Quality Assurance and Performance Improvement
Concurrent Education Session - 60 minutes
Joan Hebden, RN, MS, CIC, FAPIC
Infection Prevention Consultant
IPC Consulting Group LLC
Aerobiotix: Speaker/Honoraria; Cepheid: Speaker/Honoraria; ICU Medical: Speaker/Honoraria; PDI, Inc: Consultant/Advisory Board
Diagnostic stewardship (DS) involves modifying the ordering, collection, and timely reporting of diagnostic tests to improve treatment of infectious conditions. Suboptimal culturing practices adversely impact patient safety, quality of care, institutional financial outcomes, and may lead to reporting of false-positive urinary tract and bloodstream infections. The enhancement of DS efforts in partnership with antimicrobial stewardship (AS) programs promotes the right interpretation of the test result, selection of the right antimicrobial, administered at the right time.
Recent reviews and surveys of urine and blood culturing practices have identified significant knowledge gaps associated with culturing processes and unacceptable rates of contamination. Inappropriate collection of these cultures may lead to the wrong diagnosis and expose patients to unnecessary testing and treatments. Historically, procedural documents for accurate collection of these cultures have been microbiology laboratory-based practice guidelines, which are likely not included in formal education of the clinicians responsible for obtaining the specimens.
Although ensuring proper urine and blood culturing techniques is recommended as a nurse-driven AS practice by the CDC and the American Nursing Association, nurses’ knowledge of proper technique is largely gained informally through experience in a see-one, do-one, and teach-one approach.
This session will help participants better understand the relationship between DS and AS and will review the “why” behind proper culturing techniques and the implications of false positive results for patients. Participants will learn how to create standardized practice guidelines to optimize patient safety and affect true behavioral change.