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BLOOD CULTURE CONTAMINATION - QT2
QT2
Despite advances in blood culture practices and technology, false-positive blood culture results due to contaminants continue to be a critical problem. Blood culture contamination rate, the primary indicator of preanalytic performance in microbiology, is associated with increased length of hospital stay, additional expense, and the administration of unnecessary antibiotics. The CAP and other accrediting organizations require you to monitor and evaluate key indicators of quality for improvement opportunities. Use this monitor to help meet CAP Checklist statement note MIC.22630: "It is recommended that blood culture statistics, including number of contaminated cultures, be maintained and reviewed regularly by the laboratory director. The laboratory should establish a threshold for an acceptable rate of contamination. Tracking the contamination rate and providing feedback to phlebotomists or other persons drawing cultures has been shown to reduce contamination rates."
Objective
Determine the rate of blood culture contamination using standardized criteria for classifying contaminants.
Data Collection
On a monthly basis, participants will tabulate the total number of blood cultures processed and the total number of contaminated blood cultures. Blood cultures from neonatal patients are tabulated separately. For the purposes of this study, participants will consider a blood culture to be contaminated if they find one or more of the following organisms in only one of a series of blood culture specimens: Coagulase-negative Staphylococcus; Micrococcus; Alpha-hemolytic viridans group streptococci; Propionibacterium acnes; Corynebacterium sp. (diptheroids); or Bacillus sp. Participants have the option to monitor institution-specific subgroups, for example, a specific department or patient population.
Performance Indicators
Neonatal contamination rate (%)
Other contamination rate (%)
Overall contamination rate (%)
Shipping Schedule
Shipment A: December 5, 2016
Shipment B: March 6, 2017
Shipment C: June 5, 2017
Shipment D: September 5, 2017
Additional Information
Participants in the Q-TRACKS program receive:
Users Guide
Templates and instructions for data collection
Quarterly reports that include fingerprint clusters, customer-defined groups, and all institution comparisons
Peer directory
Q-TRACKS activities meet the American Board of Pathology MOC Part IV Practice Performance Assessment requirements.
Satisfaction With Outpatient Specimen Collection (QT7)
✓
✓
✓
Stat Test Turnaround Time Outliers (QT8)
✓
✓
✓
✓
✓
Critical Values Reporting (QT10)
✓
✓
✓
✓
Turnaround Time of Troponin (QT15)
✓
✓
✓
✓
✓
✓
Corrected Results (QT16)
✓
✓
✓
✓
✓
✓
✓
Outpatient Order Entry Errors (QT17)
✓
✓
✓
Mislabeled Cases, Specimens, Blocks, and Slides in
Surgical Pathology (QT19)
✓
✓
✓
Q-MONITORS
Monitoring of Troponin Metrics for Suspected MI (QM1)
✓
✓
✓
✓
✓
✓
✓
✓
*The CAP requires accredited laboratories to have a quality management plan that covers all areas of the laboratory and includes benchmarking key measures of laboratory performance (GEN.13806, GEN.20316, COM.04000). The Joint Commission requires accredited hospitals to regularly collect and analyze performance data (PI.01.01.01, PI.02.01.01). CLIA requires laboratories to monitor, assess, and correct problems identified in preanalytic, analytic, and postanalytic systems (§493.1249, §493.1289, §493.1299).
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