¶ … Changing Blood Transfusion Policy and Practice" by Catherine Stupnyckyj, RN, Sheryl Smolarek, BSN, RN, OCN, Colleen Reeves, BSN, RN, OCN, Judith McKeith, BSN, RN, CMSRN, and Morris Magnan (December 2014), American Journal of Nursing, 114(12), 50-59

What is the problem that the research is addressing?

Challenging, the "that's the way we've always done it" mindset and citing the dearth of scientific evidence in support of using 20-gauge or larger catheters for blood transfusions, Stupnyckyj et al. (2014) systematically analyzed existing guidelines and consulted with experts to identify optimal catheter gauge sizes for blood transfusions. In sum, the authors cite a paucity of timely and relevant research concerning the use of 20-guage or larger catheters for blood transfusion and emphasize that "the patient's age and condition, as well as the condition and size of the vein to be used, often suggest that a smaller catheter would be more suitable" (Stupnyckyj et al., 2014, p. 50).

Why is this problem significant to nursing practice?

Registered nurses are tasked with the primary responsibility for blood transfusions, as well as for monitoring patients for adverse reactions and ensuring patient comfort and safety. Therefore, ensuring that the least damaging catheter size is used represents a fundamental responsibility of nursing practice, but there remains a dearth of evidence in support of the use of 20-gauge or larger catheters.

Summarize the findings from this research article.

Citing the need for individualized and patient-centered care as well the ongoing heavy demand for regular blood transfusions for many patients, the evidence-based study by Stupnyckyj et al. (2014) evaluated the efficacy of using catheter gauges that were smaller than the 20-gauge or larger sizes previously recommended by the American Association of Blood Banks and the Infusion Nurses Society.

Describe the recommendation for nursing practice.

Although they do not provide specific guidelines concerning the size of catheters that should be used in any given situation, the authors conclude that there is a lack of evidence to support the use of 20-gauge catheters and recommend that depending on patients' age, conditions, and size of available veins, registered nurses should carefully evaluate the potential for using smaller gauge catheters than 20-gauge for blood transfusions.