Knowledge of Transfusion Medicine Among Resident Doctors in Clinical Specialities: A Cross-Sectional Study from a Tertiary Care Centre

Education in transfusion medicine, Part III - The importance of haemovigilance education

According to the literature, there are significant differences in the availability of education and training in transfusion medicine worldwide, with significant heterogeneity in the existing curricula. Recognising the need for education with the aim of achieving globally standardised competencies in transfusion medicine, a group of experts collaborating in the European and Mediterranean Initiative in Transfusion medicine (EMITm) proposed a process of incremental training and education. Subsequent to two previous papers published by this group on general education in transfusion medicine, this paper specifically refers to the field of education in haemovigilance. This topic is of particular importance when one considers the role of haemovigilance in improving the safety of transfusion practice, and the fact that this role can only be realised through the cooperation of all participants in the transfusion chain. In addition to promoting the importance of education in haemovigilance, this paper provides an overview of the available literature on this topic and proposes an education programme on haemovigilance for medical students and residents.

Knowledge and practices of physicians on blood component therapy: a cross-sectional study from two tertiary hospitals in Nigeria

INTRODUCTION

Comprehension of blood component therapy (BCT) has profound impact on transfusion outcomes. Variations from the standards in practices of BCT may jeopardize patient care.

AIM

To assess the understanding and implementation of BCT by physicians.

METHODS

The study was carried out at two tertiary health care centres. It was a descriptive cross-sectional study using a self-administered, questionnaire comprising of 30 questions.

RESULT

A total of 265 physicians responded from various clinical specialties. Physicians studied showed remarkable knowledge (98%) of BCT. Nevertheless, 92.8% of the respondents' were inclined to prescribing whole blood and the commonest reason given was ready availability at the blood bank. More than half of the respondents' have prescribed BCT with sedimented red cells and platelet concentrates being the most frequently prescribed blood components. Non-availability of blood components and cost implications were some of the identified limitations to the use of BCT.

CONCLUSION

Majority of the physicians have a good knowledge concerning BCT. Nonetheless, there was a knowledge-practice mismatch attributable to the unavailability of the various blood components limiting optimal practice of BCT. Strategies should be formulated to overcome these identified challenges to ensure quality transfusion services in our healthcare facilities.

Do advanced clinical practitioners have the theoretical knowledge to authorise blood components for transfusion? A cross sectional survey Study

AIM

The aim of this study is to investigate whether non-medical authorisers of blood component transfusion, in a single centre working at an advanced level, have the theoretical knowledge to potentially undertake this task safely.

BACKGROUND

Authorisation of blood components for transfusion has predominantly been a medical role in the United Kingdom. Advanced Clinical Practitioners (ACP) are increasingly undertaking this role in order to maintain timely transfusion care.

DESIGN

A cross sectional study design was utilised for this study which was conducted between 05th March 2018 and the 4th of April 2018.

METHODS

A total of 81 participants (49 medical authorisers and 32 Advanced Clinical Practitioners of which 21 were nurses and 11 were Allied Healthcare Professionals) working in a single centre completed the BEST-TEST, a previously validated knowledge assessment tool (Transfusion, 54, 2014, 1225). This study's methods were compliant with the STROBE Checklist.

RESULTS

The overall mean was 8.74 out of a possible 20 questions. Doctors scored higher within the basic science domain compared to Advanced Clinical Practitioners (p = .01). This study found the method of training received by its participants was statistically significant with those receiving formal training scoring more than those who had received on the job training from their colleagues (p = .02). When all specialities were compared for differences with the mean correct scores a statistically significant difference was found (p = .01).

CONCLUSION

This study demonstrates there is no statistically significant difference in transfusion medicine knowledge between professional subgroups working in a single centre. Furthermore, there is deficits in the knowledge of all subgroups.

