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Where does this area fit within Jordan’s classifications of research priorities?

Knowledge and practice of blood transfusion: a survey of nurses in the north and middle regions of Jordan. By.

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Where does this area fit within Jordan’s classifications of research priorities?

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  1. Knowledge and practice of blood transfusion: a survey of nurses in the north and middle regions of Jordan By Dr. Belal M Hijji, RN. PhDAssistant ProfessorFaculty of Nursing, Philadelphia UniversityPresented at theKing Abdullah University Hospital, Irbid, Jordan 5th April 2009Co-investigators Dr. Awa Oweis, Dr. Rasha Dabbour

  2. Where does this area fit within Jordan’s classifications of research priorities? Quality of care has been identified by the JNC in the national health strategy as a high priority area 05.04.2009

  3. Learning objectives 05.04.2009

  4. By the end of this presentation, nurses/ educators will be able to: • Appreciate the central role that nursing research plays in clinical practice • Value the importance of knowledge to competent nursing practice • Have an up-to-date knowledge underpinning the care of patient in need of blood transfusion • Understand how patients in need of transfusion are vulnerable to various types of errors that nurses can prevent or eliminate 05.04.2009

  5. Contents • Background • Aim and objectives • Methods • Results • Recommendations 05.04.2009

  6. Background 05.04.2009

  7. Nurses play a crucial role in the administration of blood transfusions Their relevant knowledge and practice are important determinants of the safety of transfusions Published information about nurses' blood transfusion knowledge and practice is lacking To fill this information gap, this study was undertaken in Jordan 05.04.2009

  8. Aim 05.04.2009

  9. Principal Aim To investigate nurses’ knowledge and practice of blood transfusion • Objectives • A. Investigate nurses’ knowledge and/ or reported practice of: • Patient preparation before blood collection • Blood pack collection • Pre-transfusion initiation nursing activities • Post transfusion initiation activities and issues • B. Identify statistically significant differences in mean knowledge scores of nurses with different characteristics 05.04.2009

  10. Methods 05.04.2009

  11. Design, Settings and Access • A descriptive cross-sectional survey using an interviewer-administered questionnaire • The study involved in-patient areas where blood transfusion events were common • 3. Four teaching and public hospitals • 4. Ethical approvals • 5. Participant information sheet • 6. Voluntary informed consent • 7. Anonymity and confidentiality 05.04.2009

  12. Population and sample Population: 906 nurses Sample: 320 nurses selected at random Inclusion criteria: Registered nurses with direct care responsibilities Exclusion criteria: Auxiliary staff, head nurses, and nurses in out-patient areas and OT. 05.04.2009

  13. An overview of data collection Nurses’ knowledge and reported practice of blood transfusion was measured via a questionnaire developed following consultation with nursing literature. It has 44 items in seven sections. A: nurses’ demographics and training (8 items); B: patient preparation before blood collection (4 items); C: blood bag collection (3 items); D: pre-transfusion initiation nursing responsibilities (8 items); E: post transfusion initiation nursing responsibilities (11 items); F: complications related to blood transfusion (8 items); and G: issues related to local policies (2 items). 05.04.2009

  14. Validity and Reliability of the Questionnaire • A panel of seven international transfusion specialist nurses • Pilot study • The Flesch Reading Ease (RE) Index is 66.15. 05.04.2009

  15. An overview of data collection (continued…) Data collection started on 5th November 2008 and was completed by 31st January 2009. • Two research assistants collected the data • They attended a session on questionnaire administration and collection • They received written instructions 05.04.2009

  16. Data Analysis Allocation of scores For most items, one point was awarded for the correct answer and 0 for the incorrect one. The maximum score was 57 (100%) points. Descriptive and inferential statistics were used to analyse data 05.04.2009

  17. Results 05.04.2009

  18. Knowledge Scores 05.04.2009

  19. 305 nurses (95.3%) filled in the questionnaire 05.04.2009

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  27. Possible Transfusion Combinations From: http://www.redcrossblood.org/portal/NC/facts.htm 05.04.2009

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  34. Inferential Statistics One-way ANOVA revealed no statistically significant differences in nurses’ mean knowledge scores with different hospital affiliation, qualifications, gender, level of involvement in blood transfusion, ward experience, and previous training 05.04.2009

  35. Key Findings • Nurses had serious knowledge deficits and practice deficiencies that are potentially threatening to patients health and safety • Patients were at risk of developing complications, in particular bacterial infection, destruction of red blood cells, and receiving incorrect transfusions 05.04.2009

  36. Recommendations 05.04.2009

  37. Action is needed, nationwide, to assist nurses in the pursuit of safer blood transfusion practice • Strengthening the nursing workforce by implementing urgent bedside training as recommended by the WHO • Systems must be developed to ensure that nurses are competent in performing blood transfusion • Development of blood transfusion policies and guidelines for nurses • Collaboration between service providers and higher education institutions 05.04.2009

  38. Errors in blood transfusion (3.3 million red cell units) (McClelland, D. and Phillips, P. (1994). BMJ ;308:1205-6) 05.04.2009

  39. Re-produced with permission from the UK Serious Hazards of Transfusion (2008) Initiative 05.04.2009

  40. How does Jordan compare with the UK concerning blood transfusion safety regulations? 05.04.2009

  41. Acknowledgements 05.04.2009

  42. We are immensely grateful to the Ministry of Health, all nursing staff, and hospitals for their valuable support. We express our gratitude to Philadelphia University Deanship of Scientific Research and Postgraduate Studies for funding the study. 05.04.2009

  43. Thank You Principal Investigator bhijji@philadelphia.edu.jo 05.04.2009

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