Evidence Based Practice

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Collection of Blood Cultures

Evidence Based Practice for The Baccalaureate Prepared Nurse

Abstract Proper collection of blood cultures are necessary and the most direct method of determining whether or not a patient is septic. The purpose of obtaining blood cultures is to identify and isolate the bacteria that are causing an illness and then determine the best course of treatment based on the sensitivity of the bacteria to particular antibiotics. One of the most frustrating problems plaguing hospitals is the increased rate at which blood culture results are being returned as contaminated specimens. These results can lead to a significant increase in cost to the hospital and patient as well as an increased length in hospital
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A total of 5,432 blood cultures were obtained from 2,642 patients and a significantly lower rate of contamination were seen in those specimens obtained by a dedicated phlebotomist. The phlebotomist collected cultures had a contamination rate of 2.4-3.6%, with an overall rate of 3.1% and the non-phlebotomy collected cultures showed contamination rates 6.2-10.2%, with an overall rate of 7.4% (Gander et al., 2009). The difference in the median patient charges between the negative ($18,752) and false-positive cultures ($27,472) resulted in additional charges totaling $8,720 for each contaminated event (Gander et al., 2009). The median increase for length of stay only increased from 4 days (negative culture) to 5 days (false-positive culture); whereas, patient’s with significant bacteremia had an additional median charge of $32,303 and 8-day median length of stay (Gander et al., 2009). This study goes on to state that with the estimated $8,720 for each episode of a contaminated blood culture, the prevention of only five contaminated blood cultures a year might fund the yearly salary for one dedicated phlebotomist in the ED and could potentially save the hospital $4.1 million in excess charges annually (Gander et al., 2009). This literature precisely defines reasonable need for correct collection of blood cultures in the emergency setting and provides evidence for former PICOT question.
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