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Introduction: Clinical practice requires knowledge of health professionals for the application of problem solving of different tasks in various clinical settings. Therefore, a set of reliable measurement tools is required to assess various components of the professional knowledge including factual knowledge, skills and competence as outcomes of nursing education and training. Traditional questionnaires and test methods do not allow the measurement of these characteristics properly, as these tools typically provide overall scores without relevant insight into areas in which nurses perform well, and those where their knowledge and/or skills should be improved substantially. Aim: The aim of this nationwide survey conducted among nurses between November 2014 and February 2015 was to determine how the teaching/training objectives have been achieved in the nurses’ transfusion practice. The authors attempted to exceed the capabilities of classical test theory and acquire a detailed picture about what the nurses know about transfusion therapy and how they are involved and behave in routine clinical practice. Method: The knowledge and skills of 657 participants were assessed using a validated instrument consisting of a set of questions covering every aspects of transfusion therapy. The answers to these items were evaluated on a binary (good or bad) scale. Recorded answers of the participants were analysed using hierarchical cluster analysis and item response theory tools such as the one-parametric Rasch model suitable for dichotomous data. Data analysis was performed with the SPSS program and the ltm module of the R statistical program. Results: The paper presents the distribution of correct and incorrect answers to various questions about transfusion therapy along with the corresponding logit values and odds ratios, respectively. The characteristic curves of each item were determined on the basis of the number of correct answers that have been recorded. These curves highlight which questions were answered easily and which items were found harder to answer by the nurses who participated in the survey. In addition to the separate analysis of individual questions, a set of response patterns is also presented which shows how frequently the nurses responded correctly to different combinations (sub-sets) of questions. On the whole, nurses exhibited medium level performance in terms of knowledge and skills required for efficient and safe transfusion practice. Conclusions: Objective and reliable measurement of the level of acquired knowledge is a key requirement in nursing education. This paper, which demonstrates the use of cluster analysis and item response theory for the assessment of transfusion-related knowledge of nurses, focuses on this issue for the first time in nursing research. The results of this survey have revealed substantial limitations and deficiencies both in knowledge and skills of nurses which need to be addressed by training in order to improve the efficiency and safety of transfusion therapy. Orv. Hetil., 2015, 156(37), 1497–1508.

Absztrakt Bevezetes: Nemzetkozi szakirodalmi adatok egyertelműen bizonyitjak, hogy a transzfuzios terapiaban folyamatosan nő az apolok szerepe, amelyet kizarolag komoly szakmai ismeretek es keszsegek birtokaban tolthetnek be. Celkitűzes: A szerzők a transzfuzios terapia gyakorlatanak, az apolok transzfuzios terapiaval, valamint sajat kompetenciaik meghatarozasaval kapcsolatos ismereteinek orszagos szintű felterkepezeset tűztek ki celul. Tovabbi celjuk a hasonlosagok es kulonbozősegek feltarasa volt a kutatas idejen hatalyos Transzfuzios Szabalyzat (2008) előirasainak betartasara vonatkozoan. Modszer: A 2014. november 19. es 2015. februar 20. kozotti intervallumban vegzett orszagos reprezentativ felmereshez sajat keszitesű kerdőivet alkalmaztak. Az adatgyűjtest papir- es webalapu anonim, onkitoltős, standardizalt korulmenyek kozott, retegzett mintaveteli technikaval vegeztek. A vizsgalt mintaba (n = 657 fő) olyan apolokat vontak be, akik felnőtt fekvőbeteg-osztalyon, valtozo rendszeresseggel vettek reszt transzfuzios terapiaban. A keresztmetszeti kutatas adatait első lepesben leiro statisztikai eljarasok segitsegevel dolgoztak fel. Eredmenyek: Megallapitottak, hogy a vizsgalt minta transzfuziologiaval kapcsolatos ismeretei erősen hianyosak (50,72%), az apolasi funkciokat csak az apolok fele (52,3%) rendszerezte helyesen, es jelentős kulonbsegek voltak a transzfuzios terapia gyakorlatara vonatkozoan is. A vizsgalt intezmenyek tulnyomo tobbsege rendelkezett sajat protokollal, de a betegosztalyok mindossze 23,9%-an dolgozott megbizott transzfuzios felelős apolo. Kovetkeztetesek: A szerzők a feltart problemak megoldasat az apolok szakmai felelőssegenek noveleseben, az apolas vezetőinek a jelenleginel nagyobb mertekű felugyeleteben, a megfelelő transzfuziologiai kepzes es rendszeres tovabbkepzes biztositasaban latjak. Orv. Hetil., 2015, 156(34), 1383–1392.

