Compliance with Blood Volumes Collected for Blood Cultures between Physicians and Phlebotomists
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Blood culture is essential for the diagnosis and management of bloodstream infections. Blood volume is a key parameter determining the success of blood cultures. Studies comparing compliance between physicians and phlebotomists regarding optimal blood culture procedure are very rare in Korea. Methods: After educating physicians (interns) and phlebotomists about the correct procedure for blood culturing, the blood volumes of forty-three percent of randomly selected aerobic and anaerobic culture sets for adult patients (≥18 years old) were compared between these two groups over a period of three months. Physicians obtained blood from all admitted patients except those in the emergency department, where phlebotomists performed blood collection. Results: The numbers of blood culture sets requested during the study period were 3,238 and 2,136 for the physician and phlebotomist groups, respectively. The blood volumes of blood culture sets were significantly higher for the phlebotomists (16.7 mL) than for the physicians (9.2 mL). The positive rate of blood culture was also higher for the phlebotomist group (10.3% vs. 7.9%). The contamination rates (0.8%) were the same for both groups. Conclusion: Although the patients' medical conditions, antibiotics prescriptions, or duration of hospitalization may have affected the positive rate of blood cultures, this rate might also have been influenced by the blood volume. The compliance of phlebotomists was greater than that of physicians regarding the blood volume collected for blood cultures.
Abstract
Background: Blood culture is essential for the diagnosis and management of bloodstream infections. Blood volume is a key parameter determining the success of blood cultures. Studies comparing compliance between physicians and phlebotomists regarding optimal blood culture procedure are very rare in Korea. Methods: After educating physicians (interns) and phlebotomists about the correct procedure for blood culturing, the blood volumes of forty-three percent of randomly selected aerobic and anaerobic culture sets for adult patients (≥18 years old) were compared between these two groups over a period of three months. Physicians obtained blood from all admitted patients except those in the emergency department, where phlebotomists performed blood collection. Results: The numbers of blood culture sets requested during the study period were 3,238 and 2,136 for the physician and phlebotomist groups, respectively. The blood volumes of blood culture sets were significantly higher for the phlebotomists (16.7 mL) than for the physicians (9.2 mL). The positive rate of blood culture was also higher for the phlebotomist group (10.3% vs. 7.9%). The contamination rates (0.8%) were the same for both groups. Conclusion: Although the patients' medical conditions, antibiotics prescriptions, or duration of hospitalization may have affected the positive rate of blood cultures, this rate might also have been influenced by the blood volume. The compliance of phlebotomists was greater than that of physicians regarding the blood volume collected for blood cultures.
참고문헌 (19)
- Reimer LG, "Update on detection of bacteremia and fungemia", Clin Microbiol Rev, 10, pp.444~465 (1997)
- Weinstein MP, "The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults", Clin Infect Dis, 24, pp.584~602 (1997)
- Alahmadi YM, "Clinical and economic impact of contaminated blood cultures within the hospital setting", J Hosp Infect, 77, pp.233~236 (2011)
- Gander RM, "Impact of blood cultures drawn by phlebotomy on contamination rates and health care costs in a hospital emergency department", J Clin Microbiol, 47, pp.1021~1024 (2009)
- Hall KK, "Updated review of blood culture contamination", Clin Microbiol Rev, 19, pp.788~802 (2006)
- Cockerill FR 3rd, "Optimal testing parameters for blood cultures", Clin Infect Dis, 38, pp.1724~1730 (2004)
- Towns ML, "Guidelines on blood cultures", J Microbiol Immunol Infect, 43, pp.347~349 (2010)
- Principles and Procedures for Blood Cultures; Approved Guidline, "Clinical and Laboratory Standards Institutes", Clinical and Laboratory Standards Institute, ~, pp.Document M47-A (2007)
- 신정환, "Nationwide Survey of Blood Culture Performance Regarding Skin Disinfection, Blood Collection and Laboratory Procedure", Annals of Clinical Microbiology, 14(3), pp.91~96 (2011), 대한임상미생물학회
- Bouza E, "Is the volume of blood cultured still a significant factor in the diagnosis of bloodstream infections?", J Clin Microbiol, 45, pp.2765~2769 (2007)
- 신정환, "Comprehensive Analysis of Blood Culture Performed at Nine University Hospitals in Korea", Annals of Laboratory Medicine, 31(2), pp.101~106 (2011), 대한진단검사의학회
- Schifman RB, "Blood culture contamination: a College of American Pathologists Q-Probes study involving 640 institutions and 497134 specimens from adult patients", Arch Pathol Lab Med, 122, pp.216~221 (1998)
- Gibb AP, "Reduction in blood culture contamination rate by feedback to phlebotomists", Arch Pathol Lab Med, 121, pp.503~507 (1997)
- 강혜경, "Comparison of Chlorhexidine-Alcohol and Povidone-Iodine for Skin Antisepsis and the Effect of Increased Blood Volume in Blood Culture", Annals of Clinical Microbiology, 15(1), pp.37~42 (2012), 대한임상미생물학회
- Eskira S, "Reduction of blood culture contamination rate by an educational intervention", Clin Microbiol Infect, 12, pp.818~821 (2006)
- Roth A, "Reducing blood culture contamination by a simple informational intervention", J Clin Microbiol, 48, pp.4552~4558 (2010)
- Bekeris LG, "Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions", Arch Pathol Lab Med, 129, pp.1222~1225 (2005)
- Surdulescu S, "Phlebotomy teams reduce blood-culture contamination rate and save money", Clin Perform Qual Health Care, 6, pp.60~62 (1998)
- Weinbaum FI, "Doing it right the first time: quality improvement and the contaminant blood culture", J Clin Microbiol, 35, pp.563~565 (1997)