Infection prevention in practice · 2026
Application of the Blood Culture Train model based on procedural and behavioural interventions to improve the quality of blood culture collection.
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Wang N, Huang T, Hu M, Jiang X, Wu H, Wang J, Sun Z, Liu B
Аннотация
OBJECTIVE: This study evaluated whether a multi-modal intervention based on the 'Blood Culture Train' (BCT) framework could enhance blood culture collection compliance and diagnostic yield in adult inpatients.
METHODS: We conducted a single-centre, before-and-after quasi-experimental study that compared key collection indicators in 2023 (before the intervention) and 2024 (after the intervention). The intervention consisted of a Clinical and Laboratory Standards Institute M47-A-compliant standardized workflow, blockchain-enabled traceability, virtual reality-based simulation training and a closed-loop quality feedback system. Primary outcomes were the bilateral collection rate and achievement of target blood volume; secondary outcomes included culture positivity, contamination and staff knowledge proficiency. Multi-variable logistic regression and a difference-in-differences (DID) analysis were used to test the independence and causality of observed effects.
RESULTS: After implementation, the bilateral collection rate rose from 44.5% to 89.9%, and blood-volume compliance increased from 62.0% to 92.5% (both P < 0.001). Culture positivity improved from 6.56% to 9.43% (P < 0.001), whereas the contamination rate decreased from 2.28% to 0.72% (P = 0.02). Staff knowledge scores increased by >25%. BCT exposure was independently associated with compliance (adjusted odds ratio = 5.67, 95% confidence interval: 4.53-7.09, P < 0.001), and the DID analysis confirmed a causal link between the intervention and outcome gains.
CONCLUSION: The BCT-based multi-modal strategy significantly improved blood culture collection compliance, reduced contamination and enhanced diagnostic yield. Its scalable design, underpinned by digital technologies, may be applicable to other primary and secondary healthcare settings.
METHODS: We conducted a single-centre, before-and-after quasi-experimental study that compared key collection indicators in 2023 (before the intervention) and 2024 (after the intervention). The intervention consisted of a Clinical and Laboratory Standards Institute M47-A-compliant standardized workflow, blockchain-enabled traceability, virtual reality-based simulation training and a closed-loop quality feedback system. Primary outcomes were the bilateral collection rate and achievement of target blood volume; secondary outcomes included culture positivity, contamination and staff knowledge proficiency. Multi-variable logistic regression and a difference-in-differences (DID) analysis were used to test the independence and causality of observed effects.
RESULTS: After implementation, the bilateral collection rate rose from 44.5% to 89.9%, and blood-volume compliance increased from 62.0% to 92.5% (both P < 0.001). Culture positivity improved from 6.56% to 9.43% (P < 0.001), whereas the contamination rate decreased from 2.28% to 0.72% (P = 0.02). Staff knowledge scores increased by >25%. BCT exposure was independently associated with compliance (adjusted odds ratio = 5.67, 95% confidence interval: 4.53-7.09, P < 0.001), and the DID analysis confirmed a causal link between the intervention and outcome gains.
CONCLUSION: The BCT-based multi-modal strategy significantly improved blood culture collection compliance, reduced contamination and enhanced diagnostic yield. Its scalable design, underpinned by digital technologies, may be applicable to other primary and secondary healthcare settings.