1.1 Introduction
Blood transfusion is defined as the process of transferring blood or blood components from a donor into the bloodstream of a recipient to replace lost components or treat specific medical conditions (World Health Organization, 2020). It is an essential therapeutic intervention in modern healthcare, particularly for patients suffering from severe anemia, trauma, surgery, or chronic conditions that affect blood production. Blood transfusion not only saves lives but also improves the quality of life for recipients by restoring physiological balance and supporting recovery (Oladele et al., 2019).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Blood transfusion has a long and evolving history, dating back to early experimental procedures in the seventeenth century. According to Murphy (2017), the first recorded human-to-human blood transfusion was attempted in 1667 by Jean-Baptiste Denis in France, marking the beginning of transfusion as a medical intervention. Early attempts were largely unsuccessful due to limited understanding of blood compatibility, lack of sterile techniques, and absence of standardized procedures.
The discovery of blood groups by Karl Landsteiner in 1901 represented a major milestone, as it enabled the matching of donor and recipient blood types, significantly reducing transfusion-related fatalities (Landsteiner, 1901). Subsequent advancements, such as anticoagulants, refrigeration techniques, and improved storage methods, further enhanced the safety and accessibility of blood transfusions (Hillyer, 2013).
In Nigeria, formal blood transfusion services were established in the mid-20th century, with the National Blood Transfusion Service (NBTS) founded to coordinate blood collection, screening, and distribution across the country (Ojo, 2018). According to Adebayo, Omotayo, and Balogun (2018), the NBTS has played a pivotal role in promoting voluntary blood donation and standardizing transfusion practices, although challenges remain in ensuring consistent adherence to safety protocols in all healthcare facilities (Adebayo et al., 2018). Blood transfusion is a critical healthcare intervention that involves transferring blood or blood components from a donor to a recipient to manage blood loss, anemia, or other medical conditions. According to the World Health Organization (2020), safe blood transfusion is fundamental to reducing mortality and morbidity, particularly in emergency medical situations and during complex surgical procedures. Proper transfusion practices not only save lives but also prevent the spread of transfusion-transmissible infections, including HIV, hepatitis B, and hepatitis C.
Oladele et al. (2019) reported that incidents of unsafe transfusion continue to pose significant challenges in healthcare delivery, especially in low- and middle-income countries, where resource constraints, inadequate staff training, and poor adherence to protocols compromise patient safety (Oladele et al., 2019). Healthcare workers' knowledge, attitude, and compliance with established blood transfusion guidelines are essential determinants of transfusion safety, as asserted by Adebayo, Omotayo, and Balogun (2018), who emphasized that lapses in procedure, improper storage, and errors in administration are major contributors to transfusion-related complications.
Eke, Onah, and Uche (2021) stated that monitoring and evaluation mechanisms within blood transfusion services are often weak, leading to underreporting of adverse transfusion events. They affirmed that strengthening these systems is critical to improving adherence to safety protocols and ensuring the availability of safe blood for patients. On the other hand, innovations in blood screening technologies and standardized operating procedures provide opportunities to enhance transfusion safety if effectively implemented and consistently maintained. Furthermore, researchers contend that the National Blood Transfusion Service in Nigeria has made substantial progress in institutionalizing blood safety practices, but gaps in uniform implementation and compliance across different facilities persist (Adebayo et al., 2018; Oladele et al., 2019). This study is set against the backdrop of these ongoing challenges and opportunities within the National Blood Transfusion Service, aiming to evaluate blood transfusion safety practices and provide evidence-based recommendations for enhancing patient safety.
1.3 Statement of Problems
Investigation revealed that the process of blood transfusion is fraught with potential risks, including the transmission of infectious diseases such as HIV, hepatitis B, and hepatitis C, as well as immunological complications and transfusion reactions (World Health Organization, 2020). On the other hand, the effectiveness of blood transfusion services is influenced not only by technical procedures but also by the knowledge, skill, and compliance of healthcare personnel with established guidelines. Studies have shown that lapses in staff training, improper handling and storage of blood, inadequate screening processes, and failure to follow standard operating procedures significantly increase the risk of adverse transfusion outcomes (Adebayo et al., 2018).
Furthermore, patient-related factors, such as lack of awareness about transfusion risks and the absence of effective monitoring and reporting systems, are contributing issues in maintaining transfusion safety (Eke et al., 2021). The prevalence of these challenges suggests that while the National Blood Transfusion Service has protocols in place, there is variability in adherence across facilities, resulting in inconsistent safety outcomes. It is against this backdrop that this study seeks to evaluate blood transfusion safety practices in the National Blood Transfusion Service.
1.4 Aim and Objectives of Study
The aim of this study is to assess and evaluate blood transfusion safety practices within the National Blood Transfusion Service. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the current blood transfusion procedures and protocols in the NBTS.
- To evaluate the level of compliance by healthcare staff with established transfusion safety guidelines.
- To identify the challenges and risks associated with blood transfusion practices.
- To assess the effectiveness of monitoring and reporting systems for transfusion-related incidents.
- To provide recommendations to improve blood transfusion safety and service delivery.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the current blood transfusion procedures and protocols in the NBTS?
- To what extent do healthcare staff comply with established transfusion safety guidelines?
- What are the key challenges and risks associated with blood transfusion practices in the NBTS?
- How effective are the monitoring and reporting systems for transfusion-related incidents?
- What measures will improve the safety and efficiency of blood transfusion services?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between the implementation of transfusion safety practices and the reduction of transfusion-related complications in the National Blood Transfusion Service
- H1: There is a significant relationship between the implementation of transfusion safety practices and the reduction of transfusion-related complications in the National Blood Transfusion Service
Hypothesis Two
- H0: The implementation of proper transfusion safety practices do not significantly reduces transfusion-related complications in the National Blood Transfusion Service.
- H1: The implementation of proper transfusion safety practices significantly reduces transfusion-related complications in the National Blood Transfusion Service
1.7 Significance of Study
It is believed that at the completion of the study, the findings will enhance healthcare professionals' adherence to protocols, improve patient confidence in transfusion procedures, and guide policymakers in designing effective interventions. The results will also contribute to academic knowledge, serve as a reference for future research, and support the continuous improvement of healthcare delivery systems.
Additionally, the study will raise awareness among patients about the safety measures in place, which will improve their confidence in blood transfusion procedures.
Furthermore, the study will support public health initiatives by emphasizing the critical role of safe transfusion practices in reducing morbidity and mortality associated with blood-borne infections and transfusion reactions.
Lastly, this research will serve as a tool for continuous improvement in blood transfusion safety, benefiting healthcare institutions, professionals, and the general population.
1.8 Scope of Study
The scope of this research is focused on evaluating blood transfusion safety practices within the National Blood Transfusion Service in Lagos State, Nigeria. It covers the procedures, protocols, staff compliance, monitoring systems, and challenges associated with the transfusion of blood and blood components.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Blood Transfusion:
Blood transfusion is the process of transferring whole blood or blood components from a donor to a recipient to replace lost components or treat medical conditions (World Health Organization, 2020).
Blood Transfusion Safety:
This refers to adherence to established procedures and guidelines that minimize risks and prevent transfusion-related complications (Adebayo et al., 2018).
National Blood Transfusion Service (NBTS):
NBTS is the government agency responsible for collecting, screening, processing, and distributing safe blood and blood components across healthcare facilities in Nigeria (Oladele et al., 2019).
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