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Nurses and nursing students' knowledge regarding blood transfusion: A

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JIN
Journal of
INTEGRATIVE NURSING
http://www.journalin.org/

Volume 4 • Issue 3 • July-September 2022

Association of Integrative Nursing

 Original Article

Nurses and nursing students’ knowledge regarding blood

transfusion: A comparative cross‑sectional study
ABSTRACT
Objective: The objective of this study is to measure and compare the knowledge of nursing students and nurses on blood transfusion in an
Indian context.
Materials and Methods: The present comparative, cross‑sectional study enrolled 296 nurses and 177 nursing students through a purposive
sampling from a medical university hospital and different nursing institutions. The data were collected in the month of June and July of year
2021, using a self‑structured questionnaire. The questionnaire had two sections: Section‑I contained demographic data (8 items for nurses and
5 for students) and section‑II included 26 items that assessed nurses’ and nursing students’ knowledge on blood transfusion.
Results: Findings indicated that nurses and nursing students had insufficient knowledge about blood transfusion. Nurses, however, had
significantly greater total blood transfusion knowledge scores than nursing students (16.51 ± 3.85 vs. 12.10 ± 3.28; P < 0.001). The marital
status (adjusted odds ratio [AOR] =0.456, 95% confidence interval [CI] 0.244, 0.853; P = 0.037), educational level (AOR = 5.072, 95% CI
1.982, 9.634 (P = 0.003); AOR = 6.540, 95% CI 2.54, 16.871; P = 0.001) and work experience (AOR = 0.216, 95% CI 0.067, 0.702 [P = 0.037];
AOR = 0.331, 95% CI 0.135, 0.811; P = 0.013) were the significant predictors of the level of knowledge among nurses. The attendance in
any educational programme on blood transfusion (AOR = 0.225, 95% CI: 0.062, 0.818; P = 0.041) was a significant predictor of the level of
knowledge among nursing students.
Conclusion: Nurses and nursing students have unsatisfactory knowledge on blood transfusion; emphasizing the critical need for immediate
and successful teaching activities in this area.

Keywords: Blood transfusion, comparative, knowledge, nurses, nursing students

INTRODUCTION
Rakhi GAUR1, Shiv Kumar MUDGAL1, Neha
SUYAL2, Suresh Kumar SHARMA3, Rajat
Since the early nineteenth century, blood transfusion has been AGARWAL4, Ritu RAJ5, Chaturvedi JITENDER6
one of the most common therapies available, with millions of 1
College of Nursing, AIIMS, Deoghar, Jharkhand, India;
patients around the globe receiving blood and its components 2
Government Nursing College, Haldwani, Uttarakhand,
every year. According to the World Health Organization report, India; 3College of Nursing, AIIMS, Jodhpur, Rajasthan, India;
about 9 million individuals get blood components each year in 4
Department of CTVS, AIIMS, Deoghar, Jharkhand, India;
90 different countries.[1,2] Despite substantial advances in blood 5
Department of Medicine, AIIMS, Deoghar, Jharkhand, India;

transfusion techniques, there are significant negative effects

6
Department of Neurosurgery, AIIMS, Rishikesh, Uttarakhand,
India
and risk factors that can lead to deterioration of the recipient’s
health. However, there is no suitable framework for evaluating Address for correspondence: Dr. Shiv Kumar MUDGAL,
the competence of professionals involved in carrying blood College of Nursing, AIIMS, Deoghar, Jharkhand, India.
E‑mail: shiv.nur@aiimsdeoghar.edu.in
transfusion to ensure maximum safety. According to the
Serious Hazards of Transfusion, transfusion mistakes are
responsible for about 70% of negative outcomes. Nurses play an Submitted: 30‑Apr‑2022 Revised: 08‑Aug‑2022
Accepted: 15‑Aug‑2022 Published: 29-Sep-2022

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How to cite this article: Gaur R, Mudgal SK, Suyal N, Sharma SK,
DOI:
Agarwal R, Raj R, et al. Nurses and nursing students' knowledge regarding
10.4103/jin.jin_39_22 blood transfusion: A comparative cross-sectional study. J Integr Nurs
2022;4:137-44.

