Knowledge, Attitude, and Practice Regarding Adverse Transfusion Reactions Among Nurses, Physicians, and Transfusion Specialists in China: A Multicenter Cross-Sectional Survey

Tingting Hu,1,* Xueying Zhou,2,* Xu OuYang,2,* Yan Wang,3 Ting Sun1 1Department of Blood Transfusion, Liaoning Cancer Hospital & Institute, Shenyang, People’s Republic of China; 2Blood Transfusion Medicine Department, General Hospital of Northern Theater Command, Shenyang, People’s Republic of China; 3Department of Blood Transfusion, Central Hospital of Yingkou Economic and Technological Development Zone (The People’s Hospital of Yingkou), Yingkou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ting Sun, Department of Blood Transfusion, Liaoning Cancer Hospital & Institute, Shenyang, 110042, People’s Republic of China, Tel +8618900917558, Email [email protected]: Adverse transfusion reactions (ATRs) can threaten patient safety. Healthcare professionals (HPs) play crucial roles in the prevention and management of ATRs. Although ATRs occur in 0.2– 0.6% of transfusions in China, no study has examined the knowledge, attitude, and practice (KAP) toward them. Therefore, the aim of this study was to investigate the KAP of HPs toward ATRs.Methods: This multicenter cross-sectional study was conducted between October and December 2023 and included HPs from 146 medical institutions enrolled through WeChat professional groups using convenience sampling. An investigator-developed web-based questionnaire (Cronbach’s α=0.82) was used to collect participants’ demographic characteristics and their KAP towards ATRs. Bloom’s cutoffs were used to categorize KAP dimension scores. Multivariable logistic regression analysis was performed, including the factors statistically significant in the univariable analyses.Results: The study included 327 (40.93%) nurses, 253 (31.66%) physicians, and 219 (27.41%) transfusion specialists. Among the participants, 598 (74.84%) were females, 238 (29.79%) held a master’s degree or higher, 389 (48.69%) possessed over 10 years of work experience. The knowledge and attitude scores were 11.78± 1.78 (possible range: 0– 14) and 50.43± 4.74 (possible range: 11– 55). The practice scores (possible range: 0– 50) were evaluated for nurses, physicians, and transfusion specialists respectively, and the mean scores were 49.22± 2.79, 47.60± 5.09, and 44.35± 14.13. Multivariate analysis showed that having a master’s degree or above (OR=1.480, 95% CI: 1.079– 2.027, P=0.015) was independently associated with knowledge. The knowledge (OR=1.280, 95% CI: 1.159– 1.423, P=0.001), department (OR=1.731– 1.763, 95% CI: 1.120– 2.696, P< 0.050), and the understanding of ATRs (OR=1.122, 95% CI: 1.035– 1.218, P=0.006) were independently associated with attitude.Conclusion: The surveyed Chinese healthcare professionals HPs displayed good KAP regarding ATRs. However, specific knowledge gaps were identified, particularly concerning bacterial contamination risks and delayed reactions. While attitudes and self-reported practices were largely positive, targeted educational interventions are recommended to address these identified knowledge deficits and reinforce best practices.Keywords: knowledge, attitude, practice, healthcare professionals, China, transfusion reaction, cross-sectional study