الفهرس 
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Abstract
Effect of Safety Blood Transfusion Protocol on the Occurrence of Acute Adverse reactions in Children at Menoufia University Hospital A- The aim of this study: 1- To assess the effect of safety blood transfusion protocol on the occurrence of acute adverse reactions in children at Menoufia University Hospital. B- Setting: This study was conducted at Pediatrics Department of El Menoufia University Hospital and Shebin El Kom Teaching Hospital. C- Sample: All available nurses working in the two hospitals (39 nurses) were included in the study. The number of nurses who shared in the study in EL Menoufia University Hospital and Shebin El Kom Teaching Hospital was 28 and 11 respectively. Total number of observed children was 490 ranged from 4 months to 15 years. D- Tools: Three tools were developed for data collection. Tool one: - A structured questionnaire sheet to assess nurse’s knowledge about blood transfusion. It was divided into three parts: a- Part one: - characteristics of studied nurses b- Part two: - Knowledge of nurses and reported nursing care related to blood transfusion. It was divided into three subparts: a. Subpart one: Knowledge about blood transfusion. b. Subpart two: Knowledge of nurses about blood products. c. Subpart three: Knowledge about acute adverse reactions. 2-Tool two: Nurse’s Observational checklist. It was included assessment of nurse’s practices. It was divided into three phases: First phase: - Care provided before blood transfusion. Second phase: - Care provided during blood transfusion. Third phase: - Care provided after blood transfusion. 3- Tool three: Blood transfusion reaction report to assess symptoms of acute adverse reactions. E- The main results of the study showed that: 1- The mean age and standard deviations of studied nurses were 29.07 ± 4.98 and 36.09 ± 8.66 in EL Menoufia University and Shebin El Kom Teaching Hospital. 2- The mean age and standard deviation of studied children in pre, post and follow-up tests were 8.35 ± 4.87, 8.20 ± 4.79 and 8.67 ± 4.812 respectively. 3- The majority of nurses had Nursing Diploma (92.3%). 4- The majority (74.4%) of nurses had more than 10 years of experience. 5- None of nurses had any previous training in blood transfusion 6- More than half of studied children in pre, post and follow-up tests were males and they were 53%, 55.1% and 55.5% respectively. 7- Approximately, two thirds of children had thalassemia major at pre, post and follow-up tests (70.2%, 65.2% and 64.7% respectively). 8- The most common type of blood transfusion was red blood cells (60.2%). 9- The mean and standard deviation of knowledge scores on pretest were 84.0 ± 10.64 compared to 113.53± 1.66 and 106.66± 4.21 on post and follow-up tests respectively. 10- Nurses had the highest level of mean scores of knowledge on posttest. 11- There were highly statistical significant differences between nurses’ at 1% level of statistical significance. 12- The majority of nurses showed the highest level of adequate practices on posttest. 13- The mean and standard deviation of practice scores on pretest were 34.17 ± 3.51 compared to 47.94 ± 2.62 and 47.84 ± 2.53 on post and follow-up tests respectively. 14- There were highly statistical significant differences between practices of nurses at 1% level of statistical significance. F- The study concluded that: Based on the finding of the present study, the following could be concluded: 1- Nurses showed an improvement in their knowledge and practices about blood transfusion after implementation of blood transfusion protocol. 2- Children who received blood transfusion got fewer acute adverse reactions after implementation of safety blood transfusion protocol. G- Based on the result of the study it was recommended that: a- Recommendation for Clinical Nursing Practice 1- Ongoing in-service education programs must be designed and implemented at Pediatric units to improve nurse’s knowledge and practices on the basis of nurse’s actual needs. 2- In each hospital, there should be specialized units for developing nurses’ knowledge and practices (training unit) based on nurses needs for practices. 3-Universal protocols for blood transfusion should be integrated into pediatric nursing curriculum. 4-Resources such as articles, Journals, Computers and Internet should be accessible in the units for staff members to develop their knowledge and practices.