Implementing a Team-Based Approach to Reduce Blood Culture Contamination Rates in the Emergency Department: A Quality Improvement Initiative

Author

Melissa Lockhart, Jacksonville State UniversityFollow

Date of Award

Summer 2025

Document Type

DNP Executive Summary

Degree Name

Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner

Department

Nursing

Faculty Chair

Dr. Jolie Wildinger, DNP

Preceptor

Dr. Leland Allen, MD

Mentor

Dr. Bridget Smith, DNP

Abstract

Background: Blood culture contaminations (BCC) present significant risks to patients, including adverse drug reactions and the exacerbation of antibiotic resistance. BCC can also result in millions of dollars in financial burdens for hospitals due to the need for follow-up testing, treatment complications, and antibiotic stewardship efforts. At this facility, the contamination rate in the emergency department (ED) consistently exceeds the national benchmark of 3%. Contributing factors include high patient turnover and increased nursing workloads, which can lead to shortcuts in essential practices such as hand hygiene and skin disinfection before collection.

Purpose: This project aimed to evaluate whether implementing a team approach for blood culture collection can reduce contamination rates to the national benchmark of 3% within eight weeks in adult ED patients requiring blood cultures.

Project Design: A collaborative approach to blood culture collection, utilizing a two-nurse culture collection team to ensure peer accountability, and adding hand sanitizer and supplemental chlorhexidine skin preparation in each culture collection kit.

Results: The contamination rates from February to March 2025 were 2.64% and 2.10%, respectively, representing a 61.68% decrease as compared to February 2024 and a 54.26% decrease from March 2024. These results are statistically significant.

Conclusion: A team approach to blood culture collection shows the potential to reduce BCC in the ED effectively.

Recommended Citation

Lockhart, Melissa, "Implementing a Team-Based Approach to Reduce Blood Culture Contamination Rates in the Emergency Department: A Quality Improvement Initiative" (2025). Doctor of Nursing Practice Projects. 132.
https://digitalcommons.jsu.edu/etds_nursing/132