OBJECTIVE: Blood culture collection practices that reduce contamination, such as sterile blood culture collection kits and phlebotomy teams, increase up-front costs for collecting cultures but may lead to net savings by eliminating downstream costs associated with contamination. The study objective was to compare overall hospital costs associated with 3 collection strategies: usual care, sterile kits, and phlebotomy teams. DESIGN: Cost analysis. SETTING: This analysis was conducted from the perspective of a hospital leadership team selecting a blood culture collection strategy for an adult emergency department (ED) with 8,000 cultures drawn annually. METHODS: Total hospital costs associated with 3 strategies were compared: (1) usual care, with nurses collecting cultures without a standardized protocol; (2) sterile kits, with nurses using a dedicated sterile collection kit; and (3) phlebotomy teams, with cultures collected by laboratory-based phlebotomists. In the base case, contamination rates associated with usual care, sterile kits, and phlebotomy teams were assumed to be 4.34%, 1.68%, and 1.10%, respectively. Total hospital costs included costs of collecting cultures and hospitalization costs according to culture results (negative, true positive, and contaminated). RESULTS: Compared with usual care, annual net savings using the sterile kit and phlebotomy team strategies were $483,219 and $288,980, respectively. Both strategies remained less costly than usual care across a broad range of sensitivity analyses. CONCLUSIONS: EDs with high blood culture contamination rates should strongly consider evidence-based strategies to reduce contamination. In addition to improving quality, implementing a sterile collection kit or phlebotomy team strategy is likely to result in net cost savings.
OBJECTIVE: Blood culture collection practices that reduce contamination, such as sterile blood culture collection kits and phlebotomy teams, increase up-front costs for collecting cultures but may lead to net savings by eliminating downstream costs associated with contamination. The study objective was to compare overall hospital costs associated with 3 collection strategies: usual care, sterile kits, and phlebotomy teams. DESIGN: Cost analysis. SETTING: This analysis was conducted from the perspective of a hospital leadership team selecting a blood culture collection strategy for an adult emergency department (ED) with 8,000 cultures drawn annually. METHODS: Total hospital costs associated with 3 strategies were compared: (1) usual care, with nurses collecting cultures without a standardized protocol; (2) sterile kits, with nurses using a dedicated sterile collection kit; and (3) phlebotomy teams, with cultures collected by laboratory-based phlebotomists. In the base case, contamination rates associated with usual care, sterile kits, and phlebotomy teams were assumed to be 4.34%, 1.68%, and 1.10%, respectively. Total hospital costs included costs of collecting cultures and hospitalization costs according to culture results (negative, true positive, and contaminated). RESULTS: Compared with usual care, annual net savings using the sterile kit and phlebotomy team strategies were $483,219 and $288,980, respectively. Both strategies remained less costly than usual care across a broad range of sensitivity analyses. CONCLUSIONS: EDs with high blood culture contamination rates should strongly consider evidence-based strategies to reduce contamination. In addition to improving quality, implementing a sterile collection kit or phlebotomy team strategy is likely to result in net cost savings.
Authors: M P Weinstein; M L Towns; S M Quartey; S Mirrett; L G Reimer; G Parmigiani; L B Reller Journal: Clin Infect Dis Date: 1997-04 Impact factor: 9.079
Authors: D Souvenir; D E Anderson; S Palpant; H Mroch; S Askin; J Anderson; J Claridge; J Eiland; C Malone; M W Garrison; P Watson; D M Campbell Journal: J Clin Microbiol Date: 1998-07 Impact factor: 5.948
Authors: Wesley H Self; Joyce Mickanin; Carlos G Grijalva; Freda H Grant; Michelle C Henderson; Glenda Corley; D Glen Blaschke Ii; Candace D McNaughton; Tyler W Barrett; Thomas R Talbot; Barbara R Paul Journal: Acad Emerg Med Date: 2014-03 Impact factor: 3.451
Authors: Jonathan Elmer; David Yamane; Peter C Hou; Susan R Wilcox; Ednan K Bajwa; Dean R Hess; Carlos A Camargo; Steven M Greenberg; Jonathan Rosand; Daniel J Pallin; Joshua N Goldstein; Sukhjit S Takhar Journal: Neurocrit Care Date: 2017-02 Impact factor: 3.210
Authors: Gary V Doern; Karen C Carroll; Daniel J Diekema; Kevin W Garey; Mark E Rupp; Melvin P Weinstein; Daniel J Sexton Journal: Clin Microbiol Rev Date: 2019-10-30 Impact factor: 26.132
Authors: David Terrero Salcedo; Eleanor A Powell; A George Smulian; Margaret V Powers-Fletcher Journal: J Clin Microbiol Date: 2020-03-25 Impact factor: 5.948
Authors: Nick Culshaw; Guy Glover; Craig Whiteley; Katie Rowland; Duncan Wyncoll; Andrew Jones; Manu Shankar-Hari Journal: Ann Intensive Care Date: 2014-11-25 Impact factor: 6.925