Standardized blood transfusion approaches are necessary for the postoperative cardiac surgery patient to reduce the rates of adverse outcomes. The project facility lacked standardization of use of blood transfusions in the postoperative cardiac surgery patient population, with rates of transfusions widely varying. The purpose of this quantitative, quasi-experimental project was to determine if the implementation of the UPMC evidence-based Restrictive PRBC Transfusion Protocol would impact units of blood transfusions, creatinine levels and hospital length of stay among post-operative adult cardiac surgery patients, when compared to current practice, in a rural Pennsylvania hospital over four weeks. Ajzen’s theory of planned behavior guided actions to change behaviors related to transfusing post-operative cardiac surgery patients. The total sample was 28 patients, n =15 in the pre-intervention group and n = 13 in the implementation group. Data analysis included a t-test showing decreased units of PRBCs transfused (mean 2 units compared to mean 0 units, t = -2.2985, p = 0.03) which was both clinically and statistically significant. A t-test was done to evaluate creatinine levels (z = -1.55, p=0.12), and decreased length of stay (mean of 8.6 days compared to 5.6 days, t =2.1, p=0.04). There was no statistical significance in creatinine levels but a statistical and clinical significance occurred in reducing LOS. Recommendations include sustainment of the protocol and further analysis and dissemination of results after six months.
|Advisor:||Clark, Amanda, Lazar, Michael J.|
|School:||Grand Canyon University|
|Department:||College of Nursing and Health Care Professions|
|School Location:||United States -- Arizona|
|Source:||DAI-B 82/2(E), Dissertation Abstracts International|
|Subjects:||Nursing, Surgery, Health care management|
|Keywords:||Acute kidney injury, Ajzen's theory of planned behavior, Cardiac surgery, Creatinine levels, Length of Stay, Restrictive red blood cell transfusion protocol|
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