An Evidence‐Based Practice and Process Improvement Initiative Decreases Blood Culture Contamination and Healthcare Costs

SIGNIFICANCE AND BACKGROUND: Blood culture contamination contributes to diagnostic errors, unnecessary antibiotic use, prolonged hospital stays, and increased healthcare costs. In 2024, a system-wide initiative was launched across a 15-hospital Midwest healthcare system to reduce contamination rates using the Practice and Process Improvement: Integrated Evidence-Based Quality (PPQ) Model, which integrates evidence-based practice (EBP) and process improvement methodologies. AIMS OF THE INITIATIVE: This initiative aimed to: (1) identify best practices for the reduction of blood culture contamination; (2) reduce blood culture contamination by implementing the best practice, which included standardized, evidence-based collection kits and dedicated teams to enhance team competency; and (3) establish a sustainable feedback system to support practice and continuous quality improvement. IMPLEMENTATION PROCEDURE: Guided by the Advancing Research through Close Collaboration (ARCC) model and the DMAIC process, a multidisciplinary team identified best practices and practice and process gaps. Interventions included redesigning blood culture kits to integrate forcing functions and aseptic techniques, embedding multimodal education strategies, and launching a small test of change with robust leadership support. Real-time data feedback loops and unit-based contextual assessments supported sustainable implementation. OUTCOMES: Post-implementation, the test unit achieved zero contaminations and zero CLABSI events over 5 months. Compliance with peripheral collection by dedicated, trained staff exceeded 98%. Projected cost avoidance included $133,500 in antibiotic use and $2.4 M from reduced length of stay. The initiative demonstrated operational feasibility, system alignment, and improved care quality. LINKING EVIDENCE TO ACTION: This project demonstrates how practice and process improvement combined with well-planned implementation leads to positive outcomes and substantial return on investment. Effective collaboration between interprofessional teams led to successful system-wide implementation, resulting in practical and sustained practice change.