Factors associated with nurses' poor knowledge and practice of transfusion safety procedures in Aquitaine, France

To (1) describe knowledge, attitudes, and reported practice of blood transfusion of nurses in Aquitaine's hospitals; (2) measure the potential threat for patient safety of poor transfusion-related knowledge and practice; and (3) identify factors associated with poor knowledge and practice.

Survey conducted in 14 hospitals in Aquitaine (one university and 13 general hospitals).

Hospitalized care.

A random sample of nurses.

Data were collected anonymously by investigators through structured individual interviews. The questionnaire contained mainly knowledge and practice questions about blood transfusion regulation.

Hazardous knowledge and practice scores have been constructed, reflecting the levels of potential danger in the answers to the questionnaire. Factors associated with these scores have been studied using a random-effect linear regression.

In our sample of 1090 nurses, poor knowledge and practice concerned mainly (1) the bedside blood compatibility test [proportion of responses (PR) with potential life threat between 12.7 and 35.5%]; (2) pre-transfusion compatibility check when receiving blood units (PR = 34.5%); (3) delay between screening of red cell antibodies and transfusion (PR = 20.5%); (4) delay in preservation of blood unit in the ward (PR = 33.4%); and (5) recognition of abnormal reactions after transfusion (PR = 47.1%). Frequency of transfusion and training were the factors most strongly associated with hazardous knowledge and practice scores.

Low training and transfusion activity were key determinants of poor transfusion-related knowledge and practice.