Comments on: Sticking Blood Cultures and “HospitalCompare”

By: Choosing a Doctor « WhiteCoat Rants

Choosing a Doctor « WhiteCoat Rants — Tue, 23 Dec 2008 11:33:53 +0000

[...] http://www.hospitalcompare.whatever.com. Stop worrying so much about “quality indicators” that have no basis in science and start worrying more about being good to your patients and your staff [...]

By: kris

kris — Wed, 03 Dec 2008 13:53:08 +0000

i’m confused…we have to draw blood cultures on all our pneumonia patients for ebm or cap protocol or some other mandated crap..no temp no elevated wbc…doesn’t matter. we admit from the er with dx like uti with sepsis…wtf..didn’t know cultures grew like in 2 hours. just a lowly floor nurse here but it does seem like overkill

By: Nurse K

Nurse K — Tue, 02 Dec 2008 01:58:46 +0000

Many an idle moment has been spent waiting for these blood cultures to be drawn successfully so I can give antibiotics. It’s hard to get like 40 cc of blood (10cc per bld cx + 20 cc for the six million other sepsis labs) out of someone with no veins. A good way to cause a net delay in antibiotic treatment is to order blood cultures on everyone.

PS Evidence-based practice has no place in JCAHO mandates. DUH.

By: cynic

cynic — Tue, 02 Dec 2008 00:30:34 +0000

Whitecoat, I 100% agree with you and this study. I read it last night and was hoping someone would do a writeup on it. So let me just say thank you.

Likewise, I would like to hear what Happy Hospitalist has to say about this. Hopefully he will chime in, or any other IM guys lurking around.

By: Andrew Garland

Andrew Garland — Mon, 01 Dec 2008 19:18:44 +0000

There was a potential savings of $16,758 in costs and $124,286 in charges at ONE HOSPITAL.

So, you want to put the hospital out of business? These tests are a moneymaker. And the false positives are worth another $200 in profit for each test given (5% x $5000 at an 8:1 charge:cost ratio). The best criteria should be to give the tests (1) where indicated, and (2) if insured. (Yes, sarcasm) You gave me a WTF moment ... until I saw the "yes, sarcasm" remark. Damn you. My brain can't take shocks like that.

By: ERP

ERP — Mon, 01 Dec 2008 15:47:28 +0000

It is my understanding that you can just do one culture as long as you take at least 15cc of blood instead of a tiny splash that just darkens the bottle. The chance of contamination is reduced. Interesting idea. I tried to find something about this online and was only able to come up with a BMJ study in neonates.