Study supports nurse-led home blood transfusions

The shift from hospital to home-based care looks set to continue, with a study demonstrating that regular blood transfusions can be safely performed in residential homes and aged-care facilities.

The collaborative study involving the University of South Australia, the Royal District Nursing Service (RDNS) and SA Health investigated 1790 blood transfusions involving 533 patients in South Australian homes and aged-care facilities over a 15-year period.

Study key findings:

• The system used to deliver blood products to the patients was efficient and safe.
• Adverse reactions occurred in less than 1% of cases. Any reactions were not serious and could be managed by a registered nurse.
• The setting (including aged-care facilities), gender and age of the patient were not a barrier to receiving a blood transfusion at home and did not influence the risk of an adverse reaction.
   

The study overwhelmingly supports home blood transfusions for medically stable patients, according to UniSA lead researcher Dr Rebecca Sharp.

“Hospitals can be alienating and strange places for older people, especially those who have dementia,” Dr Sharp said. “It is better for eligible patients if a trained nurse can go to their home and perform the blood transfusion, following strict procedures.”

Study co-author and RDNS National Nursing Director Lisa Turner said the research highlights RDNS meeting the growing trend of health care being delivered at home, not in hospitals, and leading the drive for the evidence base to support future care.

“Blood transfusions are not straightforward procedures, and our nurses are highly trained and specially skilled to conduct the transfusions safely in people’s homes,” Turner said. “The RDNS is one of very few providers in Australia able to do this at any sort of scale, which is testament to our nurses’ expertise.

“Because we’re able to perform blood transfusions in homes safely, it has the added benefit of reducing the burden on our hospitals and public health system by freeing up beds and resources that can [be] redirected towards other critical care.”

The study authors welcome the shift in health care from hospitals to homes as the strategy is cost-effective, preserves hospital beds and better supports patient wellbeing. The work is published in the Journal of Clinical Nursing.

Image caption: Registered nurse Daniel Allmand giving a blood transfusion to RDNS client Hartley. Courtesy of RDNS.