Blood cultures
programmes – a field which has not yet been fully explored.12
Is it just too expensive? One common concern regarding the use of blood cultures is the associated cost. Adding a blood culture set to the diagnostic pathway for example will increase costs in terms of reagents and potentially new equipment. Implementing improvements in all steps of the pathway may also require initial funding, so the question should rather be whether the benefits outweigh these expenses.
Given the substantial morbidity, mortality, and healthcare costs associated with BSIs, a rapid and accurate diagnosis is critical. In this context, integrating rapid pathogen identification and antimicrobial stewardship can significantly decrease hospital costs mainly associated with a reduction in length of stay.14,15
Cost savings
along the patient journey may also come from reducing treatment failure, complications, and unnecessary antibiotic use. Additionally identifying and reducing false positive blood cultures is cost-effective, as they can result in unnecessary treatment and prolonged hospital stays, which carry a significant financial burden.16 However, in order to gain a better
understanding of the cost-effectiveness of rapid diagnostic techniques and their impact on routine clinical practice, comprehensive economic evaluations should be conducted, considering the entire care pathway and all healthcare professionals involved. Blood cultures can also support antibiotic
stewardship efforts, which are crucial for reducing the emergence of antibiotic-resistant infections and achieving long-term savings. Therefore, a broad perspective and leadership involvement are essential for optimising the use of blood cultures as a cost-effective diagnostic tool.
Education and leadership NHS England are recommending to establish a governance framework that spans the entire blood culture pathway, ranging from regulator through to board, to the ward.1
This framework
aims to ensure that all stakeholders understand their role, the significance of the blood culture pathway, and how to monitor its performance. A multi-disciplinary team should be formed
to improve the blood culture pathway and one of their first tasks will be to explain the “why”, in terms that each stakeholder can understand. Most recently, several educational resources have been developed including e-learning
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modules from BSAC and NHS England, which have been cleverly targeted to specific specialties (e.g lab, paediatric and patient-facing staff).17
BioMérieux is also offering a medical
education programme in order to support laboratories and members of the healthcare team on best blood culture practices. It should be emphasised that education alone is not enough: sustained improvement requires coaching, mentoring, and ongoing feedback sessions. Continuous improvement of the whole BSI diagnostic process should be a priority to improve patient outcomes and avoid unnecessary antibiotic treatment. A set of key performance indicators should be established and seen as a core part of Trust leadership and governance. In conclusion, optimising the blood culture
pathway is essential to ensure the best possible outcome for patients with BSI or sepsis, while simultaneously providing effective antimicrobial stewardship, which will help preserve antibiotics efficacy for future generations.
References 1 NHS England. Improving the Blood Culture Pathway – Executive Summary. Available at:
https://www.england.nhs.uk/publication/ improving-the-blood-culture-pathway-
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