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Doern CD, Whitman M, Doll M, Lavoie S, Friedel D, Bearman G, Kim J, Masters H, Roseff S, Willis J, Mercer R, Hill A, Feeser R, Dhindsa H, Petruzella F, Jackson A, Vitto M, Plauny J, Bryson A. Blood culture bottle shortage mitigation efforts: analysis of impact on ordering and patient impact. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2025; 5:e6. [PMID: 39810856 PMCID: PMC11729487 DOI: 10.1017/ash.2024.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 10/22/2024] [Accepted: 11/07/2024] [Indexed: 01/16/2025]
Abstract
Objective design In June of 2024, Becton Dickinson experienced a blood culture bottle shortage for their BACTEC system, forcing health systems to reduce usage or risk exhausting their supply. Virginia Commonwealth University Health System (VCUHS) in Richmond, VA decided that it was necessary to implement austerity measures to preserve the blood culture bottle supply. Setting VCUHS includes a main campus in Richmond, VA as well as two affiliate hospitals in South Hill, VA (Community Memorial Hospital (CMH)) and Tappahannock Hospital in Tappahannock, VA. It also includes a free-standing Emergency Department in New Kent, VA. Patients Blood cultures from both pediatric and adult patients were included in this study. Interventions VCUHS intervened to decrease blood culture utilization across the entire health system. Interventions included communication of blood culture guidance as well as an electronic health record order designed to guide providers and discourage wasteful ordering. Results Post-implementation analyses showed that interventions reduced overall usage by 35.6% (P < .0001) and by greater than 40% in the Emergency Departments. The impact of these changes in utilization on positivity were analyzed, and it was found that the overall positivity rate increased post-intervention from 8.8% to 12.1% (P = .0115) and in the ED specifically from 10.2% to 19.5% (P < .0001). Conclusions These findings strongly suggest that some basic stewardship interventions can significantly change blood culture practice in a manner that minimizes the impact on patient care.
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Affiliation(s)
- Christopher D. Doern
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Melissa Whitman
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Michelle Doll
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Suzanne Lavoie
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - David Friedel
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Gonzalo Bearman
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Jeffrey Kim
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Heather Masters
- Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Susan Roseff
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Jim Willis
- Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Roxanne Mercer
- Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Aaron Hill
- Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Ramana Feeser
- Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Harinder Dhindsa
- Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Frank Petruzella
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Anne Jackson
- Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Michael Vitto
- Department of Emergency Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Josh Plauny
- Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Alexandra Bryson
- Department of Pathology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Dräger S, Osthoff M. Pitfalls for blood culture diagnostic stewardship. Author's Reply. Eur J Intern Med 2022; 105:102-103. [PMID: 36100473 DOI: 10.1016/j.ejim.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Sarah Dräger
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland; Department of Clinical Research, University of Basel, Schanzenstrasse 55, Basel 4056, Switzerland.
| | - Michael Osthoff
- Division of Internal Medicine, University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland; Department of Clinical Research, University of Basel, Schanzenstrasse 55, Basel 4056, Switzerland
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