New way of drawing blood gets dramatic results

A Medical University of South Carolina study found the use of a mechanical initial specimen diversion device and staff education led to a nearly fourfold decrease in contaminated blood cultures that was sustained over 20 months.

Results of the emergency department research were presented at the Institute for Healthcare Improvement National Forum by lead study author Lisa Steed, Ph.D., MUSC Department of Pathology and Laboratory Medicine professor.

“Working on this study and seeing such strong results speaks to the great things that can happen for patients when clinicians join forces on these issues,” Steed said. “Blood cultures and the accuracy of those cultures are incredibly important in making sure that patients are getting the right care at the right time and with the right process in place.”

Blood cultures help doctors figure out whether patients have serious and potentially life-threatening blood infections such as sepsis. Blood draws can become contaminated with bacteria-containing fragments of a patient’s skin that enter the needle during the blood collection process.

Studies have shown conventional techniques can lead to false positives. That can mean more blood has to be drawn, the patient stays longer in the hospital and may get antibiotics that aren't really needed.

The mechanical initial specimen diversion device used in the study, called Steripath, is a sterile, closed blood culture collection system that diverts, sequesters and isolates the first 1.5 to 2 milliliters of blood — the portion known to contain contaminants — during the blood draw.

“We’ve seen a significant reduction of blood culture contaminations in our emergency department by using this device, along with education and training,” said Danielle Scheurer, M.D., MUSC Health chief quality officer. “By lessening the chances of contaminating a specimen, we increase our accurate diagnoses and treat patients with real infections. This in turn leads to decreased antibiotic use and allows us to help mitigate the ongoing, nationwide problem of antibiotic resistance from over or improper use.”

The study, funded by MUSC Health, also showed that using a mechanical initial specimen diversion device, or ISDD, could reduce costs and use staff time more efficiently. Researchers suggested that MUSC would have saved $744,955 if the ISDD had been used for every blood draw in the emergency department during the study, based on a conservative estimate ($4,850) for the cost of a contaminated culture.