Good Shepherd Hospital, USA
Title: Eliminating blood culture false positives: Harnessing the power of nursing shared governance
Biography: Dawn Genevieve Moeller
Purpose: Our Emergency Department struggled with unacceptable blood culture contamination rates. The objective was to create a self-governing culture within nursing that would lead 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%.
Design: Blood Cultures: Moving Toward Zero False Positives was an evidence-based quality assurance project developed and implemented by the Emergency Department Shared Governance Quality and Safety Council.
Participants: 100% of all emergency department patients requiring blood cultures, inclusive of pediatric patients, between the time frames of January 2010 through June 2015.
Methods: The Shared Governance council partnered with the laboratory team to review the monthly epidemiology reports. The goal was to identify the number and overall percentage of contaminated specimens collected within the Emergency Department. The Emergency Department Shared Governance council conducted a review of the literature. From the information that was gathered, the Shared Governance council created a blood culture collection education tool for the Emergency Department nursing staff. The final step was to design a monthly peer review process to perform ongoing causal analysis with those individuals that were linked with contaminated specimens.
Results and Outcomes: The evidence demonstrates that the new process decreased the blood culture contamination rate from baseline of 5.37% down to 1.55%.
Implications: 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.