Clinical practice requires knowledge of health professionals for the application of problem solving of different tasks in various clinical settings. Therefore, a set of reliable measurement tools is required to assess various components of the professional knowledge including factual knowledge, skills and competence as outcomes of nursing education and training. Traditional questionnaires and test methods do not allow the measurement of these characteristics properly, as these tools typically provide overall scores without relevant insight into areas in which nurses perform well, and those where their knowledge and/or skills should be improved substantially.The aim of this nationwide survey conducted among nurses between November 2014 and February 2015 was to determine how the teaching/training objectives have been achieved in the nurses' transfusion practice. The authors attempted to exceed the capabilities of classical test theory and acquire a detailed picture about what the nurses know about transfusion therapy and how they are involved and behave in routine clinical practice.The knowledge and skills of 657 participants were assessed using a validated instrument consisting of a set of questions covering every aspects of transfusion therapy. The answers to these items were evaluated on a binary (good or bad) scale. Recorded answers of the participants were analysed using hierarchical cluster analysis and item response theory tools such as the one-parametric Rasch model suitable for dichotomous data. Data analysis was performed with the SPSS program and the ltm module of the R statistical program.The paper presents the distribution of correct and incorrect answers to various questions about transfusion therapy along with the corresponding logit values and odds ratios, respectively. The characteristic curves of each item were determined on the basis of the number of correct answers that have been recorded. These curves highlight which questions were answered easily and which items were found harder to answer by the nurses who participated in the survey. In addition to the separate analysis of individual questions, a set of response patterns is also presented which shows how frequently the nurses responded correctly to different combinations (sub-sets) of questions. On the whole, nurses exhibited medium level performance in terms of knowledge and skills required for efficient and safe transfusion practice.Objective and reliable measurement of the level of acquired knowledge is a key requirement in nursing education. This paper, which demonstrates the use of cluster analysis and item response theory for the assessment of transfusion-related knowledge of nurses, focuses on this issue for the first time in nursing research. The results of this survey have revealed substantial limitations and deficiencies both in knowledge and skills of nurses which need to be addressed by training in order to improve the efficiency and safety of transfusion therapy.

International literature data clearly show that the role of nurses in transfusion therapy, which needs professional knowledge and skills, continues to increase.The aim of the authors was to perform a national-level mapping of the practice of transfusion therapy including transfusion therapy-related knowledge of nurses and their knowledge about their competence. Further aim was to identify similarities and differences as referred to the requirements of the transfusion regulations (2008), which was valid at the time of the survey in Hungary.The nationwide survey took place between November 19, 2014 and February 20, 2015. Data were collected using paper-form and web-based anonymous, self-administered questionnaire. 657 nurses who were involved in transfusion therapy with changing regularity in adult in-patient wards took part in the survey. Data were processed using descriptive statistical methods.It was found that the transfusion therapy related knowledge of nurses was very incomplete (50.72%), and only about half of the nurses (52.3%) systematized the nursing functions correctly. Significant differences were also found in the practice of transfusion therapy. The vast majority of the institutions had their own protocol, but responsible nurses assigned for transfusion care were present only in 23.9% of the wards.The authors conclude that the identified problems can be resolved by improving professional responsibility of nurses, increasing supervision by nursing leaders and appropriate transfusiology training and regular retrainings.

All people involved in transfusion therapy have professional, legal and ethical responsibility for their own actions.The aims of the authors were to evaluate competencies, knowledge and practice of nurses about transfusion therapy.Descriptive statistical approach using observation, questionnaire survey and interview was applied. Reliability and validity of the self-made questionnaire were examined with statistical methods. Variance, standard deviation, Cronbach's alpha and Pearson correlations were calculated.Transfusiology-related knowledge of nurses regarding current transfusion regulations was almost 90%, and 56.2% of nurses systematized the nursing functions correctly. Significant differences were found among different institutions in transfusion therapy, transfusion practice and the use of relevant documentation. 75-77% of the institutions examined had their own protocol, and assigned transfusion care nurses worked in more than 20% of the wards.The authors propose a better supervision by leaders in nursing aspects of transfusion therapy, and an increased professional responsibility.Bevezetés: A transzfúziós terápiában részt vevő valamennyi személy szakmai, jogi és etikai felelősséggel tartozik saját tevékenységéért. A kompetenciák megfogalmazásához elengedhetetlen az ápolás funkcióinak meghatározása. Célkitűzés: A szerzők célul tűzték ki a transzfúziós terápia gyakorlatának, valamint az ápolók transzfúziós terápiával kapcsolatos ismereteinek feltérképezését. Módszer: A vizsgálathoz leíró statisztikai megközelítésben a megfigyelés, a kérdőíves felmérés és az interjú módszerét választották. A saját készítésű kérdőív megbízhatóságát és érvényességét matematikai statisztikai módszerekkel vizsgálták, amelynek során variancia-, standarddeviáció-, valamint Cronbach-alfa-számítást és Pearson-korreláció-meghatározást végeztek. Eredmények: Az ápolók transzfuziológiai ismeretei az érvényes transzfúziós szabályzat tekintetében megközelítették a 90%-ot, az ápolási funkciókat az ápolók 56,2%-a rendszerezte helyesen. Az intézményeknél jelentős különbséget találtak a transzfúziós terápia gyakorlatára, az idevonatkozó dokumentációk alkalmazására vonatkozóan. Az intézmények 75–77%-a rendelkezik saját protokollal, és a betegosztályok ötödén dolgozik megbízott transzfúziós felelős ápoló. Következtetések: A szerzők a megoldást az ápolás vezetőinek a transzfúziós terápia ápolási vonatkozásainak nagyobb mértékű felügyeletében, a kollégák szakmai felelősségének növelésében látják. Orv. Hetil., 2015, 156(9), 366–378.