Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Selection
2.2. The Routine Blood Transfusion Knowledge Questionnaire (RBTKQ)
2.3. Data Analyses
2.4. Ethics
3. Results
3.1. Characteristics
3.2. Overall Knowledge
3.3. Knowledge Prior to Blood Transfusion
3.4. Knowledge on Pre-Transfusion Initiation Nursing Responsibilities
3.5. Knowledge on Post-Transfusion Initiation Nursing Responsibilities
3.6. Knowledge on Complications of Blood Transfusion
3.7. Knowledge on Blood Transfusion Policy
3.8. Association between Knowledge Score and Characteristics of the Nurses
4. Discussion
Limitations and Recommendations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | n (%)/Mean ± SD |
---|---|
Age (years) | 33.2 ± 8.4 |
Ethnicity | |
Malay | 196 (98.0) |
Chinese | 2 (1.0) |
Others | 2 (1.0) |
Gender | |
Male | 11 (5.5) |
Female | 189 (94.5) |
Educational level | |
Diploma in Nursing | 184 (92.0) |
Bachelor’s and master’s in Nursing | 16 (8.0) |
Types of wards | |
Medical based | 106 (53.0) |
Surgical based | 94 (47.0) |
Working experience | |
<5 years | 63 (31.5) |
5–10 years | 58 (29.0) |
>10 years | 79 (39.5) |
Frequency of performing blood transfusion in past 6 months | |
0 times | 37 (18.5) |
1–4 times | 89 (44.5) |
>5 times | 74 (37.0) |
Previous training related to blood transfusion | |
No | 185 (92.5) |
Yes | 15 (7.5) |
Items | Correct | |
---|---|---|
n | % | |
A. Knowledge prior to blood transfusion | ||
Checking patency of IV line before blood bag collection | 177 | 88.5 |
Blood bag collection after administration of prescribed pre-medications | 136 | 68.0 |
Decisions to be taken by nurses with incomplete order of blood transfusion | 181 | 90.5 |
Three aspects of information given to the patients Reasons for blood transfusion Risks of blood transfusion Reaction symptoms | 181 152 165 | 90.5 76.0 82.5 |
Baseline vital signs’ recording (Within ½ hour before transfusion) | 164 | 82.0 |
Information to ensure collection of right blood (Patient’s identification details are identical on the blood bag and blood request form). | 165 | 82.5 |
Blood bag transport method (validated special box) | 167 | 83.5 |
Knowledge of ABO basic terminology | 135 | 67.5 |
B. Knowledge on pre-transfusion initiation nursing responsibilities | ||
Most important nursing action before starting transfusion (patient identification) | 131 | 65.5 |
Clinical indications of blood warming Exchange transfusion in infants Rapid transfusion Patients with cold agglutinins | 78 79 61 | 39.0 39.5 30.5 |
Best time to start transfusion | 121 | 60.5 |
Blood handling after delivery to ward (start transfusion immediately) | 49 | 24.5 |
Steps for patient identification Ask patient to state his/her name Ensure patient identification match on blood bag and request form Ask patient his/her date of birth | 156 98 6 | 78.0 49.0 3.0 |
Suitable filter size of transfusion set (170–200 micron) | 72 | 36.0 |
Omitting final bedside identity check (never acceptable) | 148 | 74.0 |
C. Knowledge on post-transfusion nursing responsibilities | ||
Activities to perform after starting blood transfusion Setting up flow rate Documentation of relevant information Observation of transfusion reactions | 64 164 162 | 32.0 82.0 81.0 |
Rate to initiate a transfusion in adult patient 1 (n = 161) | 82 | 50.9 |
Regulation of slow transfusion rate 2 Electronic Manual | 59 41 | 29.5 70.5 |
Maximum duration of using blood administration set in continuous multiple transfusion | 6 | 3.0 |
Rate to initiate blood transfusion in infant 3 (n = 39) | 29 | 74.4 |
Maximum duration to complete a unit of blood | 124 | 62.0 |
Indications for slow transfusion Patients with heart disease Patients with severe anemia | 178 18 | 89.0 9.0 |
