Use of ‘Blood Donation Board’ and Use of ‘Blood Donation Board’ and ‘Nurse Relative Interaction’ By ‘Nurse Relative Interaction’ By Nurses in Improving Communication Nurses in Improving Communication with Patient Relatives and with Patient Relatives and Increasing Blood Donation in Increasing Blood Donation in Neurosurgery ICU Neurosurgery ICU Geo Thomas, Deepak Agrawal Geo Thomas, Deepak Agrawal Department of Neurosurgery Department of Neurosurgery JPN Apex Trauma Centre, JPN Apex Trauma Centre, AIIMS, New Delhi AIIMS, New Delhi
Transcript
Use of ‘Blood Donation Board’ and ‘Nurse Use of ‘Blood Donation Board’ and ‘Nurse Relative Interaction’ By Nurses in Improving Relative Interaction’ By Nurses in Improving
Communication with Patient Relatives and Communication with Patient Relatives and Increasing Blood Donation in Neurosurgery Increasing Blood Donation in Neurosurgery
ICUICU
Geo Thomas, Deepak AgrawalGeo Thomas, Deepak Agrawal Department of NeurosurgeryDepartment of Neurosurgery JPN Apex Trauma Centre,JPN Apex Trauma Centre, AIIMS, New DelhiAIIMS, New Delhi
INTRODUCTIONINTRODUCTION
INTRODUCTIONINTRODUCTION
Due to nature of emergency services being Due to nature of emergency services being provided, blood products are in perpetual provided, blood products are in perpetual scarcity in trauma centres like JPNATC. scarcity in trauma centres like JPNATC.
Also, patients’ relatives frequently complain of Also, patients’ relatives frequently complain of lack of timely and appropriate information lack of timely and appropriate information regarding the clinical status of their patients. regarding the clinical status of their patients.
AIMS & OBJECTIVESAIMS & OBJECTIVES
AIMS & OBJECTIVESAIMS & OBJECTIVES
To assess prevailing levels of blood donation To assess prevailing levels of blood donation for ICU patients and see for improvement (if for ICU patients and see for improvement (if any) following use of ‘Blood donation boards’ any) following use of ‘Blood donation boards’ in one ICU.in one ICU.
AIMS & OBJECTIVESAIMS & OBJECTIVES
1. To assess prevailing levels of blood 1. To assess prevailing levels of blood donation for ICU patients and see for donation for ICU patients and see for improvement (if any) following use of ‘Blood improvement (if any) following use of ‘Blood donation boards’ in one ICU.donation boards’ in one ICU.
AIMS & OBJECTIVESAIMS & OBJECTIVES
2. A study of the satisfaction level among 2. A study of the satisfaction level among relatives of ICU patient’s regarding relatives of ICU patient’s regarding communication with healthcare workers and to communication with healthcare workers and to see for improvement (if any) following a see for improvement (if any) following a specific behavioural change by nurses in one specific behavioural change by nurses in one ICUICU
MATERIALS & METHODSMATERIALS & METHODS
MATERIALS & METHODSMATERIALS & METHODS
This prospective study was carried out over This prospective study was carried out over one month (15 Dec 09 -15 Jan 2010) in two one month (15 Dec 09 -15 Jan 2010) in two intensive care units (ICU’s) of JPN Apex intensive care units (ICU’s) of JPN Apex Trauma Centre. Trauma Centre.
MATERIALS & METHODSMATERIALS & METHODS
The ICU were no active interventions/ The ICU were no active interventions/ behavioural changes were done was taken as behavioural changes were done was taken as the ‘the ‘control ICUcontrol ICU’’
the ICU where active interventions/ the ICU where active interventions/ behavioural changes were undertaken was behavioural changes were undertaken was taken as ‘taken as ‘Test ICUTest ICU’.’.
MATERIALS & METHODSMATERIALS & METHODS
Intervention in the form of a ‘blood donation Intervention in the form of a ‘blood donation board’ was introduced in the ‘test ICU’.board’ was introduced in the ‘test ICU’.
This blood donation board is a 1foot by 1foot This blood donation board is a 1foot by 1foot board placed on the wall next to each patient’s board placed on the wall next to each patient’s bed with the details of blood donated. bed with the details of blood donated.
The donation details are updated by nurses in The donation details are updated by nurses in every shift.every shift.
MATERIALS & METHODSMATERIALS & METHODS
MATERIALS & METHODSMATERIALS & METHODS
No ‘blood donation board’ was used in No ‘blood donation board’ was used in ‘control ICU’.‘control ICU’.
Blood donation per patient over one month Blood donation per patient over one month
was calculated for both ICU’s by reviewing was calculated for both ICU’s by reviewing the blood donation register in the blood bank.the blood donation register in the blood bank.
MATERIALS & METHODSMATERIALS & METHODS
Behavioural change in the form of ‘nurse-Behavioural change in the form of ‘nurse-relative interaction’ was introduced in the ‘test relative interaction’ was introduced in the ‘test ICU’. ICU’.
MATERIALS & METHODSMATERIALS & METHODS
The ‘nurse-relative interaction’ involves the The ‘nurse-relative interaction’ involves the nurse explaining the patient’s condition to the nurse explaining the patient’s condition to the relatives in every shift and answering relatives in every shift and answering questions they might have.questions they might have.
This ‘interaction’ is then documented as This ‘interaction’ is then documented as ‘relative notes’ in the nursing chart in every ‘relative notes’ in the nursing chart in every shift by the concerned nurse.shift by the concerned nurse.
MATERIALS & METHODSMATERIALS & METHODS
No such behavioural change was introduced in No such behavioural change was introduced in the ‘control ICU’. A questionnaire was given the ‘control ICU’. A questionnaire was given to relatives of patients in both ICU’s on the to relatives of patients in both ICU’s on the last day of study and results compared.last day of study and results compared.
80 patients in the test ICU and 37 patients in the 80 patients in the test ICU and 37 patients in the control ICU were evaluated during the study control ICU were evaluated during the study period.period.
Total number of blood units donatedTotal number of blood units donated Test ICU- Test ICU- 270 units 270 units Control ICU- Control ICU- 106 units.106 units.
Number of units donated per patientNumber of units donated per patient Test ICU Test ICU 3.373.37 control ICU control ICU 2.82.8
This was significantly higher in the test ICU compared to control This was significantly higher in the test ICU compared to control ICU (p<0.01).ICU (p<0.01).
questionnaire was administered to 15 relatives questionnaire was administered to 15 relatives in the test ICU and 10 relatives in the control in the test ICU and 10 relatives in the control ICU.ICU.
With respect to timely & appropriate With respect to timely & appropriate communication regarding patient’s condition, communication regarding patient’s condition, the overall satisfaction the overall satisfaction
Test ICU=== 100% (n=15) Test ICU=== 100% (n=15) Control ICU 10% (n=1) Control ICU 10% (n=1) And this was also highly statistically And this was also highly statistically
significant (p<0.001)significant (p<0.001)
CONCLUSION:CONCLUSION: Simple interventions such as Simple interventions such as ‘blood donation board’ and behavioural ‘blood donation board’ and behavioural changes like ‘nurse-relative interaction and changes like ‘nurse-relative interaction and markedly improve blood donation as well as markedly improve blood donation as well as improve satisfaction levels amongst the improve satisfaction levels amongst the relatives of patients.relatives of patients.
Due to the immense benefits and no costs Due to the immense benefits and no costs involved, we recommend that these measures involved, we recommend that these measures be made mandatory in all intensive care units.be made mandatory in all intensive care units.
