Improvement methodology increases guideline recommended blood cultures in children with pneumonia

Pediatrics
Eileen Murtagh KurowskiLilliam Ambroggio

Abstract

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). 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. 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. Quality improvement methods were used to increase adherence to ev...Continue Reading

Citations

Mar 11, 2016·Current Infectious Disease Reports·Russell J McCulloh, Karisma Patel
Nov 5, 2016·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Lori RutmanRita Mangione-Smith
May 21, 2019·Journal of the Pediatric Infectious Diseases Society·Todd A FlorinNathan Kuppermann
Sep 15, 2019·Hospital Pediatrics·Susan C LipsettMark I Neuman
Aug 31, 2017·Hospital Pediatrics·Michelle W ParkerPatrick W Brady
Sep 19, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·David P JohnsonMarquita Genies
Jan 15, 2016·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Kavita ParikhSamir S Shah
Jul 14, 2020·Pediatric Quality & Safety·Corinne E ShubinRebekah A Burns
Dec 26, 2018·Pediatric Quality & Safety·Amanda J RogersAndrea K Morrison

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