© 2022 Journal of Integrative Nursing | Published by Wolters Kluwer ‑ Medknow 137

 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion
important role in the blood transfusion system and having the
requisite knowledge and skills is vital considering their close
contact with patients. As a result, assessing this knowledge
has been a popular topic of discussion among researchers.[2,3]
The knowledge and skills of the nurses are critical in ensuring
the safety and effectiveness of this procedure. It may result
in fatal complications if proper precautions are not followed
during a blood transfusion. Acute hemolytic reactions, febrile
events, and hypersensitivity are the most frequent acute
reactions that occur quickly after the initiation of a blood
transfusion. Furthermore, the incidence of these events is
linked to considerable morbidity and mortality.[4,5] Human
errors in hospital wards, such as bedside mixing of blood
units, misidentification of donors and misinterpretation
of screening results cause the majority of complications.
The lack of knowledge and skill of such practices among
the nursing staff is considered the root cause of these
complications.[6] Nurses are increasingly being asked to have
the adequate knowledge and competency on hemotherapy.
Hence, it is very important that these competency and
knowledge are inculcated from the very beginning, when an
individual steps into this profession as a nursing student.[7]
Nurses with an evidence‑based understanding of the technique
of blood transfusion are more likely to administer safer
blood transfusions and contribute to the avoidance of
transfusion‑related morbidity and mortality. Nurses must be
thoroughly versed with this procedure in order to carry out
safely. According to certain research, nurses lacked appropriate
knowledge regarding blood transfusion guidelines/protocol,
prevention of potential complications, and safe blood transfusion
processes.[8‑11] Assessing health care providers’ knowledge is
crucial for creating training materials and schedules to ensure
the quality and safety of blood, its components and transfusions.
[12‑14]
Moreover, it was stressed that nurses’ knowledge and
practice should be evaluated on a frequent basis.[12]
Taking all of this into consideration, it is necessary to determine
the present state of knowledge on blood transfusion among
nurses and nursing students. As an introduction to health care
quality improvement programme, we conducted this study to
assess and compare nurses’ and nursing students’ knowledge
of blood transfusion, emphasizing their critical role in the
transfusion procedure. These findings may serve as a guide
for nurse managers, educators, and clinicians in developing
routine in‑service training to assure the safe blood transfusion
practices. The present study was done with an objective to
determine the level of knowledge about blood transfusion
among nurses and nursing students, as well as the factors
that influence their level of knowledge.
138 Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022
MATERIALS AND METHODS
This study was approved by the Institute Ethics Committee
(IEC) of Pacific Medical College & Hospital, Udaipur District,
India, with the approval number IEC/PMCH/21/236 on July
23, 2021.
Study design
This cross‑sectional comparative‑analytical study was
performed during June and July of 2021.
Study settings
The current study was conducted in one teaching and
referral hospital and five nursing colleges in India that are
affiliated with a government medical university and are
recognized by the Indian Nursing Council. Over 750 beds
are split throughout medicine, surgery, emergency, neonatal,
pediatric and dialysis wards, as well as coronary care, critical
care, and neonatal intensive care units. The nursing staff
has good exposure of broad specialties such as medicine,
surgery, pediatrics, pulmonary medicine along with super
specialties such as cardiology, neurology, endocrinology,
and gastroenterology. The hospital has continuous inflow of
patients from South‑west Rajasthan, India, within a 300 km
radius in this hospital; nursing and medical staff perform
a variety of advanced medical and surgical treatments in
collaboration with university‑based medical experts who
educate healthcare students.
Study population
The nurse’s population (n = 970) included all nurses
employed in various treatment wards, including medicine,
surgery, emergency and intensive care units. Nurses with
minimum diploma in nursing or higher degree, minimum
work experience of 6 months and direct involvement in
patient care were selected for the study. The criteria of
selection of nursing students (n = 277) were based on their
enrolment in final year of bachelor’s degree at the time of
data collection and lack of any formal hospital job experience.
Dropping out of the study or submitting an incomplete
questionnaire was considered as exclusion criteria.
Sample size determination and sampling technique
We calculated the required sample size for cross‑sectional
research using the “N = N/(1 + ne) 2” method, presuming a 95%
confidence interval (CI) and a 5% type I error rate.[15] Based on
an anticipated population of 277 final‑year nursing students
and 970 nurses, a minimum of 163 nursing students and 282
nurses were deemed sufficient to power the study and allow for
more precise results. One hundred and eighty nursing students
