The effect of aseptic blood collection protocol training on blood culture contamination rate in the emergency department

Background and Objective: The blood culture test is a widely used method to detect septicemia in the emergency departments. However, false positive (contamination) blood culture results are not infrequent. Increasing frequency of blood culture contamination causes laboratory costs, unnecessary use of antibiotics and an increase in patient care costs. Therefore, various methods are being investigated to reduce contamination rates. In this study, we aimed to evaluate the effect of a standard aseptic blood collection protocol training configured in the emergency department on blood culture contamination rate. Material and Method: The study was carried out in three stages in a university hospital emergency department. In the first stage, the results of all blood cultures of the same period of the previous year, which were taken in the adult emergency room by untrained personnel, were examined. In the second stage, a structured standard aseptic blood culture protocol training was given to all staff working in the emergency room. At the third stage, all blood culture results obtained by trained personnel were examined and the groups before and after the training were compared Results: The study included 338 patients in the pre-training group and 298 patients in the post-training group. There was no significant difference between the groups in terms of gender and age. Forty doctors and 26 nurses were trained. It was determined that there was no significant difference between true positivity (13.9% vs 17.8%), contamination (15.7% vs 15.4%) and negative (70.4% vs 66.8%) between before and after training. (p = 0.40). There was no relationship between sex and contamination rate, but there was a significant increase in true positive reproductive rate in patients over 65 years of age (p <0.05). It was found that the rate of contamination was significantly lower in the cultures where the nurses took the blood culture and the nurses received (p = 0.48). The most common cultures were taken from the right brachial vein, the blood cultures from the brachial region had significantly lower contamination rates (p <0.05), and doctors took more blood from the femoral region (p <0.05), and the direction and tissue did not affect the outcome. It revealed. It was determined that there was no significant relationship between the emergency service working time of the staff and the time of transfer of blood cultures to the laboratory and the result. Conclusion: In our study, it was found that structured standard education did not have a significant effect on blood culture contamination rate, but contamination increased in patients over 65 years old and in cultures from femoral region. Keywords: blood culture, contamination, blood collection training, emergency room