REDUCTION IN BLOOD CULTURE CONTAMINATION RATE BY FEEDBACK TO PHLEBOTOMISTS

Objective.-To determine whether monitoring and feedback of blood cultu re contamination rates to phlebotomists would reduce the overall conta mination rate. Design.-Before and after interventional study. Setting. -Blood cultures collected by venipuncture by phlebotomists at Foothill s Hospital, Calgary, a tertiary care teaching hospital. Intervention.- Feedback of contamination rates calculated from a laboratory definitio n of blood culture contamination. The definition was based on isolatio n of typical skin organisms from a single blood sample when two sample s were obtained. Main Outcome Measure.-Reduction in the laboratory-def ined contamination rate in the second year. Results.-Of 8462 cultures collected by phlebotomists in the prefeedback year, 224 (2.6%) were co ntaminated, compared to 131 (1.4%) of 9282 cultures in the postfeedbac k year. There was a rise in the total number of positive cultures rega rded as significant but a fall in the number of coagulase-negative sta phylococci that were regarded as significant by our definition. The ra te of contamination in blood cultures collected by nonphlebotomists di d not change. Conclusions.-The contamination rate decreased after feed back. Our definition of contamination was imperfect and could be impro ved, but it was valuable in achieving a real reduction in blood cultur e contamination.