Agents compatible with blood Normal Saline Morphine | 183 6 | 91.5 3.0 |
Vital signs’ recording after starting transfusion (start transfusion at 2:00 p.m.) 2:05 p.m. 2:15 p.m. 3:15 p.m. 4:15 p.m. | 142 142 60 50 | 71.0 71.0 30.0 25.0 |
Timing and duration of when it is essential to physically observe patient | 67 | 33.5 |
D. Knowledge on complications of blood transfusion | ||
Nursing interventions to minimize risk of transfusion reactions Administration of compatible blood Starting transfusion within 20 min Total transfusion duration not more than 4 h Avoid incompatible drug/solution | 150 70 91 129 | 75.0 35.0 45.5 64.5 |
Signs and symptoms of acute hemolytic transfusion reaction (AHTR) Tachycardia Chest pain Hypotension Nausea/vomiting | 154 153 128 80 | 77.0 76.5 64.0 40.0 |
Nursing management of AHTR Stop blood transfusion Keep vein open with Normal Saline Check patient’s vital signs Notify doctor and begin emergency treatment | 198 80 180 183 | 99.0 40.0 90.0 91.5 |
Actions to do for delay in starting blood transfusion | 52 | 26.0 |
Usual presenting complaint of mild transfusion reaction | 184 | 92.0 |
First action to take in mild allergic reaction | 3 | 1.5 |
Commonest cause of fatal transfusion reaction | 67 | 33.5 |
Complication of rapid administration of cold blood | 114 | 57.0 |
E. Knowledge of transfusion policy | ||
Availability of written policy for blood transfusion in the ward No Yes Do not know | 8 182 10 | 4.0 91.0 5.0 |
Reading the policy No Yes Not indicated | 4 178 18 | 2.0 89.0 9.0 |
Variables | ba (95% CI) | p-Value |
---|---|---|
Age (years) | 0.07 (−0.05, 0.20) | 0.259 |
Gender | ||
Male | 0 | 0.466 |
Female | 1.73 (−2.94, 6.41) | |
Qualification | ||
Diploma | 0 | 0.185 |
Bachelor and master | −2.64 (−6.56, 1.28) | |
Type of ward | ||
Surgical | 0 | 0.897 |
Medical | 0.14 (−2.00, 2.28) | |
Working experience (years) | ||
Less than 5 | 0 | |
5 to 10 | −1.61 (−4.35, 1.13) | 0.248 |
More than 10 | 0.20 (−2.35, 2.74) | 0.878 |
Frequency of performing blood transfusion | ||
None | 0 | |
1 to 4 | 4.13 (1.25, 7.01) | 0.005 |
5 and above | 1.06 (−1.91, 4.03) | 0.481 |
Participation in training program | ||
Not participate | 0 | 0.117 |
Participate | 3.21 (−0.81, 7.24) |
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Mohd Noor, N.H.; Saad, N.H.; Khan, M.; Hassan, M.N.; Ramli, M.; Bahar, R.; Mohamed Yusoff, S.; Iberahim, S.; Wan Ab Rahman, W.S.; Zulkafli, Z.; et al. Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience. Int. J. Environ. Res. Public Health 2021, 18, 11194. https://doi.org/10.3390/ijerph182111194
Mohd Noor NH, Saad NH, Khan M, Hassan MN, Ramli M, Bahar R, Mohamed Yusoff S, Iberahim S, Wan Ab Rahman WS, Zulkafli Z, et al. Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience. International Journal of Environmental Research and Public Health. 2021; 18(21):11194. https://doi.org/10.3390/ijerph182111194
Chicago/Turabian StyleMohd Noor, Noor Haslina, Noor Hafiza Saad, Mohammad Khan, Mohd Nazri Hassan, Marini Ramli, Rosnah Bahar, Shafini Mohamed Yusoff, Salfarina Iberahim, Wan Suriana Wan Ab Rahman, Zefarina Zulkafli, and et al. 2021. "Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience" International Journal of Environmental Research and Public Health 18, no. 21: 11194. https://doi.org/10.3390/ijerph182111194
APA StyleMohd Noor, N. H., Saad, N. H., Khan, M., Hassan, M. N., Ramli, M., Bahar, R., Mohamed Yusoff, S., Iberahim, S., Wan Ab Rahman, W. S., Zulkafli, Z., & Islam, M. A. (2021). Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience. International Journal of Environmental Research and Public Health, 18(21), 11194. https://doi.org/10.3390/ijerph182111194