Blood culture quality improvement: A College of American Pathologists Q- probes study involving 909 institutions and 289 572 blood culture sets

Ronald B Schifman, Paul Bachner, Peter J. Howanitz

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23 Citations (Scopus)

Abstract

Objective.-To evaluate solitary blood culture (SBC) collections as a preanalytic quality indicator of blood culture practice. Design and Setting.- Two College of American Pathologists Q-Probes laboratory quality improvement studies involving prospective evaluation of the proportion of and reasons for SBC collections in 909 institutions. Outcome.-Reduction in the proportion of SBCs. Results.-Of 289 572 blood culture sets studied, the median proportion of SBCs per institution was 10.1% and 12.1% among adult inpatients, 25.4% and 33.3% among adult outpatients, and 89.0% and 100% among pediatric/infant patients in the first and second (follow-up) studies, respectively. The two most common reasons for not performing a second culture in adults were (1) test not indicated and (2) physician believed one was sufficient. When compared with inpatient cultures, a significantly higher proportion of outpatient SBCs were classified as not indicated (P < .0001). Among 198 institutions participating in both studies, a significant decline in SBC rates was observed in the subgroup (n = 50) that continued to monitor SBCs (P = .004). Conclusions.-Interinstitutional evaluation of solitary blood cultures provides a benchmark for quality assessment and an opportunity for performance improvement in blood culture specimen collections.

Original languageEnglish (US)
Pages (from-to)999-1002
Number of pages4
JournalArchives of Pathology and Laboratory Medicine
Volume120
Issue number11
StatePublished - Nov 1996

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Quality Improvement
Blood Specimen Collection
Inpatients
Outpatients
Benchmarking
Blood Culture
Pathologists
Prospective Studies
Pediatrics
Physicians

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

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abstract = "Objective.-To evaluate solitary blood culture (SBC) collections as a preanalytic quality indicator of blood culture practice. Design and Setting.- Two College of American Pathologists Q-Probes laboratory quality improvement studies involving prospective evaluation of the proportion of and reasons for SBC collections in 909 institutions. Outcome.-Reduction in the proportion of SBCs. Results.-Of 289 572 blood culture sets studied, the median proportion of SBCs per institution was 10.1{\%} and 12.1{\%} among adult inpatients, 25.4{\%} and 33.3{\%} among adult outpatients, and 89.0{\%} and 100{\%} among pediatric/infant patients in the first and second (follow-up) studies, respectively. The two most common reasons for not performing a second culture in adults were (1) test not indicated and (2) physician believed one was sufficient. When compared with inpatient cultures, a significantly higher proportion of outpatient SBCs were classified as not indicated (P < .0001). Among 198 institutions participating in both studies, a significant decline in SBC rates was observed in the subgroup (n = 50) that continued to monitor SBCs (P = .004). Conclusions.-Interinstitutional evaluation of solitary blood cultures provides a benchmark for quality assessment and an opportunity for performance improvement in blood culture specimen collections.",
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