Efecto de una acción formativa en cuidados intensivos sobre la tasa de contaminación de hemocultivos / Effect of a training programme on blood culture contamination rate in critical care

La contaminación de hemocultivos puede ocurrir desde la extracción al procesamiento, y su tasa no debería exceder del 3%. Objetivo: Evaluar el impacto de una acción formativa sobre la tasa de hemocultivos contaminados tras la instauración de recomendaciones de extracción de muestras basadas en la mejor evidencia. Método: Estudio prospectivo antes-después en una unidad de cuidados intensivos polivalente de 18 camas. Se establecieron dos fases (enero-junio 2012, octubre 2012-octubre 2015) con un período formativo entre ellas. Principales recomendaciones: técnica estéril, mascarilla quirúrgica, doble desinfección de piel (alcohol 70° y clorhexidina alcohólica 2%), desinfección con alcohol 70° de tapones de frascos de cultivo e inyección de muestras sin cambiar aguja. Incluidos todos los hemocultivos de pacientes con solicitud facultativa de extracción. Variables: demográficas, gravedad, patología, motivo de ingreso, estancia y resultados de hemocultivos (negativo, positivo y contaminado). Estadística descriptiva básica: media (desviación estándar), mediana (rango intercuartílico) o porcentaje (intervalo de confianza del 95%). Calculadas tasas de contaminación por 100 hemocultivos extraídos. Análisis bivariado entre períodos. Resultados: Incluidos 458 pacientes. Extraídos 841 hemocultivos, 33 de ellos contaminados. En las variables demográficas, gravedad, diagnóstico y estancia en pacientes con contaminación de la muestra, no se observaron diferencias con no contaminados. Tasas de contaminación pre-formación vs post-formación: 14 vs 5,6 por 100 hemocultivos extraídos (p = 0,00003). Conclusión: Una acción formativa basada en la evidencia ha reducido la contaminación de las muestras. Es necesario seguir trabajando en la planificación de actividades y cuidados para mejorar la detección de contaminantes y prevenir la contaminación de las mismas

Blood culture contamination can occur from extraction to processing; its rate should not exceed 3%. Objective: To evaluate the impact of a training programme on the rate of contaminated blood cultures after the implementation of sample extraction recommendations based on the best evidence. Method: Prospective before-after study in a polyvalent intensive care unit with 18 beds. Two phases were established (January-June 2012, October 2012-October 2015) with a training period between them. Main recommendations: sterile technique, surgical mask, double skin disinfection (70° alcohol and 2% alcoholic chlorhexidine), 70° alcohol disinfection of culture flasks and injection of samples without changing needles. Including all blood cultures of patients with extraction request. Variables: demographic, severity, pathology, reason for admission, stay and results of blood cultures (negative, positive and contaminated). Basic descriptive statistics: mean (standard deviation), median (interquartile range) and percentage (95% confidence interval). Calculated contamination rates per 100 blood cultures extracted. Bivariate analysis between periods. Results: Four hundred and eight patients were included. Eight hundred and forty-one blood cultures were taken, 33 of which were contaminated. In the demographic variables, severity, diagnosis and stay of patients with contaminated samples, no differences were observed from those with uncontaminated samples. Pre-training vs post-training contamination rates: 14 vs 5.6 per 100 blood cultures extracted (P = .00003). Conclusion: An evidence-based training programme reduced the contamination of samples. It is necessary to continue working on the planning of activities and care to improve the detection of pollutants and prevent contamination of samples

Effect of a training programme on blood culture contamination rate in critical care. / Efecto de una acción formativa en cuidados intensivos sobre la tasa de contaminación de hemocultivos.

Blood culture contamination can occur from extraction to processing; its rate should not exceed 3%. OBJECTIVE: To evaluate the impact of a training programme on the rate of contaminated blood cultures after the implementation of sample extraction recommendations based on the best evidence. METHOD: Prospective before-after study in a polyvalent intensive care unit with 18 beds. Two phases were established (January-June 2012, October 2012-October 2015) with a training period between them. Main recommendations: sterile technique, surgical mask, double skin disinfection (70° alcohol and 2% alcoholic chlorhexidine), 70° alcohol disinfection of culture flasks and injection of samples without changing needles. Including all blood cultures of patients with extraction request. VARIABLES: demographic, severity, pathology, reason for admission, stay and results of blood cultures (negative, positive and contaminated). Basic descriptive statistics: mean (standard deviation), median (interquartile range) and percentage (95% confidence interval). Calculated contamination rates per 100 blood cultures extracted. Bivariate analysis between periods. RESULTS: Four hundred and eight patients were included. Eight hundred and forty-one blood cultures were taken, 33 of which were contaminated. In the demographic variables, severity, diagnosis and stay of patients with contaminated samples, no differences were observed from those with uncontaminated samples. Pre-training vs post-training contamination rates: 14 vs 5.6 per 100 blood cultures extracted (P=.00003). CONCLUSION: An evidence-based training programme reduced the contamination of samples. It is necessary to continue working on the planning of activities and care to improve the detection of pollutants and prevent contamination of samples.