How Hospital Nurses Identify and Manage Transfusion Reactions

This report delves into the crucial role of hospital nurses in identifying and managing acute transfusion reactions. It begins by establishing the significance of blood transfusions in various medical scenarios and highlights the potential for adverse reactions. The report emphasizes the importance of nurses in overseeing the transfusion process and the critical need for prompt recognition of transfusion reactions, which can range from acute to chronic and life-threatening complications. The study focuses on the health system in Oman, noting the absence of local guidelines and policies, as well as the lack of data on transfusion reaction incidents. It aims to analyze knowledge gaps among nursing professionals, identify preventive measures, and explore the relationship between inadequate nursing knowledge and management of transfusion reactions. The report investigates causes of transfusion reactions, explores how nurses can help manage them, identifies the reasons behind the lack of knowledge in identifying symptoms, and examines how hospitals and healthcare leaders can improve the management of acute transfusion reactions. It underscores the importance of this research in improving patient care and safety, particularly in light of the underreporting of transfusion reactions and their impact on healthcare quality.

Running head: HOW HOSPITAL NURSES IDENTIFY AND MANAGE ACUTE
TRANSFUSION REACTION
HOW HOSPITAL NURSES IDENTIFY AND MANAGE ACUTE TRANSFUSION
REACTION
Name of the Student:
Name of the University:
Author Note:

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Chapter 1: Introduction
1.1 Introduction
Blood transfusion is practised commonly in hospitals for many critical scenarios, scenarios
such as excessive blood loss. Blood transfusion is often known as a life-saving approach. The
nursing professionals play an important role in the procedure of blood transfusion, and they
supervise the entire procedure (who.int 2020). However, in many cases, patients suffer the
transfusion reaction and nursing professionals often failed in identifying the transfusion
reaction. A transfusion reaction is always considered to be a critical issue. The acute
transfusion reaction should be addressed at the emergent level as well as the chronic
transfusion reaction result in complications such as life-threatening. The management of the
hospital should focus on prevention as well as diagnosis of the transfusion reaction (Pirenne,
Bartolucci and Habibi 2017). The management in transfusion reaction also depends on the
level of reaction. On identifying the transfusion reaction, the healthcare professionals should
stop the process of transfusion immediately. This research aims to understand how hospital
nurses identify as well as manage acute transfusion reactions. In addition to this, it will also
study briefly regarding the key factor that is restricting the nursing professionals to manage
the acute transfusion reaction.
1.2 Background of Blood Transfusion
Blood transfusion can be defined as the transfer of blood or component of blood from the
donor to recipient. The major components of blood are platelets, red blood cells, plasma, as
well as white blood cells. Platelets help in preventing the loss of blood due to any vascular
injury. Another major function of platelets is to release substances that stimulate repair of
tissues as well as influence the processes, such as inflammation (Thomas and Storey 2015).
Red blood cell component consists of hemoglobin that plays multiple roles in different

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aspects in developing the functions in the human body. The average RBC in human lives
100-120 days along with there are 5.2 million red cells per cubic millimetre of blood in the
adult human. The transfusion of blood can be completed within a few hours. The blood can
be retrieved from either blood bank or any volunteer donors. Another safe approach for
transfusion of blood is transfusing of person's blood. However, it requires efficient planning
and consultation from the physician. Transfusion of blood can takes place among a similar
component of blood groups. The type ‘O’ blood group is considered as a universal donor
whereas the type AB blood group is considered a universal receiver. It is always advisable to
discuss with the consulting physician before making any decision on the transfusion of blood.
1.3 Background of Health system in Oman
The acute transfusion reactions can be recognised as well as monitored for the efficient along
with the effective process of transfusion of blood. To ensure the safety of the procedure, it is
a crucial step to execute a nationwide haemovigilance system. The hospitals must incorporate
the guidelines that have policies related to transfusion reactions. It will result in smooth
functioning in identifying as well as managing the transfusion reactions. It is found that there
are no local guidelines as well as policies incorporate in the hospitals of Oman (Al-Riyami et
al. 2014). In Oman, the blood is generally collected in secondary as well as a tertiary health
system. The efficiency, as well as the incidence of blood transfusion reaction, is still
unknown that leads to a major gap in understanding the actual data of transfusion reactions.
Hepatitis C viral infections are high in Oman. The screening of HCV was not done in the
initial stage that is before the process of blood transfusion (Al-Naamani et al. 2015). It was
observed that transfusion create multiple challenges such as RBC alloimmunisation (Al-
Riyami et al. 2014). The health system in Oman has three phases of health planning to
promote the effective delivery of health care. The first phase covered 1976 to 1990, during

