1. Reduction of Peripheral Blood Culture Contamination Team Membership Sandra Chakonas MBA, MS, MT(ASCP),Laboratory Manager Theresa Pavone RN, MSN Nursing Education Nursing Staff 3 NEWS Laurie Gillard MS, MT(ASCP), SBB Compliance Specialist Clinical Laboratories Kathryn Clancy RN, MSN, Nursing Education

2. Opportunity for Improvement Each contaminated blood culture results in: –4.5 additional hospital days –Increased use of antibiotics and patient charges of $4400 Reduction of Contaminated Blood Culture Rate to 2.5% will result in a reduction of patient charges of $853,803 annually. Reference: Barenfinger, Clinical Microbiology Newsletter Vol. 28,No. 3,Feb 2006

3. Project Aim Statement To evaluate the use of a disposable blood culture adapter to reduce the number of needle stick injuries and contaminated blood cultures. According to CAP (College of American Pathologists), benchmark is 2% contamination rate. Evidence is Shifman et al. (1998). Blood Culture Contamination: a College of American Pathologists Q-Probe Study. Archives of Pathology and Laboratory Medicine: 122, 216- 221.

4. Summary 3NEWS Pilot Study Retrospective Study January-October 2006: Blood Culture Contamination Rate was 6%. Two Month Trial Results: –May 2007 : Blood Culture Contamination Rate 4% –June 2007: Blood Culture Contamination Rate 1%

5. Pilot Study 3 NEWS Goal was to reduce peripheral blood culture contamination rate to 2.5% 3 NEWS pilot lasted 2 months with a reduction in blood culture rate from contamination from 6% to 1% Decision to role out project house wide Jan 2009

6. With the introduction of the adapter, the rate of contamination decreased on average of 2.6 for the past three months. January 2009 experienced a decrease to 2.3, surpassing our goal of 2.5.

7. Analysis Implementation of the blood culture adapter house wide has resulted in a blood culture contamination rate of 2.7% in January and February The implementation of the adapter has decreased contamination rate

8. Next Steps Monitor the monthly blood culture to insure that the target contamination rate of 2.5% is met Evaluate additional blood culture adapter which could be used in blood culture line draws to reduce contamination rate below 2%