Frequency of Blood Cultures Performed in a Community Hospital

Jaslyn M. Maurer, Janice M. Burns, Mary R. Godfrey, Carl M. Urban, Sorana Segal-Maurer

Administration, New York Hospital Queens, Flushing, USA.
Department of Medicine, New York Hospital Queens, Flushing, USA.
Department of Nursing, New York Hospital Queens, Flushing, USA.
Franklin and Marshall College, New York Hospital Queens, Flushing, USA.
Weill Cornell Medical College, Cornell University, New York, USA.

DOI: 10.4236/ojmm.2013.32019                

Abstract

Background: Blood cultures (BCs) are obtained to identify etiologic organisms, demonstrate antibiotic efficacy, determine duration of treatment, and/or suggest further interventions. Published guidelines do not clearly state indications and timing for obtaining BCs. As a result, clinicians may obtain too many BCs, increasing cost and patient discomfort. Objective: To determine frequency of BCs performed at our hospital as part of a quality improvement project. Design: Retrospective review of all BCs submitted during a randomly selected month. Setting: A New York City 535-bed, university-affiliated community hospital. Measurements: Patient demographics and BC data were obtained from medical and laboratory records. Results: During the selected month, 2280 BCs were performed for 379 patients. Negative BCs were seen in 221 patients (58%) with one-half having multiple BCs performed within 48 hours of admission and prior to obtaining results of initial BCs. Repeat BCs frequently did not reveal further pathogens among patients with either negative or positive initial BCs. Conclusions: Two-thirds of BCs were obtained from less than one-half of patients without added clinical utility. Often, BCs were repeated prior to results of initial BCs or repeated in patients receiving antibiotics in spite of known low yield following antibiotic initiation. Clinical assessment and review of initial BCs prior to obtaining further BCs is necessary. Staff education regarding appropriate clinical setting for BCs and indications for repeat BCs is required to maximize utilization of resources, improve diagnostic yield, and limit patient discomfort.

Keywords

Blood Cultures; Contamination; Repeat Blood Culture Timing

Conflicts of Interest

The authors declare no conflicts of interest.

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