The development of a nursing practice guideline for children with thalassemia in receiving a blood transfusion in General pediatrics ward, Loei Hospital

Abstract

Blood transfusion is an essential treatment for thalassemia children to stop other complications. However, Blood transfusion in children is complicated and requires systematic management. This study aimed to develop and study the outcomes of a nursing practice guideline for children with thalassemia in receiving a blood transfusion in the General pediatrics ward, Loei Hospital. The Research and Development have applied the Deming cycle consisting of Plan, Do, Check, and the Action to be a framework of the study. This study conducted 3 months (February–April 2020). The participants included 13 nurses and 30 thalassemia patients. Quantitative measurements consisted of 1) Assessment of patient readiness preparation before and after using the guideline, 2)Nursing satisfaction questionnaire. Qualitative measurements were focus group discussion. The quantitative data analysis used percentage, frequency, mean, standard deviation, and compared the data by McNemar's Chi-Square test, and Wilcoxon signed - ranks test. Qualitative data analysis using content analysis.  The study focused on the participation by focus group and brainstorming sessions. Findings were presented in 2 cycles. The first cycle, situation analysis past 2 years of the incidence, found that there was a blood supply error 2 times. Also, patients got side effects after giving blood were 6 times causing by different practices. These problems came from the knowledge and experience of the nurses. Conclusion, the lack of nursing practice guidelines for clear led to the development of a nursing practice guideline for thalassemia patients who received blood. In the second cycle by analyzing the results of cycle 1, found that the outcomes of both development cycles having clear nursing guidelines for thalassemia patients receiving blood. Nursing behaviors for blood transfusion scores were increased significantly (p = 0.002). Also, nurses were satisfied with guidelines at the significance level (p< 0.001). Patients were evaluated and documented abnormal signs to increase significantly (p = 0.031, and no incidence of wrong blood given. Therefore, the development of nursing practice guidelines for thalassemia patients who received blood increased nursing quality practice and provided good clinical outcomes for patients.