Does time matter? An investigation of knowledge and attitudes following blood transfusion training

Blood Transfusion Procedure: Assessment of Serbian Intensive Care Nurses' Knowledge

Many patients require administering one or more blood components during hospitalisation in the Intensive Care Unit (ICU). Therefore, nurses' knowledge of who is responsible for immediately administering blood transfusions, monitoring patients, and identifying and managing transfusion reactions is crucial. This cross-sectional descriptive-analytical study aimed to assess the knowledge of ICU nurses in tertiary healthcare institutions about blood transfusion procedures. The questionnaire about the transfusion procedure was designed and reviewed by experts. The questionnaire consisted of 29 items divided into three domains. The scores on the knowledge test ranged from 10 to 27. Generally, 57.7% of nurses had moderate, 23.4% low, and 18.9% high levels of knowledge about the transfusion procedure. Most nurses answered correctly about refreezing fresh frozen plasma, verifying the transfusion product, and identifying the patient. Of the nurses, 91.0% would recognise mild allergic reactions, and 98.2% knew about the supervision of sedated patients. Nurses showed poor knowledge of the length of usage of the same transfusion system for red blood cells, labelling, and transfusion administration in febrile patients. Nurses with higher education and longer working experience had significantly better outcomes (p = 0.000) on the knowledge test. Continuous education of ICU nurses on safe transfusion usage is recommended.

Improving nurses' blood transfusion knowledge and skills

The World Health Organization (2019) has determined that patient safety is a global public health challenge. In UK clinical areas, policies and procedures are in place for the safe prescribing and delivery of blood and blood product transfusions, yet patient safety incidences continue. Undergraduate nurse education and training may provide the underlying knowledge to practitioners, while postgraduate standalone training sessions support skill development. However, over time, without regular experience, competence will diminish. Nursing students may have little exposure to transfusion practice and COVID-19 may have exacerbated this challenge with a reduction in placement availability. The use of simulation to support theory with follow-up and ongoing drop-in training sessions may help to inform practitioners and improve patient safety in the management and delivery of blood and blood product transfusion.

Knowledge of Blood Transfusion in Medical And Biology Students

Introduction: Blood transfusion (hemotherapy) is a therapeutic intervention used in treatment strategies of multiple diseases, thus, proper education is of utmost importance. Since currently there are no specified educational programs, undergraduate students were evaluated for the knowledge gained during university courses.

Purpose: To evaluate and compare the level of knowledge of students of the faculty of Health Science, Department of Medicine (DM), and Department of Molecular Biology-Genetics (DMB&Gs) on issues related to the transfusion of blood products.

Methods: A cross-sectional observational study was carried out with 123 students from the aforementioned departments of the Democritus University of Thrace, from the third year to the last year of study. A questionnaire was used, weighted, and was based on the European Commission's Guide to the Preparation, Use and Quality Assurance for Blood Components. Statistical tests such as chi-square (χ2), t-test, analysis of variance (ANOVA), and linear regression were used to investigate the factors that affect the overall score.

Results: The mean score of the students was 42.55 while the standard deviation (SD) was 12.27. The difference in the scores between the students of the DM (M = 44.63, SD = 13.2) and those of the DMB&Gs (mean = 38.25, SD = 9.05) was statistically significant in the univariable analysis (t= 3.1, p = 0.0), but in the multivariable analysis, it was not statistically significant (β = -4.1, p = 0.1.). The results of the multiple regression model indicated that the year of study, the professional status of the father, and the grade in the hematology course were associated with the total score.

Conclusions: The level of knowledge regarding blood product transfusion among students of the faculty of Health Science is insufficient.

Residents' knowledge in transfusion medicine and educational programs: A pilot study

BACKGROUND

Residents' knowledge in transfusion medicine significantly impacts the optimal use of blood and patient safety. Little is known regarding this topic in France in particular. The objectives were to evaluate their basic knowledge, to determine whether the objectives of the curricula were attained and subsequently to suggest ways for improvement.

METHODS

A cross-sectional study was conducted on 50 first year medical and surgical specialty residents rotating in a French university hospital.

RESULTS

Major gaps in the knowledge were noted among residents of various specialties, equally between those with low and sustained transfusion practice. The majority of these young doctors expressed difficulties in prescribing and handling transfusions, identifying and managing its complications and understanding their responsibilities. The roles of hemovigilance practitioners were further somehow unclear for participants.

CONCLUSION

Given these results, action plans appear needed to limit consequences. A special transfusion medicine educational program should be added to the currently available medical education curriculum in order to ensure physicians have adequate knowledge of transfusion basics; at least a practical assisted situation during residency would be of valuable interest.

Junior doctors' perspectives on transfusion education in Australia

BACKGROUND

Early postgraduate training is a critical period to develop skills and to influence future clinical practice. Little is known about Australian junior doctors' existing transfusion knowledge and its application in patient care. This study explored their transfusion practice education preferences, developed tools to assist their practice and assessed the usefulness of these tools.

METHODS

A design-based study was conducted in two phases from April 2016 to March 2017. Phase 1 involved focus group sessions in six hospitals. Transcripts of audio recordings were analysed using thematic analysis. Findings were considered when developing transfusion practice support tools. Phase 2 surveyed junior doctors' response to the tools provided during orientation in five hospitals. Participation was voluntary.

