Abstract:
Introduction. Bloodstream infection is a critical cause of morbidity and mortality, and high-quality blood culture practice is essential for accurate diagnosis and antimicrobial stewardship, particularly in regional and remote healthcare settings.
Gap Statement. Clinicians working in rural emergency departments (EDs) encounter unique systemic, workforce and logistical barriers to optimal blood culture practice, yet these challenges are not well characterized in the existing literature.
Aim. To explore clinician-reported barriers and enablers to high-quality blood culture collection across regional EDs in Western Australia.
Methodology. A qualitative study was conducted involving semi-structured interviews with doctors and nurses from three Western Australia Country Health Service EDs. Transcripts were analysed thematically to identify factors influencing blood culture ordering, collection technique, contamination and workflow integration.
Results. Twenty-four clinicians participated, describing substantial delays between sample collection and laboratory processing, difficulty obtaining two sets per episode and limited feedback on contamination or blood volume adequacy. Workforce turnover, variable training and inconsistent guideline use contributed to practice variation. Key enablers included strong team culture, leadership from clinical champions, structured induction, refresher training and the use of dual-set kits and visual dashboards to provide timely, non-punitive feedback.
Conclusion. High-quality blood culture practice in rural EDs is shaped by multifactorial systemic, workflow and workforce constraints and targeted, locally relevant interventions are essential to improve diagnostic yield and strengthen antimicrobial stewardship.
Reference:Thomas E, Watson M, Inglis T, MacDonald S. Clinician perspectives on blood culture practice and diagnostic stewardship in regional emergency departments. J Med Microbiol. 2026 Jun;75(6):002171. doi: 10.1099/jmm.0.002171. PMID: 42274238; PMCID: PMC13257355.
