Establishing a Long-Term Model for Analysis and Improvement of Underfilled Blood Culture Volumes

Am J Clin Pathol. 2019 Jan 7;151(2):164-170. doi: 10.1093/ajcp/aqy125.

Abstract

Objectives: Underfilling of blood culture bottles decreases the sensitivity of the culture. We attempt to increase average blood culture fill volumes (ABCFVs) through an educational program.

Methods: Partnerships were established with four hospital units (surgical intensive care unit [SICU], medical intensive care unit [MICU], medical intermediate care unit [MIMCU], and hematology and oncology unit [HEME/ONC]). ABCFVs were continuously tracked and communicated to each unit monthly. Educational sessions were provided to each unit.

Results: ABCFVs for the SICU, MICU, MIMCU, and HEME/ONC were 4.8, 5.0, 5.0, and 6.3 mL/bottle, respectively. After the final education session, the SICU, MICU, MIMCU, and HEME/ONC were able to maintain an ABCFV of 6.8, 8.1, 7.9, and 8.2 mL/bottle, respectively.

Conclusions: Partnering with a specific unit and providing monthly volume reports with educational sessions has a direct positive correlation on increasing ABCFVs. Increasing ABCFVs has the potential to decrease false-negative blood cultures, time to detection of positive blood cultures, and time to appropriate and specific antimicrobial therapy, as well as improve patient outcomes in high-acuity patient care units.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Blood Culture / instrumentation
  • Blood Culture / standards
  • Blood Culture / trends*
  • Blood Specimen Collection / instrumentation
  • Blood Specimen Collection / standards
  • Blood Specimen Collection / trends*
  • Education Department, Hospital
  • False Negative Reactions
  • Health Personnel
  • Hospital Units
  • Humans
  • Laboratories, Hospital
  • Models, Statistical*
  • Nursing Staff, Hospital
  • Patient Care
  • Sensitivity and Specificity
  • Software*