Phlebotomy teams reduce blood-culture contamination rate and save money.

Abstract

Objective: To determine the extent of resource utilization due to contaminated blood cultures.

Design: Case-control retrospective analysis. Twenty-three patients who had contaminated blood cultures were matched by age, underlying diseases, and discharge diagnoses with 23 patients who had negative blood cultures.

Setting: St Luke's Medical Center, a community teaching hospital in Cleveland, Ohio. The phlebotomy team was eliminated in November 1993 to reduce the costs.

Results: Blood cultures drawn by the phlebotomy team had a lower contamination rate compared with those drawn by nonphlebotomists (2.6% vs 5.6%). Patients with contaminated blood cultures were compared to those with negative blood cultures. The following parameters were found to be statistically significant: total hospital length of stay (LOS; 13.9 vs 5.5 days; P = .002), postculture LOS (8.9 vs 4.6; P = .01), postculture number of days on antibiotics (5.9 vs 2.9; P = .03), vancomycin use (9 vs 2 patients; P = .03), postculture cost of antibiotics ($762 vs $121; P = .004), and postculture hospital cost per patient ($10,515 vs $4,213; P = .001).

Conclusions: This study demonstrated a substantial increase in resource utilization in our hospital due to contaminated blood cultures. The reinstitution of a phlebotomy team could be a cost-effective solution with savings between $950,000 and $1.5 million per year for our hospital.