RELEVANCE TO CLINICAL PRACTICE

With advanced practice roles expanding, it is essential that we realise their full potential. There is no current research examining knowledge of ACPs, who could potentially authorise blood components for transfusion, but there are some clear benefits for clinical practice such as providing safe, timely and patient centred care.

Knowledge Improvement of Blood Transfusion Safety Among Pediatricians: Post Educational Intervention

Human factors account for most reported errors in the serious hazards of blood transfusion report, thus staff training on safe blood transfusion is strongly recommended. This study aimed to assess knowledge of blood transfusion safety among pediatricians and determine the impact of an educational initiative. A quasi-experimental study was conducted on 190 pediatricians. A questionnaire was designed and validated through a pilot study after which all participants were invited to fill it pre- and posteducational intervention. The educational material has been prepared based on the WHO blood transfusion safety guidelines; prepared by the researcher and reviewed by experts in the field. Near miss was identified by 47% of the participants and around 78.3%, 63.2%, and 60% of them correctly identified the indication of red blood cells, fresh frozen plasma, and platelet transfusion. These percentages were significantly improved post education. Only 55% knew that it's not allowed to co-administer drugs or IV fluids with the transfused blood and that rose to almost 80% after intervention. Consent information and correct patient identification were well known among most of them. Only 18.4% knew the pre transfusion screening protocol, which was increased to 85.8 % posteducation. Almost 65.3% correctly responded to the transfusion reaction quiz with no significant change after intervention. Age and work experience were significant independent risk factors for poor knowledge of transfusion safety. Transfusion safety knowledge needs further enhancement with more tailored training programs focusing on the topics that did not show a significant change after our educational training.

Residents' knowledge in transfusion medicine and educational programs: A pilot study

BACKGROUND

Residents' knowledge in transfusion medicine significantly impacts the optimal use of blood and patient safety. Little is known regarding this topic in France in particular. The objectives were to evaluate their basic knowledge, to determine whether the objectives of the curricula were attained and subsequently to suggest ways for improvement.

METHODS

A cross-sectional study was conducted on 50 first year medical and surgical specialty residents rotating in a French university hospital.

RESULTS

Major gaps in the knowledge were noted among residents of various specialties, equally between those with low and sustained transfusion practice. The majority of these young doctors expressed difficulties in prescribing and handling transfusions, identifying and managing its complications and understanding their responsibilities. The roles of hemovigilance practitioners were further somehow unclear for participants.

CONCLUSION

Given these results, action plans appear needed to limit consequences. A special transfusion medicine educational program should be added to the currently available medical education curriculum in order to ensure physicians have adequate knowledge of transfusion basics; at least a practical assisted situation during residency would be of valuable interest.

Assessment of the knowledge and perceptions of Brazilian medical residents on transfusion medicine

Background

Medical education has a major social impact because it ultimately influences the quality and safety of the health service offered to the population. Several studies have acknowledged the relationship between medical knowledge on transfusion medicine and the proper use of this therapy. The rational use of blood has become a worldwide concern. In this context, the aim of the present study was to evaluate medical residents' knowledge on transfusion medicine in hospitals located in Rio de Janeiro, Brazil, and their training during their medical education.

Methods

One hundred and six residents from eight medical specialties of four hospitals participated. A questionnaire developed by the Biomedical Excellence for Safer Transfusion (BEST) group was applied to evaluate the participants' medical knowledge. Another questionnaire was also applied to evaluate participant profiles regarding frequency of transfusion prescriptions, self-perceived knowledge and relevance of the subject.

Results

The mean number of correct answers to the questionnaire on knowledge about transfusion practices was 43.5% (range: 15-80%). A relationship between training during medical residency and the obtained result was observed (p-value = 0.0007). Most residents (73%) did not receive training in transfusion medicine during their graduation or residency and 93% would like to receive additional training.

Conclusion

A clear deficit in the knowledge of transfusion medicine was verified, indicating the need for change in the teaching of this specialty. This result is similar to some developed countries.