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床边输血——护士所知晓与实施的情况:一项来自喀拉拉邦农村地区三级癌症医院的横断面研究

Bedside Blood Transfusion - What Nurses Know and Perform: A Cross-Sectional Study from A Tertiary-Level Cancer Hospital in Rural Kerala.

作者信息

Jogi Irene Elizabeth, Mohanan Nithya, Nedungalaparambil Nisanth Menon

机构信息

Amala Institute of Medical Sciences, Thrissur, Kerala, India.

Department of Immunohematology and Transfusion Medicine, Amala Institute of Medical Sciences, Thrissur, Kerala, India.

出版信息

Asia Pac J Oncol Nurs. 2021 Jan 29;8(2):197-203. doi: 10.4103/apjon.apjon_50_20. eCollection 2021 Mar-Apr.

Abstract

OBJECTIVE

Nursing professionals are expected to have updated knowledge of clinical blood transfusion guidelines while catering to cancer patients requiring bedside transfusions.

METHODS

A cross-sectional study was conducted to evaluate the knowledge and current practice of nurses at a tertiary-level cancer hospital in rural Kerala using a pretested self-administered structured 20-item questionnaire, and results were analyzed.

RESULTS

Among 246 nurses who participated, a response rate of 93.08% ( = 229) was obtained. Mean scores of 4.64 ± 1.20 out of eight for knowledge-based questions (58.00%) and 6.16 ± 1.49 out of 12 for practical aspects (51.33%) were obtained among respondents. Whereas overall scores were fair (84.28% and 65.94% nurses scoring ≥50% in knowledge-based and practice-based questions, respectively), we noticed poor knowledge-level scores for the key aspects such as time taken for cross-matching, cross-match test taking least time, storage temperature, and mandatory transfusion-transmitted infection tests before initiating transfusion. Poor scores were also noted for key clinical practices relating to warming of blood products, posttransfusion patient monitoring, rate of nonemergency blood transfusions, administration of premedications, and disposal of blood bags among the respondents. Data also revealed that there was a lack of adherence to a uniform cannula size for routine blood transfusion among nurses. Work experience or qualification had no significant relation to the nurses' scores for knowledge or practice-based questions.

CONCLUSIONS

Overall, a fair amount of theoretical and practical knowledge about bedside transfusion practices were observed among nurses with some inconsistencies not related to qualification or work experience. This illuminates inherent lacunae in the existing training system and merits urgent redressal.

摘要

目的

护理专业人员在为需要床边输血的癌症患者提供护理时,应掌握最新的临床输血指南知识。

方法

采用预先测试的、自我管理的20项结构化问卷,对喀拉拉邦农村一家三级癌症医院的护士的知识和当前实践进行横断面研究,并对结果进行分析。

结果

在参与的246名护士中,获得了93.08%(=229)的回复率。受访者在基于知识的问题(8题中平均得分为4.64±1.20,正确率58.00%)和实践方面(12题中平均得分为6.16±1.49,正确率51.33%)的得分情况。虽然总体得分尚可(分别有84.28%和65.94%的护士在基于知识和实践的问题上得分≥50%),但我们注意到在交叉配血所需时间、交叉配血试验耗时最短、储存温度以及输血前强制性输血传播感染检测等关键方面的知识水平得分较低。在血液制品加温、输血后患者监测、非紧急输血率、预防性用药的使用以及血袋处理等关键临床实践方面,受访者的得分也较低。数据还显示,护士在常规输血中缺乏对统一套管尺寸的遵循。工作经验或资质与护士在基于知识或实践问题上的得分没有显著关系。

结论

总体而言,护士们对床边输血实践有一定的理论和实践知识,但存在一些与资质或工作经验无关的不一致之处。这揭示了现有培训系统中存在的固有缺陷,值得紧急纠正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/698d/7934603/9813d766e398/APJON-8-197-g001.jpg

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