This month as we celebrated Nurse’s Week I hope you were all able to reflect on the many contributions that the profession of nursing has made in healthcare. More nursing programs than ever before are embracing evidence-based care models, developing multidisciplinary care teams and establishing professional accountability.
Significant progress with hospital initiatives focusing on the prevention of falls, pressure ulcers and hospital-acquired infections are nurse-driven and a testament to the success of coordination and teamwork in the healthcare setting. However, our work is far from finished. Hospital blood management and transfusion safety are two areas that have received minimal attention over the years. It is estimated that millions of blood products are ordered without evidence of clinical need each year in the US, resulting in unnecessary exposures to a scarce, expensive and hazardous resource. It is also estimated that 1 in 12,000-16,000 transfusions (over 2000 annually) are administered to the wrong patient, a startling number that has remained unchanged for 30 years. The nursing profession must accept a vital role in improving hospital transfusion practices if we are going to make our patients safer. The growing national focus on appropriate blood utilization and transfusion safety demonstrates the importance of blood management from a quality, safety and stewardship standpoint. Although blood management programs typically focus on physician blood utilization practices, nursing owns several crucial roles in transfusion safety. These four major roles are described below.
- Educator: educating nurses on safe transfusion practices and the management of transfusion reactions; encouraging the use of evidence-based guidelines by physicians; patient education about the risks, benefits and alternatives to transfusion
- Advocate: advocating safe and appropriate transfusion practices for our patients (right patient, product, dose, time, indication), as well as the effective use of transfusion alternatives
- Technician: managing the technological and complex aspects of safe blood administration
- Assessor: vigilant patient assessment during and after transfusion to identify adverse events early and minimize patient harm.
Nurses are the single largest group of healthcare professionals in the country, making them a powerful force to help improve patient care. As patient advocates and knowledgeable caregivers, educated and enthusiastic nurses must play a significant role in promoting evidence-based practices and optimizing the safety of the transfusion process.