Nurses' practices with blood transfusions in medical-surgical patient care units of acute care U.S. hospitals the state of the science
Aulbach, Rebecca Knippa
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Blood transfusions occur in all areas of a hospital with nurses at the point-of-care responsible for specimen collection, blood administration, patient surveillance, and adverse event reporting. Unfortunately there is a paucity of nursing research on blood transfusions. The purpose of this study was to describe the state of the science of medical-surgical acute care nurses' practices with blood transfusion therapy. Seven research questions addressed the comprehensive scope of nurses' involvement with blood transfusions. Data was collected via a valid and reliable web-based survey, Nurses' Practices with Blood Transfusions: Medical-Surgical Acute Care. A random selection of U.S. hospitals with a nurse executive who was a member of the American Organization of Nurse Executives was recruited via postal letter. One survey was completed per hospital with 148 hospitals responding (18.3% response rate).</DISS_para> <DISS_para>Nurses' practices in transfusion processes are similar across the country. The hospital's transfusion policy was the most influential source of information for nurses because it specified nurses' transfusion practices. Limitations in surveillance of the medical-surgical patient with a blood transfusion were due to the lack of current information on transfusion reaction symptoms included in the education programs, delegation of transfusion vital signs to non-licensed staff that were not educated on symptoms of a transfusion reaction and transportation of patients with blood infusing to tests and procedures. Hospitals were in the process of adopting electronic technologies to reduce or eliminate wrong-blood-in-tube errors or wrong blood administered mistransfusion errors. Nurses need to collaborate with the transfusion service to update the transfusion policy and the blood transfusion education programs; include non-licensed staff in compulsory blood transfusion education; and closely evaluate the capabilities of an electronic documentation system to truly match the patient to the blood product. This descriptive study is a foundation for future research of nurses with blood transfusions.