Frequency of Blood Cultures Performed in a Community Hospital
Frequency of Blood Cultures Performed in a Community Hospital作者机构：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
出 版 物：《Open Journal of Medical Microbiology》 (医学微生物学（英文）)
年 卷 期：2013年第3卷第2期
页 面：130-134页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Blood Cultures Contamination Repeat Blood Culture Timing
摘 要：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.
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