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62 Impact of quality improvement measures in reducing blood culture transport time
  1. Malti Nakrani,
  2. Wisdom Musabaike
  1. Great Ormond Street Hospital

Abstract

Introduction Fast and accurate positive Blood culture (BC) results provide valuable information to guide optimal antibiotic therapy early. Delay in results is influenced by transport times from collection to the delivery in the laboratory. A maximum pre-analytical interval of 2 hours is recommended by guidelines.

At GOSH BCs are transported to Microbiology laboratory via pneumatic tube system or hand-delivered by clinical staff. Delayed transport of BCs was identified by audit.

Our study aimed to implement Quality improvement (QI) measures and raise awareness across the Trust in reducing the transport times from wards to the laboratory. We evaluated BCs collected in wards in relation to the length of their transport time.

Method We designed a Driver diagram and stakeholder mapping to identify primary and secondary drivers influencing the transport time. We developed a real-time QI dashboard of measures to display the weekly average transport time.

We initiated a Trust-wide campaign to reduce BC transport time. We explored multiple approaches to raise awareness. Visual guides were developed to remind staff to send BCs via the chute.

We carried out a retrospective study of 11,011 BC collected, over a 12-month period. Average transport time before and after intervention was assessed. Percentage of BC transported within 120 minutes was studied. The wards with high numbers of delayed BCs were investigated.

Results 5383 BC taken before (01/03/2018-31/08/2018) and 5628 BC taken after intervention (01/09/2018-01/02/2019) were compared. The average transport time before was 239.15 minutes and after was 146.11 minutes respectively.

Percentage BCs transported within 2 hours were 43.56% before with an increase to 58.18% after interventions.

Conclusion Our approach has raised awareness, improved data collection and dissemination. QI dashboard is available to view at Trust and ward level. Average BC transport time shows significant improvement from before (239 minutes) to after (146 minutes) intervention.

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