DOI QR코드

DOI QR Code

Effect of Multifaceted Interventions for Ward Nurses on the Storage, Conditions, and Transportation of Specimens for Microbial Culture

병동 간호사 대상의 다각적 중재가 배양검사 검체의 보관과 상태 및 운송에 미치는 영향

  • Cho, Min Jung (Department of Nursing, Asan Medical Center) ;
  • Jeong, Jae Sim (Department of Clinical Nursing, Graduate School of Industry, University of Ulsan) ;
  • Kim, Yoon Hee (Department of Nursing, Asan Medical Center)
  • 조민정 (서울아산병원 간호부) ;
  • 정재심 (울산대학교 산업대학원 임상전문간호학) ;
  • 김윤희 (서울아산병원 간호부)
  • Received : 2022.01.12
  • Accepted : 2022.05.17
  • Published : 2022.05.31

Abstract

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A one-group pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z= -4.89, p< .001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t= -3.19, p= .003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p< .001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes (± 1 hour 52 minutes) to 3 hours 1 minute (± 1 hour 41 minutes) (t= 2.51, p= .013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% (χ2= 6.90, p= .009). Conclusion: The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

Keywords

References

  1. Galar A, Leiva J, Espinosa M, Guillen-Grima F, Hernaez S, Yuste JR. Clinical and economic evaluation of the impact of rapid microbiological diagnostic testing. Journal of Infection. 2012;65(4):302-309. https://doi.org/10.1016/j.jinf.2012.06.006
  2. Berlid D, Mohseni A, Diep LM, Jensenius M, Ringertz S. Adjustment of antibiotic treatment according to the results of blood cultures leads to decreased antibiotic use and costs. Journal of Antimicrobial Chemotherapy. 2006;57(2):326-330. http://doi.org/10.1093/jac/dki463
  3. Lee NY. Reduction of pre-analytical errors in the clinical laboratory at the university hospital of Korea through quality improvement activities. Clinical Biochemistry. 2019;70:24-29. https://doi.org/10.1016/j.clinbiochem.2019.05.016
  4. Lee YJ, Lee JY, Kong SK, Yeon GM, Hong YR, Oh CE. A multicenter survey on the current status of pediatric blood cultures in Korea. Pediatric Infection and Vaccine. 2018;25(1):17-25. https://doi.org/10.14776/piv.2018.25.1.17
  5. Clinical and Laboratory Standards Institute. Principles and procedures for blood cultures; approved guideline. 1st ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2007.
  6. Kerremans JJ, van der Bij AK, Goessens W, Verbrugh HA, Vos MC. Needle-to-incubator transport time: logistic factors influencing transport time for blood culture specimens. Journal of Clinical Microbiology. 2009;47(3):819-822. https://doi.org/10.1128/JCM.01829-08
  7. Ronnberg C, Mildh M, Ullberg M, Ozenci V. Transport time for blood culture bottles: underlying factors and its consequences. Diagnostic Microbiology and Infectious Disease. 2013;76(3):286-290. https://doi.org/10.1016/j.diagmicrobio.2013.03.031
  8. Venturelli C, Righi E, Borsari L, Aggazzotti G, Busani S, Mussini C, et al. Impact of pre-analytical time on the recovery of pathogens from blood cultures: results from a large retrospective survey. PLoS One. 2017;12(1):e0169466. https://doi.org/10.1371/journal.pone.0169466
  9. Bang HI, Lim HM, Jang EY, Park ES, Lee EJ, Kim TH, et al. Activities of quality improvement for blood culture at a university hospital. Annals of Clinical Microbiology. 2015;18(3):88-93. http://dx.doi.org/10.5145/ACM.2015.18.3.88
  10. Kerremans JJ, van der Bij AK, Goessens W, Verbrugh HA, Vos MC. Immediate incubation of blood cultures outside routine laboratory hours of operation accelerates antibiotic switching. Journal of Clinical Microbiology. 2009;47(11):3520-3523. https://doi.org/10.1128/JCM.01092-09
  11. Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, et al. A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2018 update by the infectious diseases society of America and the American society for microbiology. Clinical Infectious Diseases. 2018;67(6):e1-e94. https://doi.org/10.1093/cid/ciy381
  12. Moos RH. Work environment scale manual: A social climate scale: Development, Applications and Research. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1994.
  13. Laboratory medicine, Asan Medical Center, Specimen collection and handling. Seoul: Asan Medical Center; 2019.
  14. Hall KK, Lyman JA. Updated review of blood culture contamination. Clinical Microbiology Reviews. 2006;19(4):788-802. https://doi.org/10.1128/CMR.00062-05
  15. Lalezari A, Cohen MJ, Svinik O, Tel-Zur O, Sinvani S, Al-Dayem YA, et al. A simplified blood culture sampling protocol for reducing contamination and costs: a randomized controlled trial. Clinical Microbiology and Infection. 2020;26(4):470-474. https://doi.org/10.1016/j.cmi.2019.09.005
  16. LaRocco MT, Franek J, Leibach EK, Weissfeld AS, Kraft CS, Sautter RL, et al. Effectiveness of preanalytic practices on contamination and diagnostic accuracy of urine cultures: a laboratory medicine best practices systematic review and meta-analysis. Clinical Microbiology Reviews. 2016;29(1):105-147. https://doi.org/10.1128/CMR.00030
  17. Murray MP, Doherty CJ, Govan JR W, Hill AT. Do processing time and storage of sputum influence quantitative bacteriology in bronchiectasis?. Journal of Medical Microbiology. 2010;59(7):829-833. https://doi.org/10.1099/jmm.0.016683-0
  18. Song YA, Kim HY, Lee HK. Nursing, robotics, technological revolution: robotics to support nursing work. Journal of Korean Gerontological Nursing. 2018;20(Suppl 1);144-153. https://doi.org/10.17079/jkgn.2018.20.s1.s144
  19. Cousein E, Mareville J, Lerooy A, Caillau A, Labreuche J, Dambre D, et al. Effect of automated drug distribution systems on medication error rates in a short stay geriatric unit. Journal of Evaluation in Clinical Practice. 2014;20(5):678-684. https://doi.org/10.1111/jep.12202
  20. Summerfield MR, Seagull FJ, Vaidya N, Xiao Y. Use of pharmacy delivery robots in intensive care units. American Journal of Health-System Pharmacy. 2011;68(1):77-83. https://doi.org/10.2146/ajhp100012
  21. Hoiby EA, Sandven P, Solberg O. Effect of temperature on the survival of Neisseria meningitidis. Acta Pathologica Microbiologica Scandinavica Series B: Microbiology. 1984;92B(1-6):73-77. https://doi.org/10.1111/j.1699-0463.1984.tb02797.x