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Abstract Summary Introduction:- Around 2.9 million blood components are issued every year in the UK. Blood transfusion is generally a safe process that saves lives and improves the quality of life for patients with a large range of clinical conditions. However, there are a number of risks associated with transfusion, as with any other clinical intervention. Right blood, right patient, right time: RCN guidance for improving transfusion practice sets out pragmatic advice for nursing staff in the administration of red blood cells and other blood components (fresh frozen plasma, cryoprecipitate and platelets). The guidance is not wholly evidence-based but built on recommendations to improve the safety of blood ordering and administration from current national guidelines and Serious Hazards of Transfusion (SHOT, 2015). The administration of blood and blood components involves more than 60 steps and each of these may be subject to error. Standard protocols for the administration of blood are essential to minimize the potential for error. These protocols should be in place in each institution and should conform to standard practice as outlined in these guidelines. A quality management system should exist in each institution. This should include an active transfusion committee, a process to Summary 127 correct protocols and practice when deficiencies are identified, participation in local and regional audit and in the national haemovigilance programme (WHO, 2012). Aim of the study: - The aim of this study was to assess nurses’ performance caring for patient receiving blood transfusion through the following:- Assess nurses’ level of knowledge regarding caring for patient undergoing blood transfusion. Assess nurses’ practice regarding caring of patient undergoing blood transfusion. Assess factors affecting nurses’ performance during blood transfusion. Research questions What is the level of nurses’ knowledge about blood transfusion process? What is the level of nurses’ performance regarding caring of patient undergoing blood transfusion? What are the errors that may result during blood transfusion? The present study was carried out through: Technical design, operational design, statistical design and administrative design. Summary 128 Study tools:- Three tools were used to collect data of the study as following:- I. Self administered questionnaire sheet (Apendix I) it consists of two parts: A. 1stpart concerned with demographic data that include (age, gender,....etc) B. 2nd part concerned with nurses’ opinion about factors affecting their performance. II. Routine Blood Transfusion Knowledge Questionnaire sheet (Appendix II) and used to assess nurses’ knowledge about blood transfusion and consists of 5 parts:- 1stpart concerned with nurses’ knowledge regarding patient preparation before transfusion. 2nd Part concerned with nurses’ knowledge regarding blood pack collection. 3rd part concerned with pre-transfusion initiation nursing activities. 4th part concerned with assessing nursing knowledge about activities that should be done during. 5th part concerned with assessing nursing knowledge about complications of blood transfusion and how to deal with. Summary 129 III: Nurses’ practice observational checklist (Appendix III). Used to assess nurses’ practice in caring for patients undergoing blood transfusion; this part quoted from (Van Leuven, Wilkinson, and Pearson, 2011) and modified by the researcher, which included the following: Pre-transfusion measures . Verifying the right patient and right blood group. During transfusion measures. Post transfusion measures . Pilot study:- was conducted on 10 % of nurses under study in order to test the applicability of the developed tools, the clarity of included questions as well as the average time needed to complete all questions. Results obtained were studied and analyzed accordingly, modifications were made for the final development of the tools, the study nurses who shared in pilot study were excluded from the study sample. Field work: Was included two phases as following:- 1-Preparatory phase: it included reviewing of the current and more recent national & international literature reviews concerning nurses performance regarding blood transfusion Summary 130 of various aspects of this issue in order to develop the data collecting tools. 2-Implementation phase: including first: field work Interviewing with (60) nurses caring for patients undergoing blood transfusion in the previously mentioned settings to explain the aim of the study, the effect of this study on their performance as well as patient quality of care and take their approval to participate in the study prior to any data collection, Second: assessing nurses performance (knowledge and practice) regarding caring for patients undergoing blood transfusion. By using questionnaire sheet and observational check list. Results of this study showed that: o (46.6%) of nurses were ranged between 20 to less than 30 years, (56.7%) of them were diploma nurses and all of them (100%) did not attend training course about management of patient undergoing blood transfusion. o About half of studied sample (46.7%) were unsatisfied about factors affecting nursing performance during blood transfusion. o (70.0%) of nurses had unsatisfactory knowledge regarding caring of patient undergoing blood transfusion and (80.0%) of them had unsatisfactory practice regarding caring of patient undergoing blood transfusion. Summary 131 o There were highly statistically significant relation between nurses’ knowledge and their qualifications (X2 = 12.4 at P< 0.01). o There were statistical significant relation between nurses’ knowledge and presence of policy (X2 =6.2 at p<0.05). o There were highly statistically significant relation between the nurses’ practice and educational level (X2 = 9.7 at P< 0.01). o There were statistical significant relation between the nurses’ practice and experience (X2 = 10.5 at P< 0.05) and presence of policy (X2 = 6 at P< 0.05). o There were statistical significant relation between the nurses’ knowledge and practice (r< 0.65). It was Concluded from this study that: About three quarters of nurses had unsatisfactory knowledge regarding to management of patient undergoing blood transfusion and majority of them showed unsatisfactory level of practice regarding to management of patients undergoing blood transfusion. Furthermore, there were many factors affecting nurses’ performance as: nurses’ related factors, work’ related factors and patient’ related factors. Summary 132 The study recommended that: Establish in-service training programs for continues updating nurses’ knowledge about blood transfusion. Hospitals should establish policies for blood transfusion and should be available at each department. Develop a protocol for blood transfusion,written in Arabic and English which contain checklist about technique of blood transfusion, blood transfusion complications, how to assess patient and nursing care during blood transfusion |