Nurses' Practices with Blood Transfusions in Medical-Surgical Acute Care the U.S

Purpose:  The purpose of this presentation is to report on the state of the science of medical-surgical acute care nurses’ practices with blood transfusion therapy. Hospitals from across the U.S. were randomly selected with 143 valid responses used to describe nurses’ transfusion practices.  

Methods:  Four of the seven research questions addressed the comprehensive scope of nurses’ involvement with blood transfusions. A valid and reliable web-based survey developed by the author, Nurses’ Practices with Blood Transfusions: Medical-Surgical Acute Care, was used to report the practices related to medical-surgical nurses of that hospital; only one survey was completed per hospital. A random selection of U.S. hospitals with a nurse executive or leader who was a member of the American Organization of Nurse Executives (N = 2082, n = 807) were contacted by postal letter to participate in the study. The data was collected via the web-based survey administered via PsychData. Following four months of data collection, 148 valid responses were obtained in PsychData yielding a response rate of 18.3%.  

Results:  The overarching theme of this descriptive study of the nurses’ practices with blood transfusions in medical-surgical acute care units the research was patient safety. The hospital’s transfusion policy was the most influential source of information for nurses because it detailed and therefore prescribed nurses’ transfusion practices. Surveillance of the patient was challenged due to the lack of current information included in the education programs, delegation of transfusion vital signs to non-licensed staff who were not educated on symptoms of a transfusion reaction, and transportation of a patient with blood infusing to tests and procedures. Innovations in technologies and processes were designed to promote safety. Hospitals in this study were in the process of adopting electronic technologies to reduce or eliminate wrong-blood-in-tube errors or wrong blood administered mistransfusion errors. 

 Conclusion:  The implications for nursing emanating from this study were the need to collaborate with the transfusion service to update information in the policy and the blood transfusion education programs; include non-licensed staff and other test and procedure 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 provided a foundation for future research focused on nurses with blood transfusions.