{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:30:59Z","timestamp":1790659859379,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","award":["EMSS\u2010400R30\u20102018"],"award-info":[{"award-number":["EMSS\u2010400R30\u20102018"]}],"id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Blood cultures (BCs) remain a key investigation in ED patients at risk of bacteraemia. The aim of this study was to assess the effect of a multi\u2010modal, nursing\u2010led intervention to improve the quality of BCs in the ED, in terms of single culture, underfilling and contamination rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The present study was conducted in the ED of a large urban tertiary referral hospital. The study included four phases: pre\u2010intervention, intervention, post\u2010intervention and sustainability periods. A multi\u2010modal intervention to improve BC quality consisting small group education, posters, brief educational videos, social media presence, quality feedback, small group\/individual mentoring and availability of BC collection kits was designed and delivered by two senior ED nurses over 7\u2009weeks. Study data comprised rates of single, underfilled and contaminated cultures in each of three 18\u2010week periods: pre\u2010intervention (baseline), post\u2010intervention and sustainability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period 4908 BC sets were collected during 2347 episodes of care in the ED. Single culture sets reduced from 56.2% in the pre\u2010intervention period to 22.8% post\u2010intervention (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01) and 18.8% in the sustainability period (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Underfilled bottle rates were also significantly reduced (aerobic 52.8% pre\u2010intervention to 19.2% post\u2010intervention, 18.8% sustainability, anaerobic 46.8% pre\u2010intervention to 23.3% post\u2010intervention, 23.8% sustainability). Skin contaminants were grown from 3.7% of BC sets in the pre\u2010intervention period, improving to 1.5% in the post\u2010intervention period (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 2.1% in the sustainability period (<jats:italic>P<\/jats:italic>\u2009=\u20090.03). Total volume of blood cultured was significantly associated with diagnosis of bacteraemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant improvements in BC quality are possible with nursing\u2010based interventions in the ED.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14329","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T07:50:12Z","timestamp":1698652212000},"page":"133-139","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Changing culture: An intervention to improve blood culture quality in the emergency department"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-7307","authenticated-orcid":false,"given":"Julian","family":"Williams","sequence":"first","affiliation":[{"name":"Emergency and Trauma Centre, Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"Faculty of Medicine and Biomedical Sciences The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9832-0461","authenticated-orcid":false,"given":"Angela","family":"Hills","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre, Royal Brisbane and Women's Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"Ray","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre, Royal Brisbane and Women's Hospital Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimi","family":"Greenslade","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre, Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"School of Public Health and Social Work Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idh.2021.09.032"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-1282.194924"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2021.02.006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1696"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"e_1_2_9_7_1","volume-title":"Principles and Procedures for Blood Cultures. 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