Reduction in Blood Culture Contamination Rates - การลดอัตราการปนเปื้อนเชื้อจุลชีพในตัวอย่างเลือดที่ส่งตรวจเพาะเชื้อ

Abstract

        Blood culture is a procedure for diagnosis of bacteremia. Blood culture samples must be collected carefully to prevent contaminations, common problems in hospitals. Nurses should have knowledge and follow blood culture procedure properly. The purposes of this randomized controlled trial were to compare knowledge among nurses and to compare blood culture contamination rates between a control group and two experimental groups. The control group adopted routine blood culture procedure. The first experimental group was given training and feedback and the second experimental group was given training, feedback, and provision of blood culture collection kit. This study was done at the H.M. Queen Sirikit hospital, Naval Medical Department during December, 2007 - February 2008. The study subjects were 155 nurses selected by stratified random sampling and 641 blood culture specimens collected by the researchers. Research instruments included a blood culture knowledge test, a demographic data questionnaire, a blood culture recording form, a lesson plan, and a feedback recording form. The content validity was examined by 5 experts, with a blood culture knowledge test resulting in a content validity index of 0.96. Interrater reliability of the blood culture contamination diagnosis was 1.00, and the reliability of the blood culture knowledge test was 0.80. Data were analyzed using descriptive statistics, chi-square test, Fisher’s exact test and two-way ANOVA.

        Results revealed that after implementing training, feedback, and provision of blood culture collection kit, the means of knowledge scores of the two experimental groups were significantly higher than that of the control group at the level of 0.001. Furthermore, blood culture contamination rates among the three groups were significantly different at the level of 0.05. The risk reduction of blood culture contamination rates of the first and the second experimental groups were 66.09 percent and 86.76 percent respectively.

         The findings of this study suggest that the provision of training, feedback, and blood culture collection kit are effective in improving knowledge and compliance on blood culture technique among nurses and duly reduced blood culture contamination rate.

Key words: training, feedback, blood culture collection kit, blood culture contamination