The Effectiveness of Safe Blood and Blood Products Transfusion Training for Intensive Care Nurses

Öz

Aim: Nurses play an essential role in blood transfusion, and more than half of the steps in the transfusion chain are dependent on the nurses’ knowledge, awareness and skills. This study was conducted to determine the effect of safe blood and blood products transfusion training on knowledge of nurses in intensive care unit (ICU). Methods: This quasi-experimental pretest-posttest designed research was completed on (n=166) volunteering nurses working in ICUs. At first, a pretest evaluating the knowledge of nurses on blood and blood products transfusion was performed. Then, a training was provided to nurses and pop-up informative screen messages were sent via hospital information system each time when they sign in the system. Posttest was performed on nurses one month after the completion of the blood and blood products transfusion training. p<0.05was accepted as statically significant. Results: It was found that 48.8% of the intensive care nurses participating in the study were between 21-25 years old, 62.7% were women, 52.4% were bachelor degree graduates, and 56.0% of them had 1-5 years of experience. Mean blood and blood products transfusion knowledge score of the nurses was 60.25±8.92 before intervention and it increased to 78.17±8.19 after intervention with a statistically significant difference (p<0.001). Conclussion: It is found that blood and blood products transfusion knowledge of nurses increased after the training and messages sent on hospital information system. It is recommended that in-service training programs in line with up-to-date guidelines on blood and blood products transfusion should be provided to nurses in the institutions they work, steps of practice should be observed after the training and blood transfusion boards at the institutions should be facilitated to work effectively and efficiently.

Anahtar Kelimeler

• nursing
• blood transfusion
• intensive care

Güvenli Kan ve Kan Ürünleri Transfüzyonu Eğitiminin Yoğun Bakım Hemşirelerinin Bilgi Düzeyine Etkisi

Öz

Amaç: Hemşireler kan transfüzyonunda önemli bir rol oynamaktadır; transfüzyon zincirinin yarısından fazlası onların bilgi, farkındalık ve becerilerine bağlıdır. Bu çalışma, yoğun bakım ünitesinde çalışan hemşirelerin kan ve kan ürünleri transfüzyonu konusundaki bilgilerine eğitimin etkisini değerlendirmeyi amaçlamıştır. Metod: Bu yarı deneysel ön test-son test çalışması, gönüllü olarak katılan 166 yoğun bakım hemşiresini içermektedir. İlk olarak, hemşirelerin kan ve kan ürünleri transfüzyonu konusundaki bilgi düzeylerini değerlendiren bir ön test yapılmıştır. Daha sonra hemşirelere eğitim verilmiş ve hastane bilgi sistemi üzerinden her girişlerinde bilgilendirici ekran mesajları gönderilmiştir. Eğitimden bir ay sonra bir son test yapılmıştır. İstatistiksel anlamlılık p<0.05 olarak belirlenmiştir. Bulgular: Çalışmaya katılan yoğun bakım hemşirelerinin %48.8'i 21-25 yaş aralığında, %62.7'si kadındır, %52.4'ü lisans mezunu ve %56.0'ı 1-5 yıl deneyime sahiptir. Hemşirelerin kan ve kan ürünleri transfüzyonu bilgi puan ortalaması müdahale öncesi 60.25±8.92 iken müdahale sonrası 78.17±8.19 olarak bulunmuş ve aradaki fark istatistiksel olarak anlamlı bulunmuştur (p<0.001). Sonuç: Çalışma, eğitim ve hastane bilgi sistemi üzerinden gönderilen mesajların uygulanmasıyla hemşirelerin kan ve kan ürünleri transfüzyonu bilgi düzeyinin anlamlı şekilde arttığını ortaya koymuştur. Çalışma, kurumlarında güncel kılavuzlara uygun iç eğitim programları sağlanması, eğitim sonrası uygulama adımlarının takibi ve sağlık kurumlarında transfüzyon komitelerinin etkin işleyişinin teşvik edilmesi gerektiğini önermektedir.

