Tramalloni D, Aupérin A, Oubouzar N, Lapierre V
Unité de médecine transfusionnelle et d'hémovigilance, institut Gustave-Roussy, Villejuif, France.
Transfus Clin Biol. 2005 Dec;12(6):427-32. doi: 10.1016/j.tracli.2006.02.024. Epub 2006 Apr 17.
A first survey on nurses transfusion practices at our Hospital revealed poor knowledge. Good Transfusion Practices were written, a training program was implemented and a second survey was carried out two years later. STUDY DESIGN AN METHODS: We conducted the second survey in which 4 of the questions were identical to those in the first survey in order to assess the impact of this training strategy. The 4 questions were on blood sample identification, checking patient identification, checking "use by date" on blood product bag and the pre-transfusion bedside compatibility test. Behaviours were evaluated by checking the pre-transfusion procedures, including interpretation of bedside compatibility tests. We investigated the impact of attendance at the training course, the period of employment, day versus night shift and attempted to correlate these factors with the results of the second survey.
A significant improvement was observed in knowledge of Good Practices between the first and the second survey (P = 10(-4)). However, the multivariate analysis showed that the impact of training was heterogeneous. Pre-transfusion protocol checks have improved significantly (P = 0.05) as well as pre-transfusion bedside compatibility test interpretation of ABO compatibility (P = 0.007).
In our study, the implementation of Good practices has significantly improved nurses' knowledge about transfusion safety requirements but it is essential to continue and adapt the training and cheek regularly the impact of these implementations.
我们医院对护士输血操作进行的首次调查显示,他们的相关知识匮乏。于是编写了《良好输血规范》,实施了一项培训计划,并在两年后进行了第二次调查。
我们开展了第二次调查,其中4个问题与第一次调查中的问题相同,以评估该培训策略的效果。这4个问题涉及血样识别、核对患者身份、检查血袋上的“有效期”以及输血前床边相容性检测。通过检查输血前程序(包括床边相容性检测的解读)来评估行为。我们调查了参加培训课程、工作年限、日班与夜班的影响,并试图将这些因素与第二次调查结果相关联。
第一次调查与第二次调查之间,在良好规范知识方面观察到显著改善(P = 10⁻⁴)。然而,多变量分析表明培训的影响是异质性的。输血前方案检查有显著改善(P = 0.05),输血前床边相容性检测中ABO相容性的解读也有显著改善(P = 0.007)。
在我们的研究中,良好规范的实施显著提高了护士对输血安全要求的知识,但必须持续并调整培训,并定期检查这些实施措施的效果。