Abstract Background Blood culture contamination poses a significant challenge in healthcare settings, leading to false-positive results which can negatively affect patient care. Contaminated blood cultures result in unnecessary antibiotic use, increased antimicrobial resistance, prolonged hospital stays, and higher healthcare costs. Studies estimate that each false-positive blood culture can add approximately 4367 per patient per night in hospital expenses (Dempsey et al. , 2019). From 2016-2024, our facility decreased our contamination rates from 3. 90% to 0. 86% through multiple targeted interventions. Methods We strategized to take full ownership of blood culture collections, performed extensive training on collection site preparation and implemented a blood culture collection diversion device, which significantly reduced contamination rates to as low as 0. 36% (2021) and 0. 42% (2022). After discontinuing the use of blood culture diversion devices, our team observed an increase in contamination rates to 0. 73% (2023). Recognizing the need for an alternative solution, we conducted a thorough review of aseptic techniques and best practices. We implemented a standardized protocol emphasizing the following key interventions: Educating the team about the importance to properly clean the collection site (eg. , cost, antibiotic stewardship, antibiotic resistance, length of stay) Thoroughly cleansing the venipuncture site with clorhexidine before blood culture collectionExtending the duration of skin preparation to assure complete drying of the clorhexidine to enhance microbial eradicationKeeping blood culture bottles covered with alcohol pads once uncapped to prevent environmental contaminationEnsuring healthcare personnel tied back or covered their hair to minimize airborne contaminantsReinforcing the use of sterile gloves and proper hand hygiene throughout the procedure Results After implementing these enhanced aseptic techniques, blood culture contamination rates remained low, measuring 0. 86% in 2024 and further decreasing to 0. 46% in 2025, even without the use of diversion devices. The slight increase in 2024 was attributed to a lapse in retraining on proper collection techniques, highlighting a breakdown in the process. This underscores the necessity of ongoing education and adherence to standardized protocols to sustain low contamination rates. Conclusion This process improvement initiative demonstrated that refining blood culture collection techniques could significantly reduce contamination rates without requiring diversion devices. The COVID-19 pandemic further contributed to this reduction through the increased utilization of masks, enhanced infection control measures, and modifications in collection techniques. Strategies such as covering the hair, wearing masks, and educating patients on the importance of not speaking over the collection site or in the direction of the procedure helped minimize environmental contamination. By implementing stricter aseptic protocols, we effectively reduced false-positive blood cultures, leading to improved patient outcomes and lower hospital costs. These findings underscore the importance of continuous quality improvement in laboratory management and highlight the critical role of standardized infection prevention practices in sustaining low contamination rates.
Bowens et al. (Wed,) studied this question.