Improving Blood Culture Collection before Antibiotic Administration in Patients with Suspected Sepsis

Quality improvement project

Abstract

Objective: To assess baseline compliance with pre-antibiotic blood culture collection and evaluate the effect of targeted quality improvement interventions among patients with suspected sepsis.

Methods: This was a prospective observational study for quality improvement carried out at Ayub Teaching Hospital Abbottabad, between April 2026 and June 2026. There were 200 patients included who presented with suspected sepsis. Demographic features, timing of blood culture collection, use of antibiotics and factors associated with delay were recorded. Baseline compliance was evaluated and interventions like staff training, reinforcement of sepsis protocols and improved communication between lab and clinical services were implemented. Descriptive analysis was used to assess post-intervention compliance.

Results: Blood cultures were taken prior to antibiotic initiation in 118 of 200 patients (59%), 52 of 200 patients (26%) had blood cultures taken after antibiotic initiation, and 30 of 200 patients (15%) had no blood culture testing. The most frequent factors influencing delays in collection were delays in clinical decision-making (27%), emergencies workload (24%), and lack of knowledge of protocol (19%), laboratory-related delays (16%), and incomplete documentation (14%). After quality improvement, blood culture collection before antibiotics went from 59% to 82%.

Conclusion: Targeted quality improvement interventions were effective in increasing compliance with blood culture collection prior to antibiotic administration in patients suspected with sepsis. To improve the early diagnosis of sepsis and appropriate antimicrobial therapy, it is important to strengthen diagnostic stewardship, improve staff awareness and optimise clinical workflows.