A quality improvement initiative on blood culture processing in a Paediatric Oncology Unit (POU) at Parirenyatwa Group of Hospitals (PGH) in Zimbabwe

Abstract

Objective: Quality intervention to improve blood culture services on the Paediatric Oncology Unit (POU) at Parirenyatwa Group of Hospitals (PGH).
Design: Quality Intervention (QI).
Setting: Paediatric Oncology Unit in ward A4 at PGH.
Subjects: Health care workers on POU, laboratory personnel and admitted patients on the POU requiring a blood culture during study period (October 2018 to October 2019).
Main Outcome Measures: Increased access to blood culture kits, increased positive blood culture yield and reduction of contamination.
Results: A Standard Operating Procedure (SOP) on aseptic collection of peripheral blood was updated for the hospital. Monthly educational sessions were conducted for rotating Medical Officers (MOs) on the POU between October 2018 and October 2019 on the SOP. Ready-to-use blood culture kits were availed on the ward and placed within easy access for the MOs. A total of 190 episodes of fever were investigated using a blood culture during the study period. Of the total, 28 (14.7%) episodes of fever yielded positive growth while 15 (7.8%) yielded what were considered as contaminants. One sample did not meet acceptance criteria and the rest were negative. A decreasing trend of contamination mainly due to Coagulase Negative Staphylococcus(CoNS) was observed during the study period.
Conclusion: Continuous quality interventions at both clinical and laboratory interfaces are associated with positive results on key performance indicators of blood culture processing such as yield of pathogens and reduction of contamination.