Date of Award

2011

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

First Advisor

Marcia Miller

Abstract

Medicine has historically regarded blood transfusion as an integral component of major surgery or illness. However, clinical studies have shown that allogeneic blood transfusions are associated with increased morbidity and decreased survival. Knowledge of this research and the concepts of blood conservation so as to avoid unnecessary blood transfusions is needed in order to deliver holistic care and serve as patient advocate. This knowledge reaches every specialty of nursing care.

This study of the nurse's knowledge of blood conservation as a part of blood management utilizes The Conservation Model developed by Myra E. Levine in 1973. Levine's work is a conceptual model of nursing that focuses on conservation of the person's wholeness (Tomey & Alligood, 2002). It is defined as "keeping together" of the life systems and the integrity of the individual (Schaefer, 2006, p. 98). The Theory of Conservation is based on the assumption that all nursing actions are conservation principles (Schaefer, 2006). Conservation is further defined in the model as achieving a balance of energy supply and demand that is within the unique biological realities of the individual (Tomey & Alligood, 2002). The model proposes that the nurse participates actively in the patient's environment, and much of what the nurse does supports the patient's adaptations as he struggles in the predicament of illness. Maintaining or conserving a patient's viable resources such as skin integrity, immunity, oxygen demand and blood supply are essential in providing an environment in which the patient can heal.

Because knowledge of blood conservation as part of blood management is vital to providing appropriate care and avoidance of unnecessary blood transfusion, this research examines what knowledge practicing nurses in varying areas of expertise possess regarding blood conservation. This study of the nurse's knowledge of blood conservation as a part of blood management was conducted using a convenience sample of registered nurses employed at a rural acute care hospital with no formal blood conservation program or bloodless medicine and surgery services. The study sample represented various areas of practice and all educational levels. A survey consisting of basic questions regarding blood conservation strategies and concepts was administered to practicing registered nurses. The survey was developed using current literature focusing on blood conservation techniques. The survey found that a minority of nurses gained education regarding blood conservation in their nursing programs. It also revealed a lack of knowledge related to appropriate indicator for blood transfusion and demonstrated that nurses discard an unnecessary amount of blood when drawing blood samples from central lines. The limitations of this study included small sample size and researcher developed questionnaire.