in their final year of bachelor’s degree, and 310 nurses, were
contacted with the intention of participation in the study.
 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion
A total of 177 nursing students and 296 nurses finally agreed
to participate and were finally included in the study.
Instrument and data collection
The current study employed a researcher‑created questionnaire
to assess nurses’ and nursing students’ knowledge of blood
transfusion on the basis of previous researches.[3,6,13] To
determine the questionnaire’s validity and reliability, a panel
of faculty members remarked on the questionnaire’s items
and the content validity ratio was determined. Then, the
relevant content validity index was computed. A test‑retest
approach was utilized to measure the questionnaire’s
reliability (r = 0.9). The questionnaire was divided into two
sections: The first section contained demographic data (8
items for nurses and 5 for students). The second section
included 26 items that assessed nurses’ and nursing students’
knowledge of blood transfusion procedures (correct and
wrong). Each accurate response received one mark, whereas
an incorrect response received zero marks. In the present
study participants scored more than 60% of total marks were
considered having adequate knowledge on blood transfusion.
After obtaining approval from the IEC and consent from the
competent authorities, data was collected. During the end
of the nurses’ shifts and following the completion of nursing
students’ lectures, the researchers delivered questionnaires
to the participants in both the groups. The questionnaire
took approximately 20 min to complete. It took 2 months
to finish the entire data collection process.
Statistical analysis
After data collection, it was imported into SPSS version 26 (IBM
Corp., Armonk, New York, USA). By viewing, calculating
frequencies, and categorizing the data, they were cleansed.
The calculations of frequencies and proportions were
made. Demographic characteristics were quantified using
descriptive statistics (i.e. standard deviation, mean, minimum,
and maximum). The categorical variables were associated
statistically. For nonparametric distributions in intragroup
comparisons, the Wilcoxon signed‑rank test was utilized.
Nonparametric distributions such as the Mann–Whitney
U test and Kruskal–Wallis were utilized in the intergroup
comparisons. Then, multiple logistic regressions were used
to determine the presence of distinct predictor variables.
A P < 0.05 was judged significant.
RESULTS
Socio‑demographic characteristics of nurses and nursing
students
Table 1 depicts information about all participants (nurses
and nursing students). Nurses were aged between 21 and
Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022
34 years (mean 26.75 ± 3.28) and half of participants (148,
50.0%) were married. More than half of the participants
were females (n = 165, 55.7%) and the majority of the
participants (n = 213, 72.0%) had a bachelor degree in
nursing. Majority of the participants (n = 122, 41.2%)
belonged to rural background; had 1–3 years of working
experience (n = 109, 36.8%) in profession and approximately
half of them were working in general ward (n = 156, 52.7%).
Surprisingly, majority of them (n = 205, 69.3%) did not attend
any educational program related to blood transfusion.
The nursing students’ average age was 23.05 ± 0.89 years
(range 22 - 27 years). Females made up somewhat more than
three‑quarters of the nursing students (n = 136, 76.8%). Just
more than half (n = 89, 50.3%) of students belonged to rural
background, following with urban (n = 55, 31.1%) and semi
urban background (n = 33, 18.6%). Most of them (n = 171,
96.6%) were unmarried and approximately two‑third (n = 110,
62.1%) of them had not attended any educational programme
related to blood transfusion [Table 1].
Factors associated with knowledge of nurses and nursing
students
A Kruskal–Wallis and Mann–Whitney test found statistically
significant differences in the mean knowledge scores
of nurses based on their residence (P = 0.018), marital
status (P = 0.000), educational level (P = 0.000), working
experience (P = 0.017) and whether they had ever
attended any educational programme related to blood
transfusion (P = 0.005) while mean knowledge scores of
nurses were not having significant difference on the basis of
age category, gender, and working area [Table 1].
According to the results of a Kruskal–Wallis and Mann–
Whitney test, there were no statistically significant
difference in the mean knowledge scores of nursing
students based on their age (P = 0.143), gender (P = 0.504),
residence (P = 0.538), marital status (P = 0.775), and whether
they had attended any educational programme on blood
transfusion (P = 0.140) [Table 1].
Level of knowledge of blood transfusion
On the 26‑items knowledge questionnaire, nurses’
knowledge scores ranged 3–26, with mean score of
16.51 ± 3.85 while nursing students knowledge scores
ranged 6–21, with mean score of 12.10 ± 3.28; there
was statistically significant difference between nurses’
and nursing students’ knowledge regarding blood
transfusion (P < 0.001). It was showed in Table 2 that
58.4% nurses and only 11.9% nursing students had adequate
knowledge regarding blood transfusion [Table 2].
139
 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion

