The effectiveness of an online training program in a nursing unit: extraction of blood cultures

Zaragoza-García, Ignacio; Pérez-García, Santiago; Orellana-Miguel, María de los Ángeles; Posé-Becerra, Clotilde; Goñi-Olangua, María Andión

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Original Article • Rev. esc. enferm. USP 53 • 2019 • https://doi.org/10.1590/S1980-220X2018040003531 copy

The effectiveness of an online training program in a nursing unit: extraction of blood cultures

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To assess the effectiveness of an online training platform for procedures among nurses in an internal medicine unit to reduce the number of contaminated blood cultures.

Method:

This was a quasi-experimental pre-post intervention parallel group study. The sample consisted of internal medicine nurses in a tertiary hospital who participated in an online training program about blood culture extraction technique. Knowledge about the technique was measured pre- and post-intervention. Additionally, the study compared the number of blood cultures taken 6 months before and 3 months after the intervention.

Results:

Forty-eight nurses participated. Pre-intervention knowledge was homogeneous among both groups, improving significantly after the online training program (p=0.0001). The blood cultures taken prior to the training showed contamination levels above international standards; post-intervention, contamination levels fell by up to 3% in the intervention group.

Conclusion:

The educational intervention using the digital platform increased knowledge about the procedure and its application in clinical practice.

DESCRIPTORS
Blood Culture; Contamination; Phlebotomy; Nursing; Health Education

Variables		Experimental (N=26)	Control (N=22)	p-value
Variables		Mean(SD)	Mean(SD)	p-value
Age (years)		40.17(9.05)	39.61(7.88)	^* * Mann-Whitney U Test; 0.949
Gender
	Male	11.5%	4.5%	^ Chi-squared; 0.763
	Female	88.5%	95.5%	^ Chi-squared; 0.317
Years of experience in the internal medicine unit		2.38(1.8)	4.54(3.04)	^* * Mann-Whitney U Test; 0.65
Knowledge of BC extraction technique
Mean score
	Pre-intervention	4.62(1.57)	4.88(0.86)	p=^* * Mann-Whitney U Test; 0.983
	Post-intervention	8.2(0.72)	4.6(0.9)	p=^* * Mann-Whitney U Test; 0.0001
*p-value*		p=^* ***** Wilcoxon test 0.0001	p=^* ***** Wilcoxon test 0.106

Variables		Pre-general characteristics			Post-general characteristics
		Experimental (N=128)	Control (N=127)	p-value	Experimental (N=54)	Control (N=78)	p-value
		Mean(SD)	Mean(SD)	p-value	Mean(SD)	Mean(SD)	p-value
Age (years)		72.7±16.6	73±15.9	^* * Mann-Whitney U test, 0.762	73.8±15.6	72±16.6	^* * Mann-Whitney U test, 0.756
	Age Women (years)	75±14.2	74.5±17.1	^* * Mann-Whitney U test, 0.679	78.1210	69.9417.1	^* * Mann-Whitney U test, 0.117
	Age Men (years)	70.41±18.6	72.2±15.2	^* * Mann-Whitney U test, 0.656	66.120.3	73.416.3	^* * Mann-Whitney U test, 0.159
Gender				--			--
	Female	50.8%	35.4%	^ Chi-squared. 0.057	63%	42.3%	^ Chi-squared. 0.903
	Male	49.2%	64.6%	^ Chi-squared. 0.115	37%	57.7%	^ Chi-squared. 0.002
Length of hospital stay		18.4±12	18.72±14.3	^* * Mann-Whitney U test, 0.632	18.9±10.1	18.5±21.8	^* * Mann-Whitney U test, 0.457
	Stay Women	18.2±13.2	18.12±12.5	^* * Mann-Whitney U test, 0.564	18.5±13.9	15.5±13.6	^* * Mann-Whitney U test, 0.243
	Stay Men	18.6±14.1	19.06±155.3	^* * Mann-Whitney U test, 0.824	19.6±19.6	20.6±26.1	^* * Mann-Whitney U test, 0.926
Reason for extraction
	Fever peak	74.2%	73.4%	^ Chi-squared. 0.403	72.5%	79.5%	^ Chi-squared. 0.104
	Protocol	13.4%	14.1%	^ Chi-squared. 0.392	15.9%	2.3%	^ Chi-squared. 0.004
	Extraction without fever	10.3%	9.8%	^ Chi-squared. 0.735	11.6%	15.9%	^ Chi-squared. 0.796
	Catheter-drawn blood culture	2.1	2.7	^ Chi-squared. 0.576	--	2.3%	--

Variables	Pre-intervention BC Result			Post-intervention BC result
Variables	Case (N=258)	Control (N=325)	p-value	Case (N=168)	Control (N=158)	p-value
Sterile culture	88.4% (228)	92% (299)	^ Chi-squared. 0.002	88.7% (149)	82.5% (132)	^ Chi-squared. 0.31
Microorganism cultivated	11.6% (30)	8% (26)	^ Chi-squared. 0.724	11.3% (19)	16.5% (26)	^ Chi-squared. 0.297
Contaminated BC of total	6.6% (17)	4.6% (15)	^ Chi-squared. 0.683	3% (5)	9.5% (15)	^ Chi-squared. 0.025

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Ignacio Zaragoza-García Plaza de Ramón y Cajal, s/n, 28040 – Madrid, Spain izaragoz@ucm.es