Thesis Format

Monograph

Understanding the Nursing Practices and Perspectives of Premedication and Transfusion Reaction Reporting: A Qualitative Description Study

Wenxin Miao, The University of Western OntarioFollow

Degree

Master of Health Information Science

Program

Health Information Science

Supervisor

Solh, Ziad

Affiliation

London Health Sciences Centre & St. Joseph’s Health Care London

Abstract

This qualitative description study is a sub-study of a knowledge translation (KT) project to implement evidence-based blood transfusion practices at an urban tertiary hospital. The goals of the KT project are to reduce the use of pre-transfusion medications (premedication) and to improve transfusion reaction (TR) reporting practices at this institution. This study explored the nursing practices and perspectives of premedication and TR reporting by conducting interviews with 25 nurses. The findings showed a lack of standardized premedication and TR reporting practices at this institution. A practice change is needed to achieve the goals of the KT project. The study also revealed that nurses lack knowledge about evidence against the use of premedication and lack awareness of the importance of TR reporting. Barriers and facilitators to reducing premedication and improving TR reporting were identified. In conclusion, this study serves as a needs and barriers assessment of the KT project. It also contributes to the literature by exploring novel topics in the field of transfusion research.

Summary for Lay Audience

Blood transfusion is a common and life-saving treatment to certain patient populations. Each time a transfusion is administered, there is a risk for the patient to develop transfusion-related adverse reactions (TRs). Despite evidence suggesting the lack of efficacy and cost-effectiveness of pre-transfusion medications (premedication), premedication is routinely prescribed to patients as a means to prevent TRs in Canada. In addition, although TRs should be reported to a hospital’s blood bank to ensure transfusion safety, under-reporting of TRs exists. Literature also shows that health care professionals in Canada have poor awareness of the importance of reporting TRs.

Based on the current best evidence against premedication, a knowledge translation (KT) project is undertaken at a large urban tertiary hospital to reduce the use of premedication. The KT project also aims to improve TR reporting practices at this institution because good TR reporting practices are a foundation of evidence-based transfusion practices. As a sub-study of the KT project, this qualitative description study explored the nursing practices and perspectives of premedication and TR reporting by interviewing 25 nurses at this institution. The findings showed a lack of standardized premedication and TR reporting practices at this institution. A practice change is needed to achieve evidence-based transfusion practices. This study also revealed that nurses at this institution lack knowledge about evidence against premedication and lack awareness of the importance of TR reporting.

In conclusion, this study serves as a needs and barriers assessment of the overall KT project to reduce premedication and improve TR reporting practices at this institution. Identified barriers and facilitators will help tailor interventions to implement practice change at this institution. This study also contributes to the literature by exploring new topics in the field of transfusion research.

Recommended Citation

Miao, Wenxin, "Understanding the Nursing Practices and Perspectives of Premedication and Transfusion Reaction Reporting: A Qualitative Description Study" (2019). Electronic Thesis and Dissertation Repository. 6438.
https://ir.lib.uwo.ca/etd/6438