Implementation of an Intervention to Improve Blood Culture Stewardship in 14 Adult ICUs and Wards.

In 14 adult ICUs and wards across seven US acute care hospitals, a blood culture algorithm QI reduced BCx utilization by ~20% in four ICUs, with one showing 50% higher positivity.

• Why it matters: Evidence is limited on what drives successful diagnostic stewardship implementation to improve blood culture ordering in adult inpatient settings.
• What they did: Over one year (April 2022 to June 30, 2024), teams implemented an evidence-based BCx algorithm with education plus monitoring and feedback, then assessed 12-month BCx utilization changes using interviews, QI diaries, and a frontline provider survey.
• The result: Greater baseline BCx inappropriateness was linked to significant BCx utilization reduction, and coincidence analysis associated improved BCx utilization with perceptions that the algorithm was easy to use and reduced unnecessary repeat cultures, plus nurse involvement and regular education/feedback.

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