Building blocks for the prevention of blood culture contamination: A quality improvement intervention in emergency department

Blood culture contamination, commonly caused by skin flora, leads to false-positive results, unnecessary antibiotic use, increased costs, and antimicrobial resistance. A multimodal intervention was initiated in the emergency department of a tertiary care hospital in Western India to reduce contamination. Root cause analysis identified unstandardized collection practices and inadequate staff knowledge. Interventions included standardized blood collection kits, two-step skin antisepsis, visual posters, and repeated hands-on staff training. Post-intervention, contamination rates decreased from 9.04% to 3.8%, while paired blood culture sampling increased from 80% to 93%. The study demonstrates that standardized procedures and focused training can effectively reduce blood culture contamination.