RESULTS

Fifty-two junior doctors participated in the focus groups. Their priority was to be able to practice safely, appropriately and confidently. Preferred format for transfusion learning included expert-led face-to-face education; printed tools, for example lanyard cards; and for one app that covers essential aspects of transfusion practice. Adverse events management and practical transfusion prescribing were topics of most importance. Thirty-nine survey respondents found the transfusion practice support tools useful and recommended their use to complement practice.

CONCLUSION

There is a need for improved education to ensure best transfusion practice and patient outcomes. Australian junior doctors want immediate, practical, reliable transfusion information from credible sources to support them in practicing safely and confidently. Their educational needs are driven by real-time patient management. Promotion of the available resources and tools provided by the blood sector is important.

Does Patient-Centered Medical Home Recognition Relate to Accountable Care Organization Participation?

As of April 2015, less than 10% of Medicare Shared Savings Program Accountable Care Organizations (MSSP ACOs) included Rural Health Clinics (RHCs). In order to understand why RHCs are not participating in this ACO model in greater numbers, this study examined the influence of several factors on ACO participation. Data for this study were collected via a survey distributed during the summers of 2012, 2013, and 2014 to all RHCs in 9 states. This study had a cross-sectional design using survey research. The unit of analysis was the RHC; the total sample size was 178. This study found that those respondents who reported knowing very little about ACOs had the lowest "willingness to join an ACO" score and that the passage of time increased RHC willingness to join an ACO. Also, patient-centered medical home (PCMH) recognition was the most influential factor related to an RHC's adopting the ACO model. If ACO model adoption is to increase in rural areas, this study suggests that strategies would need to include methods for (1) targeting RHCs that have PCMH recognition; (2) increasing PCMH recognition in rural areas; and (3) increasing RHC knowledge about what an ACO is, how the model works, and why this model may benefit RHCs and other rural primary care providers.

Blood transfusion in Intensive Care Units: knowledge of the nursing team*

Objetivo: Evaluar el conocimiento de los profesionales del equipo de enfermería de Unidades de Cuidados Intensivos sobre transfusión desangre y los factores asociados a ésta.Metodología: Se trata de un estudio transversal y cuantitativo, el cual se realizó en tres hospitales. La muestra, no sistemática, se constituyó por 104 profesionales de enfermería que laboran en las Unidades de Cuidados Intensivos de estas instituciones de salud. Para la recolección de los datos, se utilizó un instrumento de tipo check-list desarrollado y validado por las autoras.Resultados: La puntuación global de conocimiento presentó una media de 50,4%. Los factores asociados al conocimiento fueron Entrenamiento u orientación y seguimiento de protocolos/directrices para llevar a cabo el proceso de transfusión; Frecuencia de los procedimientos de transfusión de sangre realizados por el profesional; y El factor autoconfianza. Para las etapas: etapa pré-transfusão, etapa de transfusão y etapa póst-transfusão, los resultados fueron 48,3%, 52,2% y 58,3%, respectivamente.Conclusiones: El presente estudio evidenció no sólo que los profesionales de enfermería poseen un mejor conocimiento de las complicaciones postransfusionales, sino también que la auto-confianza, el uso de protocolos, los programas de entrenamiento y tener sólo un empleo son factores asociados a un mejor conocimiento y a la vigilancia durante la realización del procedimiento.

Patient blood management nurse vs transfusion nurse: is it time to merge?

For many years, nurses have performed the tasks related to blood transfusion monitoring and the associated quality-control documentation. There have been multiple job titles given to healthcare providers in this field: haemovigilance officer, transfusion practitioner, transfusion nurse, patient blood management (PBM) nurse, blood conservation nurse and blood management nurse. These titles share some overlap in tasks. In this article, the authors discuss Australian and US experiences of the historical transfusion nurse role, and the newer title of PBM nurse. The article will attempt to answer the question: is it time these two job titles and roles were merged into one, creating the evolved role of PBM nurse? It will define the unique nature of these roles and attempt to explore any differences between them. PBM is becoming a standard of care and embedded in institutions around the world. The transition and adoption of a joint role is timely, and the article also addresses the issue of appropriate staffing levels. PBM has become the overarching phrase that addresses the prevention of transfusion as well as the quality and safety needs of transfusion medicine. The authors propose it is time to merge the roles of the PBM nurse and the transfusion nurse, which would ultimately benefit patients, as well as more thoroughly address the needs of hospitals.

[Professional knowledge and practice mapping among nurses regarding transfusion therapy. A pilot study on reliability and validity testing]

INTRODUCTION

All people involved in transfusion therapy have professional, legal and ethical responsibility for their own actions.

AIM

The aims of the authors were to evaluate competencies, knowledge and practice of nurses about transfusion therapy.

METHOD

Descriptive statistical approach using observation, questionnaire survey and interview was applied. Reliability and validity of the self-made questionnaire were examined with statistical methods. Variance, standard deviation, Cronbach's alpha and Pearson correlations were calculated.

RESULTS

Transfusiology-related knowledge of nurses regarding current transfusion regulations was almost 90%, and 56.2% of nurses systematized the nursing functions correctly. Significant differences were found among different institutions in transfusion therapy, transfusion practice and the use of relevant documentation. 75-77% of the institutions examined had their own protocol, and assigned transfusion care nurses worked in more than 20% of the wards.

CONCLUSIONS

The authors propose a better supervision by leaders in nursing aspects of transfusion therapy, and an increased professional responsibility.