Table 1: Association of demographic characteristics of nurses and nursing students with blood transfusion knowledge
Demographic variables Nurses (n=296) Nursing students (n=177)
Frequency (%) Mean±SD P Frequency (%) Mean±SD P
Age
20-24 68 (23.0) 15.95±3.69 0.462 173 (97.7) 12.15±3.28 0.143
25-29 164 (55.4) 16.65±4.09 4 (2.3) 9.75±2.21
30-34 64 (21.6) 16.75±3.33 ‑ ‑
Gender
Male 131 (44.3) 16.41±3.56 0.861 41 (23.2) 11.83±2.80 0.504
Female 165 (55.7) 16.60±4.07 136 (76.8) 12.18±3.41
Residence
Rural 122 (41.2) 16.20±3.55 0.018* 89 (50.3) 11.92±3.48 0.538
Semi urban 68 (23.0) 15.76±3.64 33 (18.6) 11.82±2.80
Urban 106 (35.8) 17.35±4.17 55 (31.1) 12.55±3.22
Marital status
Married 148 (50.0) 17.52±3.43 0.000* 6 (3.4) 11.17±2.85 0.775
Unmarried 148 (50.0) 15.51±3.99 171 (96.6) 12.13±3.29
Educational level
Diploma 35 (11.8) 14.00±3.06 0.000* ‑ ‑
Degree 213 (72.0) 16.68±3.69
PG 48 (16.2) 17.62±4.32
Working experience (years)
<1 72 (24.3) 17.31±4.15 0.017* ‑ ‑
1-3 109 (36.8) 16.69±3.68
4-6 86 (29.1) 16.46±3.02
>6 29 (9.8) 14.00±4.92
Working area
General ward 156 (52.7) 16.41±3.87 0.110 ‑ ‑
Operation theatre 30 (10.1) 15.00±3.85
Critical care 79 (26.7) 17.36±4.045
Emergency trauma 31 (10.5) 16.32±2.65
Ever attended any educational programme related to blood transfusion
No 205 (69.3) 15.36±4.23 0.005* 110 (62.1) 11.61±2.99 0.140
Yes 91 (30.7) 17.02±3.56 67 (37.9) 12.39±3.42
*Significant difference with a P<0.05. SD: Standard deviation, PG: Postgraduation

