blood culture collection

Reducing Blood Culture Contamination to Zero. How Do We Get There?

By Barbara DeBaun, MSN, RN, CIC, Cynosure Health

Magnolia Medical Technologies has its eyes set on one target: ZERO. As in, zero blood culture contaminations. But can hospitals actually get there? A growing body of clinical and real-world evidence shows that they can.

 

Prior Blood Culture Contamination Standards

 

Over 40 million blood cultures are drawn in the U.S. every year to evaluate patients known or suspected of having sepsis, with more than half collected in the Emergency Department (ED). Unfortunately, nearly half of the positive test results for sepsis are falsely positive due to blood culture contamination.[i]

This preventable error equates to more than 1.4 million patients being seriously impacted and subjected to increased overall morbidity and mortality.[ii]

In addition to creating significant patient safety risks for millions of Americans every year, false-positive blood culture results contribute to the global antimicrobial resistance crisis while creating approximately $6 billion annually in wasted U.S. healthcare system costs.[iii]

These contamination events represent an enormous yet avoidable economic and public health burden. Most hospitals have defined an acceptable blood culture contamination rate of 3.0% as an appropriate target. However, momentum is growing for a new national benchmark of 1% or less for blood culture contamination rates.

 


ENA and INS Blood Culture Collection Guidelines

 

How much blood should be diverted to reduce contamination rates? According to research, it's between 1.0 – 2.0mL of blood.5 The Emergency Nursing Association (ENA) Clinical Practice Guidelines and the Infusion Nurses Society (INS) standards recommend the diversion of 1.0 – 2.0mL and 1.5mL or more of blood, respectfully, prior to specimen collection to prevent blood culture contamination. Steripath is the only device that meets these clinical recommendations by diverting the initial 1.5 – 2.0mL of blood, prior to collection.

So, how do we get down to one percent and below? The overwhelming amount of compelling clinical evidence points to Steripath as being the solution for hospitals. Not only has it demonstrated the ability to reduce contamination rates down to 1.0% and below, but it’s also the only FDA 510(k)-cleared device indicated to reduce blood culture contamination.4,6,7

 


A New Standard for Blood Culture Contamination

 

Training, education, and best practices are essential in the reduction of blood culture contamination. Alone, they are simply not enough.

With Magnolia Medical’s Steripath® Gen2 Initial Specimen Diversion Device® (ISDD®), hospitals now have an extra layer of contamination protection. Steripath, the only FDA 510(k)-cleared device indicated to reduce blood culture contamination, is engineered to deliver sustained contamination rates of under 1.0% in the emergency department and throughout the hospital.3

A recent landmark Stanford Health Care study titled “Getting to Zero: Eliminating Blood Culture Contamination with the ISDD” reported zero blood culture contamination events and zero false-positive CLABSIs out of more than 11,000 blood cultures drawn with Steripath during an eleven-month hospital-wide study.4

The study concluded that the adoption of Steripath led to a substantial decrease in contaminated blood cultures and false-positive CLABSIs. These outcomes yield appropriate antibiotic usage, improved accurate diagnoses, minimized patient discomfort, and reduced healthcare-associated infections related to extended hospital stays.4

In response to the successful results and overall improved patient safety, Stanford Health Care adopted hospital-wide use of Steripath.

 


 

References

  1. Zwang O., et al. (2006). Analysis of Strategies to Improve Cost-Effectiveness of Blood Cultures. J Hosp Med. 2006 Sep:1(5):272-6.
  2. Patton, R. (2016). Blood Culture Contamination Definitions Can Obscure the Extent of Blood Culture Contamination: A New Standard for Satisfactory Institution Performance Is Needed. Infection Control & Hospital Epidemiology, 37(6), 736-738. doi:10.1017/ice.2016.30
  3. Data on file.
  4. Tompkins L., Getting to Zero Eliminating Blood Culture Contamination with an Initial Specimen Diversion Device PACCARB (2021)
  5. Patton RG, Schmitt T. Innovation for Reducing Blood Culture Contamination: Initial Specimen Diversion Technique. J Clin Microbiol 2010; 48:4501–3.
  6. Arenas M, et al. (2021). Asynchronous Testing of 2 Specimen-Diversion Devices to Reduce Blood Culture Contamination: A Single-Site Product Supply Quality Improvement Project. Journal of Emergency Nursing Vol: 47, Issue 2, P256-264.E6
  7. Indicated for use as a blood collection system that diverts and sequesters the initial specimen prior to collection of a subsequent test sample to reduce the frequency of blood culture contamination when contaminants are present in the initial blood sample compared to blood cultures drawn with standard procedure without manual diversion.

Disclosure: The author provides clinical consultation to Magnolia Medical Technologies.