The Impact of Performance Improvement Interventions and Phlebotomy Staff Counseling on Blood Culture Contamination Rates: Experience of Security Forces Hospital, Makkah, Saudi Arabia

Abstract

Background: Blood culture contamination is a global problem that heeds all healthcare settings and has many negative impacts. Objectives: to compare the effectiveness of the two implemented interventions on blood culture contamination rates. Methodology: The blood culture reports of specimens received by the microbiology laboratory during the study period were grouped into 3 groups; pre-intervention group, post-intervention I group after educational lectures and practical workshops, post-intervention II group after implementation of the same intervention I together with individual counseling for staff identified as having obtained contaminated specimens. The contamination rates were evaluated and compared to the target and as regards departments and organisms. Results: After intervention I, there was a 31.56% reduction rate while after postintervention II there was a 56.8% reduction from the pre-intervention rate. The total number of contaminants showed a highly significant difference between pre-intervention and post-intervention I & between post-interventions I and II (p=0.001) and an extremely highly significant difference between pre-intervention and post-intervention II (p=0.0001). The highest rate of contamination was found in the emergency department followed by ICUs. The contaminants were coagulase-negative staphylococci (CoNS) (82.8%, 92.6%, 93.3%) micrococci (9.7%, 5.5% 6.7%), anthracoid (4.9%,1.2%, 0%) and Corynebacterium spp. (2.6%, 0.6%, 0%) in the three groups pre or post interventions respectively. Conclusion: Intervention II proved to be more effective in reducing blood culture contamination rate. So, it is recommended to continuously track the contamination rate and train the staff on the best practice together with disciplinary counseling for those who frequently withdraw contaminated blood culture specimens.