Nurses' Knowledge and Competency Regarding Safe Blood Transfusion in Adult and Pediatric Intensive Care Units: A Cross-Sectional Study

Abstract Background Blood transfusion is a critical, life-saving procedure frequently performed in intensive care units (ICUs). Nurses play a pivotal role in ensuring transfusion safety, yet knowledge gaps and practice deficiencies may compromise patient outcomes. Aim To assess nurses’ knowledge and competency regarding safe blood transfusion in adult and pediatric ICUs at Alexandria University Hospitals. Methods A descriptive cross-sectional design was used, including all available ICU nurses (n = 63; 24 pediatric ICU, 39 adult ICU) using a convenience sampling method. A structured knowledge interview questionnaire and an observational competency checklist were used to collect the data. Results Most nurses (65.1%) had unsatisfactory knowledge, while 69.8% demonstrated competent transfusion practice. Age and years of nursing experiences were significantly associated with knowledge. In multivariate regression, years of nursing experience was the only significant predictor of knowledge (adjusted R² = 0.182), whereas practice was significantly predicted by age, prior involvement in transfusions, and expressed intent to attend training (adjusted R² = 0.619), with training intent the strongest individual predictor. Knowledge and practice were positively correlated (r = 0.315, p = 0.012). Conclusion Although nurses showed acceptable overall competency, substantial knowledge deficits were observed, particularly in pre-transfusion preparation and policy adherence. Structured training programs, continuous professional development, and standardized protocols are essential to bridge the knowledge–practice gap and strengthen transfusion safety for critically ill adults and children.