Nurses' experiences of blood sample collection from children: a qualitative study from Swedish paediatric hospital
Henrik Hjelmgren1,2, Britt-Marie Ygge3,4, Björn Nordlund3,4
1Astrid Lindgren's Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. Henrik.hjelmgren@ki.se.
Insights
Pediatric nurses find blood sampling challenging, experiencing frustration with unsuccessful attempts and pre-analytical errors. Improving skills and understanding error causes are crucial for better pediatric patient care.
Area of Science:
- Pediatric Nursing
- Phlebotomy Procedures
- Patient Experience
Background:
- Blood sampling in children is crucial but often complicated by pre-analytical errors, leading to delays and repeat procedures.
- Children report needle procedures as a highly distressing aspect of hospitalization.
- Nurses' perspectives on errors during pediatric blood sample collection remain largely unexplored.
Purpose of the Study:
- To explore and describe the experiences of pediatric nurses regarding blood sample collection from children.
- To identify challenges and needs related to pediatric phlebotomy from the nursing perspective.
Main Methods:
- Qualitative study design utilizing reflexive thematic analysis (TA).
- Three focus group interviews were conducted with 19 nurses from two Swedish pediatric hospitals.
- Purposeful sampling ensured participants had relevant experience in pediatric blood sample collection.
Main Results:
- Paediatric blood sampling presents a significant challenge for nurses.
- Nurses reported frustration with unsuccessful samplings and difficulty understanding pre-analytical errors.
- Teamwork was a key support, with venous blood sampling preferred, and a clear need for enhanced skills development was identified.
Conclusions:
- Pediatric nurses face substantial challenges in collecting blood samples from children.
- Addressing nurses' frustration and improving understanding of pre-analytical errors is essential.
- Enhancing guidelines, competence, and support systems for pediatric blood sampling is recommended for better patient care and outcomes.
Background:
Nurses play an active role in supporting the children with the blood sampling experience. Unfortunately, the blood sampling collection procedure is often affected by pre-analytical errors, leading to consequences such as delayed diagnosis as well as repeated sampling. Moreover, children state that needle procedures are the worst experience of their hospital stay. The nurses' experiences of errors occurring during blood sample collection is unknown. Therefore, the aim of this study therefore was to describe paediatric nurses' experiences of blood sampling collections from children.
Method:
We used a qualitative study design with a (reflexive) thematic analysis (TA) method described by Braun and Clarke. Three focus group interviews were conducted, with 19 nurses collected by purposeful sampling from Sweden working at two different paediatric hospitals, focusing on their experiences of the blood sample collection procedure.
Results:
From the three focus group interviews we analysed patterns and meanings of the following main theme Paediatric blood sampling is a challenge for the nurses and the four subthemes Nurses' feelings of frustration with unsuccessful samplings, Nurses believe in team work, Venous blood sampling was experienced as the best option, and Nurses' thoughts and needs regarding skills development in paediatric blood sampling.
Conclusion:
The narrative results of this study illustrate that nurses working in paediatric hospital care face a big challenge in blood sampling collection from children. The nurses felt frustrated due to unsuccessful blood samplings and frequently could not understand why pre-analytical errors occurred. Nevertheless, they felt strengthened by colleagues in their team and shared feelings of responsibility to help each other with this complex procedure. The implications of this study are that paediatric hospital care needs to focus on improving guidelines for and increasing competence in blood sampling children and helping nurses to understand why samplings may be unsuccessful and how this can be avoided.
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