Table 2: Comparison of the level of blood transfusion adequate were 5.072 and 6.540 times more likely to have better
knowledge between nurses and nursing students knowledge, respectively, than those who had diploma in
Group n (%) Mean±SD Median Z P nursing (AOR = 5.072, 95% CI 1.982, 9.634; AOR = 6.540, 95%
score CI 2.54, 16.871). Surprisingly, nurses with more than 6 years
Nurses (n=296) 173 (58.4) 16.51±3.85 17.0 11.331 <0.001
of experience and 3–5 years of experience were 78.4% and
Nursing students 21 (11.9) 12.1±3.28 12.0
(n=177) 66.9% less likely to have good knowledge, respectively, than
SD: Standard deviation those who had <1 year of experience (AOR = 0.216, 95% CI
0.067, 0.702; AOR = 0.331, 95% CI 0.135, 0.811) [Table 3].
Factors predicting the level of knowledge among nurses
The researchers employed multivariable logistic regression Factors predicting the level of knowledge among nursing
to find the determinants of blood transfusion knowledge. As students
Bivariate logistic regression analysis and multivariate
a result, coefficients were calculated as crude and adjusted
logistic regression analysis showed that except ever
odds ratio (AOR) in relation to the referent category. The
attended any educational programme related to blood
participants’ marital status and educational level were transfusion; none of socio‑demographic characteristics of
revealed to be significant predictors. As a result, unmarried nursing students were statistically significant predicting
nurses were 54.6% less likely than married nurses to have knowledge on blood transfusion. Accordingly, nursing
good knowledge (AOR = 0.456, 95% CI 0.244, 0.853). Nurses students who had not attended any educational programme
who had higher education level B.Sc. (N) and M.Sc. (N) on blood transfusion were 77.5% less likely to had good

140 Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022

 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion

Table 3: Logistic regression of knowledge with sociodemographic status of the nurses (n=296)
Demographic variables Knowledge COR (95% CI) AOR (95% CI)
Adequate, n (%) Inadequate, n (%)
Age
20-24 43 (14.5) 25 (8.4) 1 1
25-29 92 (31.1) 72 (24.3) 0.747 (0.415-1.329) 1.192 (0.543-2.161)
30-34 38 (12.8) 26 (8.8) 0.850 (0.421-1.713) 1.418 (0.486-4.141)
Gender
Male 84 (28.4) 47 (15.8) 1 1
Female 89 (30.0) 76 (25.6) 0.663 (0.414-1.062) 1.070 (0.590-1.939)
Residence
Rural 65 (22.0) 57 (19.3) 1 1
Semi urban 35 (11.8) 33 (11.1) 0.930 (0.514-1.684) 0.848 (0.424-1.694)
Urban 73 (24.6) 33 (11.1) 1.940 (1.126-3.341) 1.199 (0.637-2.255)
Marital status
Married 98 (33.1) 50 (16.9) 1 1
Unmarried 75 (25.3) 73 (24.6) 0.524 (0.328-0.838) 0.456 (0.244-0.853)*
Educational level
Diploma 7 (2.4) 28 (9.5) 1 1
Degree 140 (47.3) 73 (24.7) 7.691 (3.197-18.41) 5.072 (1.982-9.634)*
PG 26 (8.8) 22 (7.4) 4.727 (1.732-12.90) 6.540 (2.54-16.871)*
Working experience (years)
<1 48 (16.2) 24 (8.1) 1 1
1-3 69 (23.3) 40 (13.5) 0.863 (0.461-1.613) 0.862 (0.416-1.787)
4-6 45 (15.2) 41 (13.9) 0.549 (0.287-1.049) 0.331 (0.135-0.811)*
>6 11 (3.7) 18 (6.1) 0.306 (0.125-0.749) 0.216 (0.067-0.702)*
Working area
General ward 90 (30.4) 66 (22.3) 1 1
Operation theatre 12 (4.0) 18 (6.1) 0.489 (0.220-1.084) 0.610 (0.252-1.480)
Critical care 52 (17.6) 27 (9.1) 1.412 (0.804-2.480) 1.337 (0.967-2.568)
Emergency trauma 19 (6.4) 12 (4.1) 1.161 (0.527-2.557) 1.311 (0.521-3.297)
Ever attended any educational programme related to blood transfusion
Yes 43 (14.5) 48 (16.2) 1 1
No 130 (43.9) 75 (25.3) 1.935 (1.173-3.191) 1.561 (0.862-2.825)
*Significant variable with a P<0.05 in multivariate analysis. AOR: Adjusted odds ratio, CI: Confidence interval, COR: Crude odds ratio, PG: Postgraduation

