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The problems of nursing care during the application of transfusion
PEŠKOVÁ, Radmila
Abstract Issues of nursing care when transfusing Current situation: A transfusion is putting whole blood or its complements (plasma; erythrocytes) into the bloodstream. The doctor who transfuses is responsible for transfusing. While transfusing, cooperation between the nurse and the doctor is important; any mistake can endanger the patient's health and life (Vyhnálek, 2003). When transfusing, the nurse's competencies include taking the patient's blood for blood type testing and cross testing, preparing equipment and a set, ensuring the venous access, ensuring blood compatibility and blood at the patient's bedside, monitoring the patient while transfusing, and keeping documents (Vokurka, 2005). The aim of the research: To determine issues of the nursing care of a patient requiring blood transfusion. In addition, to determine whether nurses observe the standard nursing procedure for patients requiring blood transfusion. Methodology: The empirical part of the bachelor's thesis was prepared on the basis of qualitative research data collection through interviews. The qualitative research was supplemented with observations of nurses using an audit technique.The results were processed using open coding. Codes were created using a pencil and paper and then divided into categories and subcategories. Participants: Interviews were intended for general nurses working at the surgical and orthopaedic departments of hospital České Budějovice, a.s. The interviews were conducted by agreement with the nurses in charge of the departments concerned. It was a deliberate choice that was influenced by the participants' willingness to cooperate. Sampling was terminated when the data obtained were theoretically saturated. An audit was carried out in the case of 5 nurses within the semester thesis. Results: It was found out on the basis of the research that the nurses had good theoretical knowledge in the area of the care of a patient requiring blood transfusion, but there were certain areas in which the nurses showed a weakness. The nurses showed their greatest weakness in the case of blood derivatives. There we found out from the research that the nurses were unable to explain what blood derivative was during the research. The results show that the nurses' knowledge in the area of patient care before transfusing is excellent. Another examined part of the research was to determine what duties the nurses had to perform while transfusing. There it was found out that not all nurses observed the recommended procedure for monitoring the patient while transfusing. The last part of the research was to find out what responsibilities the nurses had after transfusing. The research results show that the nurses know how to handle the completed transfusion and that they should keep it in a special refrigerator for 24 hours. After the end of transfusing all the nurses interviewed also measure the patient's physiological functions and then record them in the nursing documentation. Furthermore, it was discovered by the research that the longer practice nurses have and the more often they meet with transfusing, the less danger of damage to the health of the patient is. The results of the audit of transfusing show that the most frequent mistakes the nurses made were the insufficient identification of the patient, failure to observe the recommended time of application, and the unsatisfactory checking of the patient's condition while and after transfusing. Conclusions: The research results show that the nurses interviewed have relatively wide knowledge of the issues concerned. They know the nursing care of a patient requiring blood transfusion before, while and after transfusing. The research shows that the more often the nurse meets with transfusing the better her skills in transfusing are. The research proved that although the nurses knew the standard nursing procedure for a patient requiring blood transfusion, in practice they did not observe it fully.
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