Ms Bonnie Woods1, Associate Professor Krispin Hajkowicz1,2,3, Associate Professor Patrick Harris1,2,3,4, Professor Claire Rickard1,5, Professor Jason Roberts1,2,3, Associate Professor Jessica Schults1,5, Dr Rebecca Ward1,2,3
1Herston Infectious Diseases Institute, Herston, Australia, 2University of Queensland, Frazer Institute, Herston, Australia, 3Royal Brisbane and Women's Hospital, Herston, Australia, 4Pathology Queensland, Herston, Australia, 5University of Queensland, School of Nursing, Herston, Australia
Biography:
Ms Woods is a registered nurse with 20 years clinical experience who is currently in a Nurse Research Fellow position with the Herston Infectious Diseases Institute. She is passionate about clinical research and improving patient outcomes and has a background coordinating multidisciplinary teams and research associated with device related infection.
Abstract:
Bloodstream infections (BSIs) are a leading cause of mortality among healthcare-associated infections in Australia, with approximately 3,500 deaths annually. Current hospital responses to suspected BSI are unclear and curbed by staffing and system capabilities. Early recognition pathways and rapid diagnostics offer opportunities to improve outcomes, antimicrobial stewardship (AMS), and multidisciplinary coordination. This study explored clinician and consumer experiences of BSI detection and management to inform development of a coordinated rapid response pathway.
A qualitative study using semi structured interviews and focus groups was conducted across three metropolitan hospitals. Purposive sampling recruited multidisciplinary healthcare professionals and executives involved in BSI diagnosis and management, and consumers with an inpatient BSI history. Interviews explored diagnostic processes, escalation, antimicrobial optimisation, and implementation considerations. Data were thematically analysed and mapped to the Consolidated Framework for Implementation Research.
Forty-six participants were interviewed, generating four themes: (1) Variation in BSI recognition and escalation; (2) Coordination and accountability in multidisciplinary management; (3) Operational constraints in diagnosis and antimicrobial optimisation; and (4) Implementation needs for a coordinated rapid response. Well established sepsis and microbiology notification systems exist; however, BSI management varied across settings, with stronger multidisciplinary models in high-acuity areas. Inconsistencies were identified in blood culture collection, escalation, AMS communication, and after-hours response. Participants supported a coordinated rapid response pathway introducing rapid diagnostics, streamlined notification, and multidisciplinary team involvement.
Current BSI management systems are competent, but management strategies are inconsistent in many areas. A coordinated rapid response BSI pathway may streamline timeliness, accountability, and antimicrobial optimisation across hospital settings.