Knowledge of appropriate blood product use in perioperative patients among clinicians at a tertiary hospital

Education in blood transfusion: Adequacy of the content in the Kenyan undergraduate curricula and medical doctor's perspectives and perceptions

BACKGROUND

Although blood transfusion (BT) service is important in modern health care, blood is scarce, costly, and without risks. Medical education should therefore play a role in equipping medical doctors with the necessary BT knowledge, skills, and attitudes for optimal utilization of blood. This study aimed at determining the adequacy of curriculum content of Kenyan medical schools and the clinicians' perceptions of undergraduate education in BT.

METHODOLOGY

A cross-sectional study was conducted among non-specialist medical doctors and the curricula of Kenyan medical schools. Data was collected using questionnaires and data abstraction forms and analyzed using descriptive and inferential statistics.

RESULTS

Curricula from six medical schools and 150 clinicians were studied. All six curricula covered topics that are essential in BT and had the content integrated into the haematology course taught during the third year. The majority (62%) of the doctors perceived their knowledge of BT as being either fair or poor, and 96% reported that knowledge of BT was important to their clinical practice. The rating of perceived knowledge in BT was significant between the different cadres of clinicians (H (2) = 7.891, p = 0.019), and all participants (100%) acknowledged the usefulness of additional training in BT.

CONCLUSION

The Kenyan medical schools' curricula covered topics that are essential for safe BT practice. However, the clinicians felt that their knowledge of BT was not good enough and that they needed more training in the subject.

Patient blood management and blood conservation - Complimentary concepts and solutions for blood establishments and clinical services in South Africa and beyond

Blood transfusions come with risks and high costs, and should be utilized only when clinically indicated. Decisions to transfuse are however not always well informed, and lack of clinician knowledge and education on good clinical transfusion practices contribute to the inappropriate use of blood. Low and middle-income countries in particular take much strain in their efforts to address blood safety challenges, demand-supply imbalances, high blood costs as well as high disease burdens, all of which impact blood usage and blood collections. Patient blood management (PBM), which is a patient-focused approach aimed at improving patient outcomes by preemptively diagnosing and correcting anaemia and limiting blood loss by cell salvage, coagulation optimization and other measures, has become a major approach to addressing many of the challenges mentioned. The associated decrease in the use of blood and blood products may be perceived as being in competition with blood conservation measures, which is the more traditional, but primarily product-focused approach. In this article, we hope to convey the message that PBM and blood conservation should not be seen as competing concepts, but rather complimentary strategies with the common goal of improving patient care. This offers opportunity to improve the culture of transfusion practices with relief to blood establishments and clinical services, not only in South Africa and LMICs, but everywhere. With the COVID-19 pandemic impacting blood supplies worldwide, this is an ideal time to call for educational interventions and awareness as an active strategy to improve transfusion practices, immediately and beyond.

Do advanced clinical practitioners have the theoretical knowledge to authorise blood components for transfusion? A cross sectional survey Study

AIM

The aim of this study is to investigate whether non-medical authorisers of blood component transfusion, in a single centre working at an advanced level, have the theoretical knowledge to potentially undertake this task safely.

BACKGROUND

Authorisation of blood components for transfusion has predominantly been a medical role in the United Kingdom. Advanced Clinical Practitioners (ACP) are increasingly undertaking this role in order to maintain timely transfusion care.

DESIGN

A cross sectional study design was utilised for this study which was conducted between 05th March 2018 and the 4th of April 2018.

METHODS

A total of 81 participants (49 medical authorisers and 32 Advanced Clinical Practitioners of which 21 were nurses and 11 were Allied Healthcare Professionals) working in a single centre completed the BEST-TEST, a previously validated knowledge assessment tool (Transfusion, 54, 2014, 1225). This study's methods were compliant with the STROBE Checklist.

RESULTS

The overall mean was 8.74 out of a possible 20 questions. Doctors scored higher within the basic science domain compared to Advanced Clinical Practitioners (p = .01). This study found the method of training received by its participants was statistically significant with those receiving formal training scoring more than those who had received on the job training from their colleagues (p = .02). When all specialities were compared for differences with the mean correct scores a statistically significant difference was found (p = .01).

CONCLUSION

This study demonstrates there is no statistically significant difference in transfusion medicine knowledge between professional subgroups working in a single centre. Furthermore, there is deficits in the knowledge of all subgroups.

RELEVANCE TO CLINICAL PRACTICE

With advanced practice roles expanding, it is essential that we realise their full potential. There is no current research examining knowledge of ACPs, who could potentially authorise blood components for transfusion, but there are some clear benefits for clinical practice such as providing safe, timely and patient centred care.