A Quality Improvement Initiative: Implementing a Standardized Education Protocol to Improve the Blood Culture Collection Process in a Rural Hospital Setting [paper]




Heredia, Edward R.

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Blood culture contamination represents a deviation from the quality standard of care and has financial ramifications for hospital organizations. Skoglund et al. (2019) determined that the direct and indirect hospital costs associated with a contaminated blood culture were $12,824 compared to $8,286 for a negative blood culture. Preventing a single blood culture contamination results in a cost savings of $4,538. Blood cultures are widely considered necessary and essential laboratory tests performed to diagnose severe infections (Doern et al., 2020). Blood cultures are collected by a registered nurse or a health technician with phlebotomy certification. The most common indicator of blood culture contamination is directly linked to the improper collection of blood culture specimens. Cases are classified as false positives when the automated blood culture system produces a signal and detects no microorganisms (Ebihara et al., 2019). Financial ramifications of contaminated false positives include unnecessary hospitalization, extended length of stay and risk of associated hospital-acquired conditions, additional diagnostic tests, various costly clinical procedures, and increased work for clinical staff (Steed, 2017). A study by Lalezari et al. (2020) found the median length of stay in patients with a contaminated blood culture was 2 days longer than the median length of stay in patients with a negative culture. In the United States (U.S.), 4% of hospitalized patients will die from a hospital-acquired infection (Shalini & Abiselvi, 2015). Given that blood culture contamination is directly linked to the specimen collection process, this quality improvement project will target the blood culture collection procedure and implement an evidence-based intervention to ensure that the proper blood culture collection procedure is practiced, and that the procedure adheres to the facility's improved protocol. This quality improvement project will standardize and improve the blood culture collection procedure at Crane Memorial Hospital due to detected inconsistencies with staff improperly obtaining blood culture specimens, and the quality improvement project will explore the effectiveness of implementing an evidence-based standardized education protocol to add consistency and accuracy to the blood culture specimen collection process.


An Evidence-Based Practice Capstone Project submitted to the St. David’s School of Nursing at Texas State University in partial fulfillment of the requirements for the degree of Master of Science in Nursing.


blood culture collection, hospitals, rural hospitals


Heredia, E. R. (2023). A quality improvement initiative: Implementing a standardized education protocol to improve the blood culture collection process in a rural hospital setting [Report]. St. David's School of Nursing, Texas State University.


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