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Application of participatory ergonomics to the dissemination of a quality improvement program for optimizing blood culture use
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10 2023
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Source: Jt Comm J Qual Patient Saf. 49(10):529-538
[PDF-1.93 MB]
Details:
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Alternative Title:Jt Comm J Qual Patient Saf
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Personal Author:
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Description:Background:
Blood cultures are overused in pediatric ICUs (PICUs), which may lead to unnecessary antibiotic use and antibiotic resistance. Using a participatory ergonomics (PE) approach, we disseminated a quality improvement (QI) program for optimizing blood culture use in PICUs to a national 14-hospital collaborative. The objective of this study was to evaluate the dissemination process and its impact on blood culture reduction.
Methods:
The PE approach emphasized three key principles (i.e., stakeholder participation, application of human factors and ergonomics knowledge and tools, cross-site collaboration) with a six-step dissemination process. Data on interactions between sites and the coordinating team and site experiences with the dissemination process were collected using site diaries and semi-annual surveys with local QI teams, respectively, and correlated with the site-specific change in blood culture rates.
Results:
Overall, participating sites were able to successfully implement the program and reduced their blood culture rates from 149.4 blood cultures per 1000 patient-days/month before implementation to 100.5 blood cultures per 1000 patient-days/month after implementation, corresponding to a 32.7% relative reduction (p < 0.001). Variations in the dissemination process, as well as in local interventions and implementation strategies, were observed across sites. Site-specific changes in blood culture rates were weakly negatively correlated with the number of pre-intervention interactions with the coordinating team (p = 0.057), but not correlated with their experiences with the six domains of the dissemination process or their interventions.
Conclusions:
We applied a PE approach to disseminate a QI program for optimizing PICU blood culture use to a multi-site collaborative. Working with local stakeholders, participating sites tailored their interventions and implementation processes and achieved the goal of reducing blood culture use.
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Pubmed ID:37429759
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Pubmed Central ID:PMC10688017
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