Keywords

transfusion, nurse education, oncology, teach/learning strategies, virtual learning, academic-clinical partnership

Abstract

Introduction: An estimated 30% of oncology patients receiving chemotherapy will require a blood transfusion at least once for survival. At the designated infusion clinic, blood transfusions are not provided, forcing patients into emergency departments for treatment. Clinic staff expressed the desire to administer transfusions on-site, but nurses lacked the necessary training and support. This QI project aimed to create and evaluate an educational module to ensure staff competency and aid in administering blood transfusions in the clinic.

Methods: The Johns Hopkins Nursing Evidence-Based Practice Model and the Practice Evidence Translation process were utilized to identify key stakeholders and address barriers. Based on feedback from nurses during development, an educational module was created. The module was delivered to two groups of infusion nurses: in-person training and asynchronously online. Knowledge was assessed using the newly developed Blood Administration Knowledge Assessment (BAKA) instrument; both quantitative and qualitative data were collected. The module was developed, revised, and tested.

Results: Nurses (n=25) reported the final module was helpful and informative. The module's video component (11 minutes) covered critical topics such as informed consent, transfusion setup, monitoring, and handling reactions. Barriers to implementation were identified, including staffing ratios, time constraints, space limitations, and emergency response capabilities. Post-training BAKA scores demonstrated improved/increased knowledge with 74% demonstrating correct monitoring before the module completion to 100% correct monitoring post-completion. Mean overall score went from 91.7% (pre-module) to 97.5% (post-module). Notably, 100% (n=25) of nurses were deemed competent to administer blood in the outpatient setting per the protocol and BAKA scoring after module completion. Discussion: The educational module demonstrated nurses’ competency in administering blood transfusions in an outpatient clinic. Both in-person and online training methods effectively enhanced knowledge, though the online module provided flexibility by allowing nurses to complete the training without leaving the clinic. High competence levels were noted before, but the education reinforced knowledge and improved BAKA scores. This project demonstrates how engaging nursing staff and key clinic stakeholders can help identify barriers and implement solutions to enhance care quality.