Chronic blood transfusion therapy practices to treat strokes in children with sickle cell disease.
OBJECTIVE
To identify variations in practices used by nurses for pediatric patients with sickle cell disease (SCD) receiving chronic blood transfusion therapy for strokes.


METHODS
Descriptive study of a convenience sample of 11 nurses who care for children with SCD from nine institutions completed a closed-ended questionnaire consisting of 37 items. Responses reflected practice experience with a total of 189 transfused patients with SCD.


CONCLUSIONS
A wide range of nursing practices exists for blood transfusion therapy for children with SCD and strokes. Manual partial exchange transfusion (66%) was the most commonly used method for blood transfusion in children with strokes reported among the nurses surveyed. Simple transfusions and erythrocytapheresis account for 21% and 13% of the practices reported. Opportunities exist to establish evidence-based nursing care guidelines to improve the care of children with strokes receiving blood transfusion therapy.


CONCLUSIONS
A wide range of local standard care guidelines for blood transfusion therapy exists. The results of this survey indicate that partial manual exchange transfusion is the most commonly used method of chronic blood transfusion therapy in children with SCD and stroke despite the fact that the magnitude of benefit in comparison with simple transfusion has not been established. Factors such as peripheral venous access, compliance with current chelation regimen, and the presence of antibodies are important considerations in the choice of method.
Lindsey
Terianne
T
School of Medicine, Washington University, St. Louis, MO, USA. lindsey_t@kids.wustl.edu
Watts-Tate
Nutrena
N
Southwood
Elaine
E
Routhieaux
Julie
J
Beatty
Janice
J
Diane
Calamaras
C
Phillips
Melissa
M
Lea
Gwendolyn
G
Brown
Evelyn
E
DeBaun
Michael R
MR
D000755:Anemia, Sickle Cell / Q000150:complications*; D001291:Attitude of Health Personnel; D001803:Blood Transfusion / Q000379:methods / Q000451:nursing / Q000592:standards; D002648:Child; D002908:Chronic Disease; D016238:Cytapheresis / Q000379:methods; D019317:Evidence-Based Medicine; D005078:Exchange Transfusion, Whole Blood / Q000379:methods; D006301:Health Services Needs and Demand; D006801:Humans; D008134:Long-Term Care; D009722:Nurse Practitioners / Q000458:organization & administration / Q000523:psychology; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D010371:Pediatric Nursing / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D017749:Total Quality Management; D065227:Transfusion Reaction; D014861:Washington