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Improvement Methodology Increases Guideline Recommended Blood Cultures in Children With Pneumonia
- Source :
- Pediatrics
- Publication Year :
- 2015
- Publisher :
- American Academy of Pediatrics, 2015.
-
Abstract
- BACKGROUND AND OBJECTIVE:A national evidence-based guideline for the management of community-acquired pneumonia (CAP) in children recommends blood cultures for patients admitted with moderate to severe illness. Our primary aim was to increase ordering of blood cultures for children hospitalized with CAP from 53% to 90% in 6 months. The secondary aim was to evaluate the effect of obtaining blood cultures on length of stay (LOS).METHODS:At a tertiary children’s hospital, interventions to increase blood cultures focused on 3 key drivers and were tested separately in the emergency department and inpatient units by using multiple plan-do-study-act cycles. The impact of the interventions was tracked over time on run charts. The association of ordering blood cultures and LOS was estimated by using linear regression models.RESULTS:Within 6 months, the percentage of patients admitted with CAP who had blood cultures ordered increased from 53% to 100%. This change has been sustained for 12 months. Overall, 239 (79%) of the 303 included patients had a blood culture ordered; of these, 6 (2.5%) were positive. Patients who had a blood culture did not have an increased LOS compared with those without a blood culture.CONCLUSIONS:Quality improvement methods were used to increase adherence to evidence-based national guidelines for performing blood cultures on children hospitalized with CAP; LOS did not increase. These results support obtaining blood cultures on all patients admitted with CAP without negative effects on LOS in a setting with a reliably low false-positive blood culture rate.
- Subjects :
- Moderate to severe
Male
Pediatrics
medicine.medical_specialty
Inservice Training
Psychological intervention
Bacteremia
Quality Report
Internal medicine
medicine
Inpatient units
Pneumonia, Bacterial
Humans
Blood culture
Child
Ohio
Academic Medical Centers
Evidence-Based Medicine
medicine.diagnostic_test
business.industry
Infant
Guideline
Emergency department
Length of Stay
medicine.disease
Quality Improvement
Anti-Bacterial Agents
Community-Acquired Infections
Pneumonia
Child, Preschool
Pediatrics, Perinatology and Child Health
Utilization Review
Linear Models
Female
Guideline Adherence
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....dd63fe41434d29143a2dd0da25d87dc6