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Factors associated with nursing students' adherence to venous blood collection practice guidelines: A cross sectional study
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.ORCID-id: 0000-0003-4135-7754
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
2017 (Engelska)Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 23, s. 92-98Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Venous blood specimen collection is a common procedure that nursing students perform during pre-registration courses, and training for such collections takes place on campus as well as at clinical placements. However, levels of adherence to practice guidelines are still suboptimal among both nursing students and healthcare staff. We aimed to explore nursing students' adherence to the Swedish national venous blood specimen collection practice guidelines regarding patient identification and test request management and how this adherence is related to clinical experience, capability beliefs, research use,and the perceived social climate in clinical contexts. A survey with a cross-sectional design was conducted among 305 nursing students at a medium sized university in Sweden. Descriptive statistics and logistic regression were used for data analysis. The survey showed that 82% of the students adhered to patient identification guideline practices and 80% to test request management practices. Factors associated with correct patient identification procedures were semester and frequency of research use.Factors associated with correct test request management were previous healthcare work experience,semester, and capability beliefs regarding academic abilities and evidence-based practice. We conclude that there is a need to develop educational tools to train students in research use and evidence-based practice in order to enhance guideline practice adherence and improve patient safety.

Ort, förlag, år, upplaga, sidor
2017. Vol. 23, s. 92-98
Nyckelord [en]
Guideline adherence, Patient safety, Practical skills, Venous blood specimen collection
Nationell ämneskategori
Omvårdnad Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
URN: urn:nbn:se:umu:diva-120133DOI: 10.1016/j.nepr.2017.02.002ISI: 000398876200014PubMedID: 28278444OAI: oai:DiVA.org:umu-120133DiVA, id: diva2:926793
Tillgänglig från: 2016-05-09 Skapad: 2016-05-09 Senast uppdaterad: 2019-05-10Bibliografiskt granskad
Ingår i avhandling
1. Adherence to Venous Blood Specimen Collection Practice Guidelines Among Nursing Students and Healthcare Staff
Öppna denna publikation i ny flik eller fönster >>Adherence to Venous Blood Specimen Collection Practice Guidelines Among Nursing Students and Healthcare Staff
2016 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Background Patient safety is an undisputable part of healthcare. The use of clinical practice guidelines, usually based on evidence-based practice/best practice, promotes patient safety and high quality care, reduces unnecessary patient suffering, and healthcare costs. Analysing results from venous blood specimen collection is one of the most commonly used services within healthcare, and a substantial number of decisions on diagnosis, treatment, and treatment evaluation are based on the results. Hence, the accuracy of these tests are vitally important. Earlier research has demonstrated that healthcare staff report suboptimal adherence to venous blood specimen collection guidelines together with the need for improved practices. Blood sample collection is carried out by several professionals, among them registered nurses and, as a consequence, nursing students too. University nursing students learn and practice venous blood specimen collection in one of their first semesters. After initial skill training at clinical skill laboratories, they continue to perform the task during clinical placements in various clinical settings. Few or no studies have been performed on nursing students, hence it seemed important to assess guideline adherence to venous blood specimen collection among university students as well as to further explore adherence to guidelines among healthcare staff. Therefore, the overall aim for this thesis was to explore adherence to, and factors influencing venous blood specimen collection guidelines practice among university nursing students and healthcare staff.

Methods The thesis includes four studies. Study I-III had a quantitative, cross-sectional design, study IV had a qualitative approach. Study I included 164 healthcare staff from 25 primary healthcare centres. Study II included 101 nursing students in their 5th and 6th semesters, and study III included 305 nursing students in their 2nd, 4th, and 6th semesters. To assess adherence to venous blood specimen collection guidelines, data were collected using the Venous Blood Specimen Questionnaire, completed with background variables (I, II, III) and additional scales (III). Descriptive statistics, multilevel and multiple logistic regression analyses were used to analyse the data. In study IV, data were collected through five focus group interviews among 6th semester nursing students (n=26). Data were analysed using qualitative content analysis.

Results Workplace affiliation was found to explain variances in reported adherence between different primary healthcare centres. Associations between reported venous blood specimen collection practices and individual as well as workplace factors were revealed. Nursing students were found to increasingly deviate from guideline adherence during their education. Also among students, several associations between guideline adherence and other iv

factors were revealed. Reported research use at clinical practice was associated with higher levels of adherence, as were higher capability beliefs regarding both evidence-based practice and academic ability. Analyses from focus group interviews summarised students’ reflections on deviations from VBSC guidelines in the overall theme ‘Striving to blend in and simultaneously follow guidelines’.

Conclusion Both healthcare staff at primary healthcare centres and nursing students demonstrate decreasing levels of guideline adherence with time. Factors influencing adherence are both individual as well as contextual. This indicate that both students and staff are subjected to socialisation processes that influences levels of adherence. In order to enhance venous blood specimen collection practices and thereby patient safety, actions must be taken - both in healthcare clinical contexts and by educators. The use of models in practical skill training, and in the ambition to bridge the theory-practice gap may be the path to success. It is reasonable to assume that collaboration between, on the one hand, education representatives and on the other, supervising RNs in clinical settings, will be fruitful. Finally, by empowering students their self-efficacy may be strengthened, and hence their ability to maintain guideline adherence.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2016. s. 63
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1794
Nyckelord
Adherence, Clinical practice guidelines, Experiences, Nursing student, Patient safety, Pre-analytical errors, Primary healthcare, Questionnaires, Venous blood specimen collection
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:umu:diva-120082 (URN)978-91-7601-444-8 (ISBN)
Disputation
2016-06-03, Aula, Vårdvetarhuset, Umeå universitet, Umeå, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2016-05-13 Skapad: 2016-05-09 Senast uppdaterad: 2018-06-07Bibliografiskt granskad

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Nilsson, KarinBrulin, ChristineGrankvist, KjellJuthberg, Christina

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OmvårdnadHälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

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