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this interval three 5-year health plan. It continued till the seventh 5-year planning between the
year 2006 to 2010 (Alshishtawy 2010).
1.4 Background of Nursing Professional
A nurse plays a critical role in addressing the transfusion reaction. The transfusion of blood
needs to be critically administered and to achieve these nurses plays an important role. Health
institutions and hospitals provide efficient quality of nursing administration to the patent post
to transfusion treatment. The failure in identifying the transfusion reactions results in a
decreasing rate of quality care. Nurses should take the initiations to minimise the discomfort
caused due to the transfusion reaction (Mattia and Andrade 2016). Many times, it occurs that
nurses are unable to identify the transfusion reaction of the patients, or often they avoid the
rise in the level of antibody. In many scenarios, nurses are not aware of potential
complications after the transfusion of blood. It is found that multiple causes of blood
transfusion reaction are due to nursing errors. These reactions can often lead to the death of
the patients (Suddock and Crookston 2019). The student-nurses do not get the opportunity to
manage transfusion reactions. However, they should be able to identify the signs as well as
the symptoms of the transfusion reaction. Due to the lack of practical knowledge in the
management of transfusion as well as monitoring the patients, the nursing student finds it
difficult to identify the transfusion reaction (Flood and Higbie 2016).
1.5 Rationale of the Study
The issue of the research is to understand the impact of transfusion reaction. Blood
transfusion can take place to any patient irrespective of their age. It can be seen that
transfusion occurs in pediatrics are more critical in nature. It is found that 5 per cent of
children admitted in the pediatric intensive care unit undergo a blood transfusion (Oakley et
al. 2015).The blood transfusion reaction can occur in multiple disciplines of the human body.

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A hypotensive transfusion reaction is one of them; it is an acute transfusion reaction. There
was an unexpected drop in systolic as well as diastolic blood pressure. This drop will be in
the initial stage of transfusion within 15 minutes and it resolves rapidly within 10 minutes
after the transfusion. These are mostly common to the patient suffering from hypertension
(Delaney et al. 2016). The transfusion reaction considered as an acute transfusion reaction
(ATR) if the reaction can be seen within the 24 hours framework. Any further reaction post to
24 hours results in a delayed transfusion reaction. This treatment is widely practised and thus,
any critical report in ATR should be addressed immediately (Hillis, Shih and Heddle 2016).
This research will shed light on the role of nursing professionals in the hospitals in
identifying as well as managing the transfusion reaction. In addition to this, this research will
also focus on multiple ways to prevent transfusion reaction and to provide quality care to the
society.
1.5 Problem Statement
The problem that arises with the blood transfusion reaction was in the Royal Hospital of
Oman. There was a underreport that stated the problem of nursing professionals in identifying
along with managing the transfusion reaction. This problem has enhanced the decreasing rate
of quality of care and has affected the deliveries of health care to the people.
1.6Research Aim
`This dissertation aims to find out the key factors to manage the transfusion reaction as well
as major gaps in nursing professionals to identify transfusion reaction. The effectiveness of
managing transfusion reaction will be measured with efficient, valid studies and supportive
theories.
1.7Research Objective

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The research objectives can be stated as follow-
 To analysis the gap of knowledge in nursing professional
 To find out the preventive measures to manage the transfusion reaction
 To find out the relationship between the inefficiency of nursing professionals and lack
of knowledge
 To provide a recommendation to improve the management of acute transfusion
reaction
1.8 Research Questions
Research questions are enclosed to achieve the research goals as well as the objectives. These
research questions are as follows:
 What are the causes of transfusion reaction?
 How can nursing professional help to manage the transfusion reaction?
 Why there is a lack of knowledge in identifying the symptoms of transfusion
reaction?
 How can a hospital or health leaders work to manage the acute transfusion reaction?
1.9 Significance of the Study
This study will help the Royal hospital as well as any healthcare leaders to understand the
effect of acute transfusion reaction. It will help in understanding the major gap in nursing
professionals in identifying the signs as well as symptoms of acute transfusion reaction. The
transfusion reaction causes both acute as well as chronic issues and thus, managing as well as
identifying these reactions is crucial to deliver quality care to the people. Moreover, this
research will provide an overview for other hospitals for understanding the major limitation
in managing the acute transfusion reaction.

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1.10 Conclusion
The first chapter of the dissertation was an introductory part of the research that includes the
research aim along with the objectives. A brief description of the health system in Oman has
been addressed in the chapter. Moreover, the wider concept of the research that needs to be
conducted by the researcher has been addressed.

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