Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Karen Kesten, DNP, APRN, CCNS, CNE, FAAN
Keywords
Hospital-acquired anemia; Blood conversation strategies; Workflow innovation; Critically ill patients
Abstract
Background: Critically ill patients subject to frequent routine phlebotomy are at increased risk of developing hospital-acquired anemia. Blood conservation strategies effectively prevent this complication and are within a nurse’s scope of practice.
Aims/Objectives: The purpose of this project was to increase nurses’ knowledge about hospital- acquired anemia and blood conservation strategies, increase self-efficacy in implementing evidence-based nursing practice, and implement a workflow for routine phlebotomy for smaller volume blood sampling, promoting blood conservation in critically ill patients and improve quality of patient care.
Methods: Pre-test/post-test design evaluated nurses’ knowledge of blood conservation content and confidence in implementation of evidence-based practice. The proposed workflow was implemented over four Plan-Do-Study-Act cycles following training. Participants provided feedback, and blood samples were monitored for rejection due to inadequate sample volume. Requests for transfusions were tallied as well.
Results: Participants reported overall satisfaction with the workflow, increased knowledge, and increased self-efficacy while implementing evidence-based practice. Requests for blood for transfusion increased, but no samples were rejected for inadequate sample volume. Knowledge of blood conservation strategies for participants with 11+ years’ experience resulted in 68% mastery on pretest and 100% on posttest. All participants with six to ten years’ experience reported using the workflow.
Conclusions: Implementation of this workflow did not disrupt lab processing. Training provided for participants increased knowledge about hospital-acquired anemia, blood conservation strategies, and perceived self-efficacy in implementing evidence-based nursing practice.
Implications for Practice: This proposed workflow should be considered for implementation on nursing units where serial phlebotomy is required for patient care.
Copyright Notice
©2025 Kimberly R. Keller. All rights reserved.
Recommended Citation
Keller, K. R. (2025). Impact of a Workflow Innovation Using Blood Conservation Strategies to Reduce Hospital Acquired Anemia: A Quality Improvement Project. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/184
Open Access
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