other

First Advisor

Dr. April Phelps

Second Advisor

Dr. Dayle Sharp

Abstract

BACKGROUND: Obtaining blood cultures is routine care for patients who are suspected to have sepsis. Contaminated blood cultures can lead to increased healthcare costs for patients suspected of sepsis. Reducing contaminated specimens could improve the quality of care delivered as well as increase patient satisfaction.

AIM: This quality improvement project aimed to reduce the number of contaminated blood cultures in a community hospital emergency department by using an initial specimen diversion tube to meet the new national benchmark of below 1% contamination rate.

METHODS: Twenty-seven diversion specimens were collected over an eight-week period via initial intravenous catheter insertion in a community hospital emergency department.

COMPARISON: Contamination rates in both the diversion group and the standard procedure group. As well as superuser performance and number of pathogens isolated.

RESULTS: The overall contamination rate during the study period for the standard procedure group yielded 2.92% rate with a mean contamination rate of 3.17%. The diversion protocol group’s overall contamination rate yielded 3.70% rate with one contaminated specimen resulting in a mean contamination rate of 2.38%. Nine pathogens were isolated in the standard procedure group compared to one in the diversion group. Superuser performance was variable.

IMPLICATIONS: Even though the overall standard protocol contamination rate was lower than the diversion contamination rate, the mean contamination rates and the month-to-month contamination rate data suggest that the diversion protocol may yield a lower and more sustainable rate over time.

LIMITATIONS: Given the small sample size of this quality improvement project results cannot be generalized to the larger population. Unforeseen circumstances led to the project being abruptly halted. Further study is necessary.

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