Question

The microbiology manager has noticed a significant increase in contaminated blood cultures this month.

Contamination occurs due to improper phlebotomy technique (i.e., not thoroughly cleaning the puncture site prior to specimen collection) allowing skin flora to enter the culture bottle. This can result in the patient being prescribed antibiotics that are not needed. Their hospital stay may also be extended in order to r/o sepsis.

Blood cultures are collected by phlebotomists from the laboratory and by nurses on the floors.

You are the Allied Health and Nursing Education Coordinator for the hospital.

Use the PDCA tool to develop a plan of action that will help decrease the number of contaminated cultures. Be clarified*

Answer 1

Plan:

To Wash hands

To Apply non-sterile gloves

To Place tourniquet

To Selec venipuncture by appropriate palpation

To Open blood culture bottles with clean tops with alcohol

To Open sterile blood culture collection kit

To do Skin antisepsis

To do Sterile gloving

To relocate site, and insertion of needle to vein

To Remove blood and inject into culture bottle.

Do:

Washing hands

Application of non-sterile gloves

Placing tourniquet

Selecting venipuncture by appropriate palpation

Open blood culture bottles with clean tops with alcohol

Open strile blood culture collection kit

Skin antisepsis

Sterile gloves donning

relocate site, insert needle to vein

Remove blood and inject into culture bottle.

Check:

Observed by Supervisor

Observed by peers

Facility inspection

Root cause analysis

Action:

Corrective measures

Communications by supervisors, peers

Feedback

New or improvement in collecting blood culture

Recognition and compliments