ABSTRACT
INTRODUCCIÓN: Los hemocultivos contaminados (HC) conllevan un incremento de pruebas diagnósticas, tratamientos innecesarios, aumento de la carga asistencial, estancia hospitalaria y costes. Objetivos Disminución de los HC a través de un programa educacional. Material y métodos Periodo preintervención (Ppre): valoración clínica restrospectiva de los hemocultivos positivos y análisis de indicadores de contaminación. Periodo postintervención (Ppos), tras programa educacional, se comparó la incidencia de contaminación entre ambos periodos. La formación comprendió: un cuestionario donde se valoraba el grado de conocimientos acerca de la técnica de extracción, el significado de los HC, su diagnóstico y prevención, la impartición de sesiones y la revisión de resultados. ResultadosSe impartieron sesiones formativas en todas las unidades de hospitalización. La mediana de participación fue del 64% (40,8-78,5). La mediana de aciertos en el cuestionario fue del 69% en el Ppre (54,1-83,3) y de 85,7% (83,3-100) en el Ppos, mejorando en el 85,7% de las unidades que pudieron compararse. Durante el Ppre hubo 136 (4,2%) HC y 186 (6,05%) fueron HC en el Ppos (p = 0,005). La mediana de HC por unidades entre 2011 y 2012 fue del 5 vs. 7,5% (p = 0,79). Solo en 2 unidades se objetivó una reducción del 2 y del 2,5% que no fue significativa. CONCLUSIONES: Nuestro programa formativo no consiguió reducir los HC en el periodo del estudio pero logró una mejoría en la capacitación de las enfermeras. Los resultados nos permitieron identificar los problemas que necesitan modificarse de cara a conseguir mejores resultados y poder implantar un programa continuado
INTRODUCTION: Blood culture contaminations can lead to unnecessary diagnostic procedures and treatments, increasing workload, length of stay, and costs. OBJETIVES: Development of an educational program to reduce contamination rates. MATERIAL AND METHODS: Our study compared contamination rates (CR) between a pre-intervention period (Ppre) and post-intervention period (Ppos), where clinical charts from patients with positive blood cultures were reviewed. Intervention consisted of a questionnaire where knowledge of blood culture practice and its significance was assessed. Results are discussed and explained. RESULTS: A presentation on blood culture guidelines was discussed in every nurse station. There was a median of 64% (40.8-78.5) attendance rate. The median of correct answers was 69% in the Ppre (54.1-83.3) with 85.7% (83.3-100) in the Ppos, indicating an improvement in 85.7% of the departments that could be compared. There were 136 (4.2%) contaminants in the Ppre and 186 (6.05%) in the Ppos (P=.005). Among the different departments the average of CR varied from 5% vs 7.5% (P=.79) between 2011 and 2012. Only 2 departments reduced CR by 2% to 2.5%, the difference was not significant. CONCLUSIONS: The intervention failed to reduce overall contamination rates, but knowledge of blood culture practice improved. Our results identified the errors that will help us to design a successful approach in future follow-up programs
Subject(s)
Humans , Specimen Handling/methods , Blood Specimen Collection/methods , Analytic Sample Preparation Methods/methods , Environmental Pollutants/adverse effects , Microbiological Techniques/methods , False Positive ReactionsABSTRACT
INTRODUCTION: Blood culture contaminations can lead to unnecessary diagnostic procedures and treatments, increasing workload, length of stay, and costs. OBJETIVES: Development of an educational program to reduce contamination rates. MATERIAL AND METHODS: Our study compared contamination rates (CR) between a pre-intervention period (Ppre) and post-intervention period (Ppos), where clinical charts from patients with positive blood cultures were reviewed. Intervention consisted of a questionnaire where knowledge of blood culture practice and its significance was assessed. Results are discussed and explained. RESULTS: A presentation on blood culture guidelines was discussed in every nurse station. There was a median of 64% (40.8-78.5) attendance rate. The median of correct answers was 69% in the Ppre (54.1-83.3) with 85.7% (83.3-100) in the Ppos, indicating an improvement in 85.7% of the departments that could be compared. There were 136 (4.2%) contaminants in the Ppre and 186 (6.05%) in the Ppos (P=.005). Among the different departments the average of CR varied from 5% vs 7.5% (P=.79) between 2011 and 2012. Only 2 departments reduced CR by 2% to 2.5%, the difference was not significant. CONCLUSIONS: The intervention failed to reduce overall contamination rates, but knowledge of blood culture practice improved. Our results identified the errors that will help us to design a successful approach in future follow-up programs.
