Blood culture testing is routinely used to diagnose infections in symptomatic patients admitted t... more Blood culture testing is routinely used to diagnose infections in symptomatic patients admitted to the emergency department. Blood cultures are necessary for accurate identification of pathogens and to provide targeted antibiotic therapy. Unfortunately, contamination of blood cultures from microorganisms outside the bloodstream is common, resulting in delayed or imprecise treatment, increased risks of morbidity, extended hospital stays, and increased costs of care. 1-3 This article summarizes recent interventions that have lowered blood culture contamination rates in emergency departments, including the implementation in our emergency department of a multistep intervention including education, use of a one-step 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG/IPA) skin antisepsis solution (ChloraPrep; CareFusion, San Diego, CA), not repalpating the site with a nonsterile glove, and data review and feedback. Interventions that are particularly effective in reducing blood culture contamination are reviewed, including the role of skin antisepsis, sterile glove technique, site selection for drawing blood, and the advantages of using dedicated staff to obtain samples. Approaches to developing interventions in the emergency department to lower contamination rates are described.
Blood culture testing is routinely used to diagnose infections in symptomatic patients admitted t... more Blood culture testing is routinely used to diagnose infections in symptomatic patients admitted to the emergency department. Blood cultures are necessary for accurate identification of pathogens and to provide targeted antibiotic therapy. Unfortunately, contamination of blood cultures from microorganisms outside the bloodstream is common, resulting in delayed or imprecise treatment, increased risks of morbidity, extended hospital stays, and increased costs of care. 1-3 This article summarizes recent interventions that have lowered blood culture contamination rates in emergency departments, including the implementation in our emergency department of a multistep intervention including education, use of a one-step 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG/IPA) skin antisepsis solution (ChloraPrep; CareFusion, San Diego, CA), not repalpating the site with a nonsterile glove, and data review and feedback. Interventions that are particularly effective in reducing blood culture contamination are reviewed, including the role of skin antisepsis, sterile glove technique, site selection for drawing blood, and the advantages of using dedicated staff to obtain samples. Approaches to developing interventions in the emergency department to lower contamination rates are described.
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Papers by Jennifer Denno