Background/Case Studies: Monitoring vital signs [VS] during transfusions is critical for early detection of adverse reactions, as severity is dose-dependent. Compliance remains low and while trained transfusionists improve safety, studies reveal gaps in nursing knowledge. Educational interventions, including interprofessional education, improve knowledge, but their impact on compliance remains uninvestigated. This study investigates compliance in monitoring VS following implementation of laboratory-led educational initiatives.
Study
Design/Methods: A retrospective quasi-experimental one-group pretest-posttest study tested whether transfusionists participating in laboratory-led education improve compliance with VS recording. In 2024, three initiatives were implemented at a tertiary care facility: a job aid for transfusion reactions, a revised job aid color, and a skills fair led by transfusion service personnel on transfusion monitoring. Data was collected for two months before the first initiative and two months after implementation of each initiative. Compliance was assessed per facility policy at each documentation interval (pretransfusion, 15-minute intratransfusion, every 30-minute intratransfusion, and posttransfusion) for each VS (temperature, heart rate, respiration rate, and blood pressure). Each expected VS was documented as present or absent (compliance frequency), and from this, overall compliance for each transfusion was calculated (calculated compliance) using a weighted scale (pre-/15-minute/post- = 30% each, overall 30-minute = 10%). A total of 1,273 electronically documented transfusion events were evaluated for vital sign monitoring compliance using chi-squared analysis and one-way ANOVA as appropriate.
Results/Findings: Compliance frequency was highest for all vital signs during pretransfusion (100%) and slightly lower posttransfusion 95.7–98.8%). Intratransfusion compliance was higher at the 15-minute check (85.1–87.8%) and lowest at the 30-minute interval (8.0–11.3%). Mean calculated compliance across all time periods was 87.3%. Educational initiatives did not show statistically significant improvement in compliance frequency (see table 1) or calculated compliance (p = 0.117). Conclusions: Laboratory-led educational initiatives did not significantly increase VS monitoring compliance. These findings suggest that educational initiatives alone are insufficient for achieving improvement in compliance. A multifaceted approach that includes process improvements, education, and regular auditing may have a more substantial impact. Further research is needed to determine the most effective approach for improving transfusion VS monitoring.