Anahtar Kelimeler

• yoğun bakım
• hemşirelik
• kan transfüzyonu

Kaynakça

1. 1. Bielby L, Haberfield A, Kelsey G, Kay S. The role of the transfusion practitioner in the multidisciplinary team. ISBT Science Series. 2018;13(3): 338-46.
2. 2. Topal G, Şahin İ, Çalışkan E, Kılınçel Ö. Investigation of the knowledge levels of healthcare professionals about blood transfusion and reactions. J DU Health Sci Inst. 2019;9(1): 1-5.
3. 3. Bielby L, Peterson D, Spigiel T. Transfusion education for nurses and transfusion practitioners in Australia. ISBT Science Series. 2018;13(3), 259-67.
4. 4. Göktaş SB, Yıldız T, Koşucu SN, Urcanoğlu ÖB. Assessment of nursing practice of blood transfusion. IAAOJ Health Science. 2015; 3(2): 10-20.
5. 5. Bielby L, Moss RL. Patient blood management and the importance of the transfusion practitioner role to embed this into practice. Transfus Med. 2018;28(2), 98-106.
6. 6. Raasveld SJ, De Bruin S, Reuland MC at al. Red blood cell transfusion in the intensive care unit. JAMA 2023;330(19):1852-1861.
7. 7. Falaki M, Ahmadinejad M, Razban F, Najafipour M A, Asadi N. The effect of learning management system on ICU nurses' sustained learning about safe blood transfusion: A quasi‐experimental study. Health Science Reports. 2022;5(4): e629.
8. 8. Hijji B, Parahoo K, Hussein MM, Owen Barr O. Knowledge of blood transfusion among Nurses. J. Clin. Nurs. 2013;22(17-18):2536–50.

