What Are the Barriers and Facilitators for Critical Care Nurse Participation in a Patient Blood Management Program?

Abstract

BACKGROUND Patient blood management (PBM) programs strive to implement best practices, mitigating blood loss through procedures to decrease anemia and the need for transfusion. Critical care nurses may have the greatest impact on blood preservation and anemia prevention for the most critically ill patients. Nurse perceptions of barriers and facilitators in PBM are not fully understood. OBJECTIVES The primary aim was to determine critical care nurses' perceptions of barriers and facilitators to participation in PBM. The secondary aim was to understand ways in which they believe the barriers can be addressed. METHODS A qualitative descriptive method was used following Colaizzi's process. Critical care nurses (n = 110) were recruited from 10 critical care units in 1 quaternary care hospital to participate in focus groups. Data were analyzed using qualitative methodology and NVivo software. Communication interactions were categorized into codes and themes. RESULTS Study findings were gathered under 5 categories: assessing need for blood transfusions, laboratory challenges, availability and appropriateness of supplies, minimizing need for laboratory draws, and communication. Three prominent themes indicated that (a) critical care nurses have a limited awareness of PBM, (b) critical nurses must be empowered to engage in interprofessional collaboration, and (c) addressing barriers is not complex. CONCLUSION The data provide insight into the challenges of critical care nurse participation in PBM, driving next step efforts in building on the institution's strengths and improving engagement. It is imperative that the recommendations derived from critical care nurses' experiences be further developed.