Table 4: Logistic regression of knowledge with sociodemographic status of the nursing students (n=177)
Demographic variables Knowledge COR (95% CI) AOR (95% CI)
Adequate, n (%) Inadequate, n (%)
Age
20-24 21 (11.9) 152 (85.9) ‑ ‑
25-29 0 4 (2.2)
Gender
Male 2 (1.1) 39 (22.0) 1 1
Female 19 (10.8) 117 (66.1) 3.167 (0.706-14.21) 0.352 (0.075-1.644)
Residence
Rural 9 (5.1) 80 (45.2) 1 1
Semi urban 2 (1.1) 31 (17.5) 0.573 (0.117-2.805) 0.432 (0.086-2.168)
Urban 10 (5.7) 45 (25.4) 1.975 (0.747-5.22) 2.158 (0.787-5.918)
Marital status
Married 0 6 (3.4) ‑ ‑
Unmarried 21 (11.9) 150 (84.7)
Ever attended any educational
programme related to blood transfusion
Yes 3 (1.7) 64 (36.1) 1 1
No 18 (10.2) 92 (52.0) 0.240 (0.068-0.847) 0.225 (0.062-0.818)*
*Significant variable with a P<0.05 in multivariate analysis. AOR: Adjusted odds ratio, CI: Confidence interval, COR: Crude odds ratio

Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022 141

 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion
knowledge than those who ever attended (AOR = 0.225,
95% CI 0.062, 0.818) [Table 4].
DISCUSSION
Nurses are the most important members of the human chain
engaged in the multi‑step blood transfusion procedure
because of their close contact to the patients. To maintain
patient safety, it is necessary for them to have a theoretical
and practical awareness of the numerous stages involved in
blood transfusion. The purpose of this study was to evaluate
and compare nurses’ and nursing students’ knowledge toward
blood transfusion in the Indian context, with the intention of
promoting and integrating material for a sustainable training
programme and increased emphasis on blood transfusion in
nursing curricula.
Our findings indicate that 58.4% of nurses and just 11.9% of
nursing students meet the 60% cutoff criteria required for
adequate knowledge in blood transfusion.[16] Similarly, earlier
research has revealed that nurses and nursing students’ overall
awareness of blood transfusion is poor to moderate.[16‑19]
According to studies, possible explanations for nursing
students’ lack of understanding include insufficient training
in pediatric pain treatment in nursing curriculum.[20,21] Limited
options for registered nurses to receive continuous education
on this subject may also contribute to these results.[22,23] These
findings emphasize the importance of enhancing nurses’ and
nursing students’ awareness on blood transfusions.
Our findings demonstrated a statistically significant difference
in the mean of blood transfusion knowledge scores between
the two groups. The knowledge of blood transfusions
among nurses was significantly greater than that of nursing
students. While there are no researches to compare our
findings with when it comes to blood transfusion knowledge,
there are studies on pediatric pain management knowledge
among nurses and nursing students that show a comparable
knowledge gap.[24] These findings contrast with those of
another study,[25] which found that nursing students scored
much higher than nurses. This disparity could be due to
the participants’ backgrounds. The notion that knowledge
learned in nursing education programme may be enhanced
during practice might be used to justify these findings.
Nurses with a bachelor’s or master’s degree in nursing scored
significantly more on knowledge tests than nurses with a
diploma in nursing. This finding is consistent with those
of Duarte et al.[18] and Encan and Akin[10] who reported that
nurses with a bachelor’s degree in nursing had significantly
greater knowledge scores than those with a diploma in
142 Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022
nursing. Perhaps the content and duration of training have
an effect on the knowledge acquisition. Similarly, participants
who were residing in cities outperformed those who lived
in semi‑urban and rural areas, which is consistent with the
findings of Mudgal’s[26] and Dubey et al.’s studies.[27] This could
be explained by the participants’ increased and easy access
to learning resources for updating their skills and knowledge
available in urban areas.
In contrast to the findings of Duarte et al.[10] and Dubey
et al.,[27] nurses with less experience in the present study
scored significantly greater than those with more experience.
These surprising results might be explained by the fact that
nurses who had less experience might be careful in applying
transfusion practice more cautiously. Another explanation
could be that nurses with less experience answered questions
according to their theoretical knowledge rather than their
real practice.
Nurses’ knowledge regarding blood transfusion was
significantly higher among those who had attended any
educational programme than their counterpart. These
findings are in line to the results of Dubey et al.[27] and
Sindhulina and Joseph,[28] whereby nurses who received
in‑service education on the subject had a significantly
higher knowledge scores compared to those who had not
attended it. This research demonstrated that continuing
education enhances nurses’ ability to do efficient practice of
blood transfusions. This indicates the importance of close
monitoring, designing education programme tailored to the
educational needs of nurses, and increasing in‑service blood
transfusion instruction in clinical settings.
There was no statistically significant difference between the
knowledge scores and the socio‑demographic variables of
nursing students in this study. The possible reasons might be
that all students are studying in final year, following standard
curricula and practical training. In multivariate analysis,
nursing students who attended any educational programme
on blood transfusion had significantly higher knowledge
score than those who had not attended educational
programme. These results demonstrate the importance and
further need of educational programs in addition to the
standard curriculum. The students should be encouraged to
participate in such programs.
Strengths and limitations of the study
Based on existing literature, this may be the pioneer study
of its kind in India and Southeast Asia, to the best of the
authors’ knowledge. The sample size employed in this
study indicates that the investigation was well powered to
 Gaur, et al.: Nurses and nursing students’ knowledge on blood transfusion
confirm the findings, which can be applicable to other similar
scenarios. The inclusion of a varied range of educational
institutions and healthcare institutes adds to the study’s
credibility. One of the study’s flaws was that participants were
recruited purposely rather than randomly primarily on their
accessibility and availability at the research settings. Despite
these limitations, this study gives valuable information about
nurses’ and nursing students’ knowledge of blood transfusion
in the Indian context.
Implications
The current practice of nursing education, policy, and future
research are all implicated by the study findings. Blood
transfusion practice and measures should be reinforced in
the nursing curriculum. The multiple approaches to education
that aim to transform good knowledge to safe clinical
practice should be used and measures should be taken for
participation in such programme. Nurses should be motivated
to involve in self‑directed learning as well as continuing
professional education to increase their awareness of blood
transfusion. Any revisions in existing blood transfusion
guidelines should be communicated and followed to guide
nursing practice. Qualitative research methods should be
used in future studies to better understand the elements
that influence nurses’ and nursing students’ knowledge
about the issues. Observational studies on the approach
in which blood is transfused in hospitalized patients may
potentially be informative and contribute in the creation of
future educational initiatives.
CONCLUSION
Nurses and final year nursing students have inadequate
knowledge of blood transfusion, highlighting the necessity
for immediate and effective training activities in this field.
The governing authorities should take immediate action
like including training courses to give the necessary
expertise regarding blood transfusions and measures to
ensure maximum participation. Nursing school curricula
should be updated to include transfusion medicine for the
better delivery of good and clinically sound nurses to the
healthcare. There should be implementation of regular
medical education activities among the nurses to augment
their current knowledge and expertise. There should be
regular questionnaires among the nursing staff to test their
knowledge of blood transfusion and personnel lacking in
any area should be updated. The implementation of these
measures can be vital in minimizing human errors in practice
of blood transfusion.
Financial support and sponsorship
Nil.
Journal of Integrative Nursing / Volume 4 / Issue 3 / July‑September 2022
Conflicts of interest
There are no conflicts of interest.
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