9. 9. Rambiritch V, Verburgh E, Louw VJ. Patient blood management and blood conservation–Complimentary concepts and solutions for blood establishments and clinical services in South Africa and beyond. Transfus Apher Sci. 2021;60(4):103207.
10. 10. American Society of Anesthesiologists (ASA) Task Force on Perioperative Blood Management. Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management. Anesthesiology. 2015;122(2), 241-75.
11. 11. Pagliaro P, Turdo R. Transfusion management using a remote-controlled, automated blood storage. Blood Transfus. 2008;6(2):101-106.
12. 12. Freixo A, Matos I, Leite A et al. Nurses knowledge in Transfusion Medicine in a Portuguese university hospital: the impact of an education. Blood Transfus. 2017;15(1):49-52.
13. 13. Şahin H. The level of knowledge of nurses about blood transfusion and the effect of training into it. Master thesis. Afyon Kocatepe University, Institute of Health Sciences; 2006.
14. 14. Ertürk A. Questionnaire study on knowledge, attitude and behavior measurement of anesthetists on blood and blood product transfusion in Turkey. Master thesis. Yüksek İhtisas Training and Research Hospital, Department of Anesthesiology and Reanimation; 2017.
15. 15. Güleryüz MA. Determination of the knowledge level of nurses about blood and blood product transfusion. Master Thesis. Near East University Health Sciences Institute Nursing Program; 2015
16. 16. Simin D, Dolinaj V, Brestovački Svitlica B, Grujić J, Živković D, Milutinović D. Blood transfusion procedure: assessment of serbian ıntensive care nurses’ knowledge. In Healthcare. 2024;12(7):720-725.
17. 17. Abozed DM, Fathallah M, Abd Elwahab M, Kandeel NA. Critical care nurses' compliance with blood transfusion guidelines in gastrointestinal ıntensive care units. Mansoura Nursing Journal. 2023;10(1):475-484.
18. 18. Köker A, Tekerek NÜ, Aydın P, Aktuna G, Dursun O. Hemovigilance questionnaire in pediatric emergency and pediatric ıntensive care units. Hemovigilance. 2022;9(2): 80-84.
19. 19. Annual shot report 2018, Serious Hazards of Transfusion. Available at: http://www.shotuk.org/home/ Accessed on 11/07/2022.
20. 20. Yudelowitz B, Scribante J, Perrie H, Oosthuizen E. Knowledge of appropriate blood product use in perioperative patients among clinicians at a tertiary hospital. Health Sa Gesondheid 2016;21, 309-14.
21. 21. Bolcato M, Russo M, Trentino K, Isbister J. Rodriguez D, Aprile A. Patient blood management: The best approach to transfusion medicine risk management. Transfus Apher Sci. 2020;59(4):102779.
22. 22. Vlaar APJ, Dionne JC, de Bruin S et al. Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Med 2021; 47, 1368–92
23. 23. Daichman S, Ostrovsky D, Dreiher J, Pikovsky O. Does training make a difference? Proficiency training in transfusion guidelines and its effect on red blood cell administration. Transfus. 2022;62(5):1121-1127.
24. 24. Pavenski K, Stanworth S, Fung M et al. Quality of evidence-based guidelines for transfusion of red blood cells and plasma: a systematic review. Transfus Med Rev. 2018;32(3):135-43.
25. 25. Engelbrecht S, Wood EM, Cole‐Sinclair MF. Clinical transfusion practice update: haemovigilance, complications, patient blood management and national standards. Med J Aust. 2013;199(6): 397-401.
26. 26. Storch EK, Custer BS, Jacobs MR, Menitove JE, Mintz PD. Review of current transfusion therapy and blood banking practices. Blood Rev. 2019;38:100593.
27. 27. Cottrell S. How to safely collect and deliver blood components for transfusion. Nurs Stand. 2021;36(11):79-82.
28. 28. NICE Guideline Published, 18/11/2015. Blood Transfusion. Availeble at: https://www.nice.org.uk/guidance/ng24;2015 Accessed on 11/07/2022.
29. 29. Erkoç D. Improving the blood transfusion process in a state hospital in the Turkish Republic of Northern Cyprus. Master Thesis. Dokuz Eylül University Health Sciences Institute Nursing Program, 2010
30. 30. Encan B, Akin S. Knowledge of blood transfusion among nurses. J Contin Educ Nurs. 2019; 50(4): 176-82.
31. 31. Soliman H M, Elhapashy HM. Nurses' Competence in Safety Blood Transfusion: The Impact of a Training Module. Int. J. Nurs. Educ. 2021;13(3):25-35.
32. 32. Ibrahim S, El-Sayed E, Khalil A. Effect of implementing educational program about safety blood transfusion on the nurse’s knowledge and practice. Int J Adv Res. 2019;7(9):1067-107.
33. 33. Vlaar AP, Oczkowski S, de Bruin S, Wijnberge M, Antonelli M, Aubron C, Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intensive Care Med. 2020;46(4):673-96.
34. 34. Lahlimi FZ, Tazi I, Sifsalam M, Bouchtia M, Mahmal L. Assessment of transfusion practice: Assessing nurses’ knowledge in transfusion medicine at Mohamed VI Hematology and Oncology Center of Marrakesh, Morocco. Transfus Clin Biol. 2015; 22, 12-16.
35. 35. Molina-Arrebola MA, Fernández-Guerrero E, Aguirre-Ortega FJ, Avivar-Oyonarte C. Digital resources for transfusion education. J Educ Health Promot. 2020; 28(9):173.
36. 36. Hood AM, King AA, Fields ME et al. Higher executive abilities following a blood transfusion in children and young adults with sickle cell disease. Pediatr Blood Cancer. 2019;66(10), e27899.
37. 37. Valentine SL, Bembea MM, Muszynski JA et al. Consensus recommendations for red blood cell transfusion practice in critically ill children from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9): 884-898.