Good practices in the pre-analytical phase of blood cultures: a quasi-experimental study in an emergency department
DOI:
https://doi.org/10.29352/mill0214e.31247Keywords:
blood culture; contamination; nurse; knowledgeAbstract
Introduction: Blood culture unequivocally identifies the microorganism responsible for bloodstream infections. The diagnostic value of blood culture depends on the quality of each moment of the pre-analytical phase, with full compliance with recommended best practices being essential. The nurse must implement the most current evidence-based recommendations to avoid external contamination of the sample and to obtain a contamination rate of less than 3%.
Objective: To analyse the impact of a training intervention on nurses' knowledge and practice of the pre-analytical phase of blood cultures.
Methods: This study follows a quasi-experimental, prospective and longitudinal methodology, through the application of a knowledge assessment questionnaire, based on a narrative search of the literature, the elaboration of a training plan and the construction of a Specific Procedure. The knowledge assessment questionnaire was administered to nurses in two stages - before and after training.
Results: Sixty percent of the nurses in an Emergency Department of a hospital in central Portugal participated in the study, constituting a convenience non-probabilistic sample. Participants answered 60.4% of questions correctly before the intervention, increasing to 78.3% two months after. A positive change was observed in all questions, with 67.4% of the sample showing increased knowledge. The blood culture contamination rate reached 12.1% two months before the intervention, with no reduction after the intervention.
Conclusion: Nurses' knowledge improved after in-service training and the implementation of a specific procedure (p<0.001). However, there was no reduction in the contamination rate, indicating resistance to changes in behaviour. It is necessary to maintain educational intervention and add other strategies appropriate to the team's characteristics to reduce the blood culture contamination rate effectively.
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