Objective: collection, Knowledge, practice Introduction: Venous blood specimen collection

Objective: the study was carried out to was to investigate the effectiveness
of structured teaching program on knowledge and practice regarding blood
specimen collection among nurses Methods: Research design: A quazi
experimental design was utilized. Setting: Menoufia University Hospital at
Menoufia governorate, Egypt. Subjects: A purposeful sample of 286 nurses from
different departments in Menoufia university hospital, Menoufia governorate,
Egypt. Tools for data collection: Interviewing questionnaire includes
socio demographic date, structured knowledge questionnaire sheet: regarding
blood specimen collection, and observational checklist. Results: more
than half of studied sample aged above 30 years, they mainly working in
surgical department. The measures taken to improve prominence of vein showed
statistically significant difference before and after structured educational
program, nurses’ knowledge regarding blood specimen collection showed obvious
improvement and good practice after structured educational program. Conclusions:
The program helps the Staff nurses to improve their knowledge on BSC. This
will ultimately improve their practice that reflects on patient’s safety. The
findings of the study indicate that there is improvement in knowledge of Staff
nurses and practice even this improvement was less slightly which indicate that
the STP is an effective in improving the knowledge and practice of the staff

Key Words: blood specimen
collection, Knowledge, practice

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Venous blood
specimen collection (VBSC) is a common procedure in nursing care. A fundamental
responsibility for nurses is to alleviate suffering. Repeated VBSC due to
deficiencies in the organization or suboptimal VBSC practices can be prevented.
Training in work technique is important for safety and well-being of patients.
Good practical skills in nursing that combine technical, theoretical,
psychosocial and physical elements are therefore needed. (1). 

results play a key role in patient care. It is estimated that around two thirds
of important clinical decisions about admissions, discharge and medication are
based on laboratory test results that is also an important source of medical errors
that can affect patient safety. (2)

Venous blood
specimen collection (VBSC) is one of the most common procedures that were done
in every ward for disease diagnosis and prognosis.  (3). Errors in VBSC
may lead to patient suffering and endanger patient safety (4). .Injuries
related to VBSC errors are caused most often by human mistakes and relatively
few are related to technical errors (5). In addition, VBSC errors
are latent and distant from direct control and thus often go unrecognized.
Therefore, VBSC practices should strictly follow guidelines based on evidence
and best practices. (6)


Staff nurses
working in the clinical field are said to be backbone of the hospital. Most of
the care of patients is taken by the staff nurses working in the hospital. She
is the person who stays most of the time with patient and their relatives who
are present in the hospital or comes in the clinic with patients. Obviously,
the role of nurse is increased due to long stay with the patient. She has to
take care of patients as well as she has to provide health education to patient
and their relatives regarding necessary care for the prevention of
complications progressive to disease. (7)


The role of
nurse is important for management of central venous access device. She has to
perform routine dressing and flushing of the device. She has the important role
in health education of patient and caregivers regarding venous access device
care. (7)& (8)


VBSC can be
viewed as a dependent practical skill, meaning that different kinds of
professionals perform and encompass the totality of VBSC practices. Worldwide,
different professionals perform VBSC, but venipuncture should be performed by educated
and competent personnel, because VBSC practices demand theoretical knowledge as
well as good practical skills (9
& 10
 &  6).


Nurses in
clinical practice collect blood from patients as part of routine laboratory
tests. It is well known that these results are often erroneous due to several
factors, one of which being incorrect performance of venous blood specimen
collection. (3)

education facilities assure that they follow the guidelines when teaching VBSC
practices, so the fact that health care staff does not always adhere to VBSC
guidelines to the letter (8) .must mean that nursing students
or newly graduated nurses are deviating from guideline practices over time. To
improve knowledge in regard to adherence to VBSC guidelines and patient safety,
it is important to investigate to what extent nursing students in clinical
practice adhere to VBSC guidelines and the reasons why they tend to deviate from
those guidelines. (3)

professionals must know the best practice technique for the management of
intravenous cannulation and complications caused by intravenous cannulation
including ways to prevent and manage these complications. We need not forget
that nurses are the ones mainly responsible for improving knowledge and
application of best practice technique for the management of intravenous
cannulation. As nurses, we are responsible for maintaining our skills and
knowledge in relation to all aspects of patient care. (12).


Theoretical framework

In nursing
research there exists a lack of evidence-based knowledge focused on hands-on
performance in clinical settings. However, this focus is as important as taking
care of the mind and emotions. Attention should be given to physical and
practical aspects of how nurses develop and perform practical skills (11).
VBSC is a nursing skill that demands theoretical knowledge as well as good
practical skills (13).
A theorisation based on a model of practical skill performance in nursing (9)
might contribute to a more holistic approach to VBSC. (6) Therefore,
practical skills within nursing research must be worthy of interest. Using a
model for practical skills in nursing to describe VBSC in a more holistic and less
technical way might highlight VBSC as a practical nursing skill. (14).



of the study:


is important to assess the ability of nurses to create positive change in the
practice. The correctness of the blood test is closely related to the sample.
According to the recent reported data, 80 percentage unsatisfactory results of
the clinical test are due to the poor quality of sample, especially the blood
sample (15). Clinical practice guide (CPG) is directly to
instruct the clinical nursing practice. And the recommendations in the clinical
practice guide are based on the best available study evidences.  (16)


Aim of the Study:

The aim of the study was to investigate the
effectiveness of structured teaching program on knowledge and practice regarding
blood specimen collection among nurses.

To assess the knowledge and practice of nurses regarding blood specimen
collection at different departments of selected hospital before and after structured
teaching program.

To find out association between knowledge score and practice score regarding blood
specimen collection among staff nurses and selected demographic variables


Research Hypothesis:

Implement the structured teaching program regarding
blood specimen collection will improve nurses’ knowledge and practice that
improve patient safety.

Inclusion criteria:

1. Staff nurses who have completed
graduation in nursing.

2. Nurses who are willing to participate in the

Exclusion criteria:

1. Nurses who have completed
specialized course in venous access device care.

2. Nursing superintendent.

and Method:

The present research design was quasi experimental.

present study conducted at different department (medical, surgical, orthopedic
departments,……ect) of the Menoufia University Hospital at Menoufia governorate,

Subject: A
purposeful sample of 286 nurses from different departments in Menoufia
university hospital, Menoufia governorate, Egypt. 

Sample size:

Sample size was calculated utilizing the following Equation
1: Where: n = sample size; N = total population number (1100);
e = margin error (0.05). A total 293 of nurses administered
were recruited in the current study but 7 nurses refused to complete the study
so the final recruited number were 286. They were allocated into pre and post groups
(286 nurses). The data collection was carried out from June 2017 to September
2017. Tools:Tool
1: socio demographic data sheet to assess subject
characteristics as age, gender, professional status, department, years of
experience Tool
2: structured knowledge questionnaire sheet: regarding blood
specimen collection. It was developed and used by the researchers after
reviewing the related literature (1, 14, 25) to assess patients’
knowledge. It consisting of 20 items of open questions covering the following
areas: inspection of vein, Measures to Improve Prominence of Vein, strategies
after blood collection to avoid complications, and safety aspects during blood
collection. The scoring system was categorized as follow: •Poor knowledge  (