الفهرس 
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Abstract
Summary
Introduction:-
Around 2.9 million blood components are issued every
year in the UK. Blood transfusion is generally a safe process
that saves lives and improves the quality of life for patients
with a large range of clinical conditions. However, there are
a number of risks associated with transfusion, as with any
other clinical intervention. Right blood, right patient, right
time: RCN guidance for improving transfusion practice sets
out pragmatic advice for nursing staff in the administration of
red blood cells and other blood components (fresh frozen
plasma, cryoprecipitate and platelets). The guidance is not
wholly evidence-based but built on recommendations to
improve the safety of blood ordering and administration from
current national guidelines and Serious Hazards of
Transfusion (SHOT, 2015).
The administration of blood and blood components
involves more than 60 steps and each of these may be subject
to error. Standard protocols for the administration of blood are
essential to minimize the potential for error. These protocols
should be in place in each institution and should conform to
standard practice as outlined in these guidelines. A quality
management system should exist in each institution. This
should include an active transfusion committee, a process to
Summary
127
correct protocols and practice when deficiencies are identified,
participation in local and regional audit and in the national
haemovigilance programme (WHO, 2012).
Aim of the study: -
The aim of this study was to assess nurses’ performance caring
for patient receiving blood transfusion through the following:-
Assess nurses’ level of knowledge regarding caring for
patient undergoing blood transfusion.
Assess nurses’ practice regarding caring of patient
undergoing blood transfusion.
Assess factors affecting nurses’ performance during
blood transfusion.
Research questions
What is the level of nurses’ knowledge about blood
transfusion process?
What is the level of nurses’ performance regarding
caring of patient undergoing blood transfusion?
What are the errors that may result during blood transfusion?
The present study was carried out through:
Technical design, operational design, statistical design
and administrative design.
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128
Study tools:- Three tools were used to collect data of the
study as following:-
I. Self administered questionnaire sheet (Apendix I) it
consists of two parts:
A. 1stpart concerned with demographic data that include
(age, gender,....etc)
B. 2nd part concerned with nurses’ opinion about factors
affecting their performance.
II. Routine Blood Transfusion Knowledge Questionnaire
sheet (Appendix II) and used to assess nurses’ knowledge
about blood transfusion and consists of 5 parts:-
1stpart concerned with nurses’ knowledge regarding
patient preparation before transfusion.
2nd Part concerned with nurses’ knowledge regarding
blood pack collection.
3rd part concerned with pre-transfusion initiation
nursing activities.
4th part concerned with assessing nursing knowledge
about activities that should be done during.
5th part concerned with assessing nursing knowledge
about complications of blood transfusion and how to
deal with.
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129
III: Nurses’ practice observational checklist (Appendix
III).
Used to assess nurses’ practice in caring for patients
undergoing blood transfusion; this part quoted from (Van
Leuven, Wilkinson, and Pearson, 2011) and modified by
the researcher, which included the following:
Pre-transfusion measures .
Verifying the right patient and right blood group.
During transfusion measures.
Post transfusion measures .
Pilot study:- was conducted on 10 % of nurses under study
in order to test the applicability of the developed tools, the
clarity of included questions as well as the average time
needed to complete all questions. Results obtained were
studied and analyzed accordingly, modifications were made
for the final development of the tools, the study nurses who
shared in pilot study were excluded from the study sample.
Field work: Was included two phases as following:-
1-Preparatory phase: it included reviewing of the current and
more recent national & international literature reviews
concerning nurses performance regarding blood transfusion
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130
of various aspects of this issue in order to develop the data
collecting tools.
2-Implementation phase: including first: field work
Interviewing with (60) nurses caring for patients undergoing
blood transfusion in the previously mentioned settings to
explain the aim of the study, the effect of this study on their
performance as well as patient quality of care and take their
approval to participate in the study prior to any data
collection, Second: assessing nurses performance
(knowledge and practice) regarding caring for patients
undergoing blood transfusion. By using questionnaire sheet
and observational check list.
Results of this study showed that:
o (46.6%) of nurses were ranged between 20 to less than 30
years, (56.7%) of them were diploma nurses and all of
them (100%) did not attend training course about
management of patient undergoing blood transfusion.
o About half of studied sample (46.7%) were unsatisfied
about factors affecting nursing performance during blood
transfusion.
o (70.0%) of nurses had unsatisfactory knowledge regarding
caring of patient undergoing blood transfusion and
(80.0%) of them had unsatisfactory practice regarding
caring of patient undergoing blood transfusion.
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131
o There were highly statistically significant relation
between nurses’ knowledge and their qualifications (X2 =
12.4 at P< 0.01).
o There were statistical significant relation between nurses’
knowledge and presence of policy (X2 =6.2 at p<0.05).
o There were highly statistically significant relation
between the nurses’ practice and educational level (X2 =
9.7 at P< 0.01).
o There were statistical significant relation between the
nurses’ practice and experience (X2 = 10.5 at P< 0.05) and
presence of policy (X2 = 6 at P< 0.05).
o There were statistical significant relation between the
nurses’ knowledge and practice (r< 0.65).
It was Concluded from this study that:
About three quarters of nurses had unsatisfactory knowledge
regarding to management of patient undergoing blood
transfusion and majority of them showed unsatisfactory level
of practice regarding to management of patients undergoing
blood transfusion. Furthermore, there were many factors
affecting nurses’ performance as: nurses’ related factors,
work’ related factors and patient’ related factors.
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132
The study recommended that:
Establish in-service training programs for continues updating
nurses’ knowledge about blood transfusion.
Hospitals should establish policies for blood transfusion
and should be available at each department.
Develop a protocol for blood transfusion,written in Arabic
and English which contain checklist about technique of
blood transfusion, blood transfusion complications, how to
assess patient and nursing care during blood transfusion