Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Related Sciences
First Advisor
Melissa Jamerson, PhD
Abstract
BACKGROUND: Patient Blood Management (PBM) has become the standard of care for transfusion services in hospitals. Transfusion Safety Officers (TSOs) have been identified by some as being a crucial part of a successful PBM program; however, no studies have been done to show their effectiveness, or if there is even a relationship between having a TSO and outcomes associated with PBM programs. The purpose of this study was to describe and test the relationship between having a TSO and six outcomes associated with PBM programs including blood product wastage (red blood cells, plasma, and platelets), hospital lengths of stay, rates of 30-day readmissions, and rates of hospital-acquired infections. Further, this study described and tested the relationship between a TSO being a nurse and the same six outcomes.
METHOD: An anonymous pre-validated online survey was used to collect data from blood transfusion professionals using purposive and snowball sampling. Participants were recruited via email and flyers posted on blood transfusion professional networks. Forty-three participants gave complete responses to all six outcome variables.
RESULTS: There were very few reporting hospitals that had a PBM program without a TSO (n = 8); therefore, these hospitals were merged with those hospitals that did not have a PBM program (n = 21) for statistical analyses. Pearson correlations showed moderate to strong, negative, statistically significant correlational relationships between having a TSO and all six of the outcomes, indicating that having a TSO was associated with less blood product wastage, lower hospital lengths of stay, lower rates of 30-day readmissions, and lower rates of hospital-acquired infections. Each of the outcomes had statistically significant differences in the means between the groups that had a TSO and those that did not. Additionally, logistic regression analyses were able to predict whether the hospital had a TSO or not from each outcome at a statistically significant level. There was a small, statistically non-significant correlational relationship between the TSO being a nurse and each of the six outcomes; there was no statistically significant difference in outcomes between the TSO being a nurse group and the TSO group that was not a nurse. However, these groups had smaller sample sizes and may not have been adequately powered to detect differences.
CONCLUSIONS: The TSO role is still a relatively new position in hospitals. No studies have been performed to show their effectiveness with PBM programs. This study was the first to show that there is a strong relationship between having a TSO and six outcomes associated with PBM programs. However, due to the small number of responding hospitals that had a PBM program and no TSO (n = 8) and the subsequent merging of this group with the responding hospitals that did not have a PBM program (n = 21), it was not possible to separate the effects of having a TSO from the effects of the hospital having a PBM program. Additionally, the results of this study did not give any evidence that there is a difference in PBM outcomes when the TSO is a nurse as opposed to when the TSO is not a nurse. This study provided the first step in exploring the relationship between having a TSO and outcomes that are associated with PBM programs.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
7-31-2024