Infectious Diseases Prevention and Control

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https://hdl.handle.net/20.500.11888/18810

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Browsing Infectious Diseases Prevention and Control by Author "Zaid,Mariam"

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    THE EFFECTIVENESS OF MULTIMODAL INTERVENTIONS ON REDUCING BLOOD CULTURE CONTAMINATION RATES IN GOVERNMENTAL HOSPITALS: A PRE- AND POST-STUDY
    (An-Najah National University, 2025-08-14) Zaid,Mariam
    Background: Blood Culture (BC) is a diagnostic standard for detecting bloodstream infections, which contribute substantially to hospital morbidity and mortality. However, even with modern medical technology, contamination rates remain a persistent challenge, potentially compromising diagnostic accuracy and clinical decision-making. Objective: This study aimed to assess the effectiveness of a multimodal intervention in reducing the blood culture contamination (BCC) rate to below 3%, in line with the Clinical and Laboratory Standards Institute (CLSI) guidelines, as well as to enhance nurses' knowledge, practice, and adherence to proper BC collection practices. Method: We conducted a six-months pre-post intervention study at secondary governmental hospital in the northern of the Palestine, assessing four primary outcomes in the pre and post intervention phases: (1) BCC rates, (2) nurses' theoretical knowledge, (3) nurses practice, and (4) procedural compliance for both peripheral and central venous access device (CVAD) collections. The intervention package comprised six key components: introducing the standard procedure of the BC collection, structured education sessions, a standardized bundle checklist, visual reminders, performance feedback, and real-time procedural corrections that were used for two months in the intervention phase. Descriptive and analytical analysis were performed to find relationships between different sociodemographic and working conditions variables and the knowledge and practice of nurses. Bloom's criteria were used to evaluate the total knowledge, practice, and compliance for the procedure of blood culture collection. Statistical analyses were performed using SPSS version 21, with significance set at p-value ≤ 0.05. Results: The multimodal intervention demonstrated significant improvements across all measured outcomes. Nurses' knowledge scores increased substantially from 55.48% (poor knowledge) in pre-intervention to 92.54% (good knowledge) in post-intervention phase (p <0.001), and nurses' practice improved significantly post-intervention from 25.36% (poor practice) to 40.19% (bad practice) (p <0.001). Procedural compliance showed marked enhancement for both peripheral vein collections (80.4% (good compliance) to 96.43% (good compliance) and CVAD collections (68.25% (bad compliance to 94% (good compliance)), with both improvements being statistically significant (p <0.001). Most importantly, the BCC rate declined from 9.4% to 2.4%, achieving the study's target of falling below the 3% CLSI benchmark. Conclusion: This study demonstrates that targeted multimodal interventions can effectively reduce BCC rates to meet clinical standards while substantially improving both theoretical knowledge and practical compliance among nursing staff. These findings underscore the value of combined educational and operational strategies in optimizing diagnostic microbiology quality, ultimately enhancing patient care through more reliable bloodstream infection detection.