ABSTRACT
AIM: Blood product administration is a vital and possibly life-threatening issue that may increase the risk of clinical damage in patients. This review aims to provide a comprehensive review of the ways to improve blood transfusion safety. METHOD: In order to conduct this systematic review, electronic databases, including PubMed/MEDLINE, EMBASE, Web of Science, Cochrane CENTRAL, Scopus, and Google Scholar, were searched for data of the last 30 years using keywords including patient safety, blood transfusion, risk management, safety management, and transfusion reaction. The inclusion criteria set for the selection of quantitative articles were articles written in English and published in peer-reviewed journals during the mentioned period. In this study the publications are reviewed in line with the PRISMA guide checklist. RESULTS: Among 6105 articles found during the initial search, 16 articles were finalized for further investigation. Fifty percent of the included articles discussed the use of modern technology including patient identification system, barcode technology, portable computer systems, and databases. Moreover, 31% of the studies evaluated the use of alternative methods for transfusion of blood products including mediastinal blood transfusion, the use of autologous blood in adult patients, the use of cord blood in children, the use of hemoglobin-based oxygen carrier-201, and the injection of fresh whole blood. About 18% of articles drew attention to indications and thresholds as an essential factor increasing patient safety. CONCLUSION: It was concluded from this study that the use of technology leads to fewer human errors and complications caused by these errors. In addition, some alternative methods can be used in a cost-effective way to reduce serious adverse events caused by common strategies.
ABSTRACT
AIM: This concept analysis was conducted to identify and define the features and functions of ethical advocacy in the end-of-life nursing care. BACKGROUND: Ethical advocacy is key to the role of the nurse in delivering quality and competent care. Despite this, the dimensions of this concept are poorly understood. DESIGN/DATA SOURCE: Databases such as Google Scholar, Scopus, Web of Science, Science Direct, and PubMed were searched systematically. To search these databases, the following keywords were used: "patient advocacy," "nursing," "ethics," "end-of-life care," and their combinations. REVIEW METHODS: Walker and Avant's method was utilized as a comprehensive review of the literature to explore how ethical advocacy in nursing can be used to improve the quality of care. RESULTS: The defining attributes of the concept of ethical advocacy included adhering to ethical principles of nursing, championing social justice in the provision of healthcare, safeguarding and defending patient's rights by applying collective wisdom, and involving hospital ethics committees. Antecedents are organizational and personal power and ethical leadership. The optimal consequence of ethical advocacy can be getting the best ethical governance. CONCLUSION: Based on this analysis, the concept of ethical advocacy is one of the most important roles for nurses which requires their awareness of this concept.
