Religious beliefs and fear of exposure to AIDS and hepatitis C make many patients refuse surgery that could be critical to their health. But now, nurses at Kettering Medical Center (KMC), Kettering, OH, and KMC-Sycamore, Miamisburg, OH, can offer their patients an another option, a blood conservation program.
This program offers a transfusion-free surgery option to people in Dayton, Cincinnati, Springfield and communities in between.
Dawn Myers, RN, manager of the blood conservation program, was tasked to do a feasibility study to gauge the need for this type of program in the hospital's geographic area. She discovered there are roughly 6,300 Jehovah's Witnesses in the Dayton area and many more people who simply refuse surgery for fear of bloodborne illness. A committee of surgery, pharmacy, registration and chaplain services joined nursing to help plan and formalize this program.
"Many of our patients do not want other people's blood or any outside protein products in their bodies through surgery processes," Myers said. "The closest hospital offering such a program is in Columbus. We think it is going to be really well received here in Dayton."
At the two medical centers, clinical and nonclinical personnel were trained in blood conservation measures. Religious sensitivity training is planned to refine this surgical offering for this specific clientele.
The nursing staff's responsibility is to alert Myers when a patient requests bloodless surgery.
"I meet with the patients prior to their surgeries and review paperwork, which includes the different products and procedures that could be used during their surgery and postoperative stay." Myers said.
Patients who choose the bloodless surgery are fitted with a "no blood" wristband, telling all clinicians and caregivers they are averse to outside blood. The patients also fill out a menu of acceptable materials so the medical center can meet the standards of the patient's specific convictions.
According to Myers, although referred to as bloodless surgery, it is not completely bloodless. It's done without introducing blood from others, which is the crucial factor to those asking for this type of service.
The program uses specific techniques in the operating room, such as the cell saver, argon beam coagulators and harmonic scalpels that use ultrasound technology, to minimize the blood loss. The cell saver is used to give the patient back their own blood versus having to use donor blood. Anemia is managed preoperatively and during the hospital stay.
"The benefits for the patient are tremendous," Myers said. "They do not risk transfusion, the recovery time is often quicker, the risk of infection is lower and pharmaceuticals can be used to support the body's natural ability to generate red blood cells. With the decreased utilization of blood from the blood bank, it makes more blood available for the emergencies that may require it. In the times of blood shortages, this is extremely important."
And for the nurses, they seem to be very accepting of the program. "They want to learn more about it, and when you think about it, it really does make sense," Myers said. "For the Jehovah's Witness patients, this program makes the world of difference because they know they can come to this facility and their religious beliefs are upheld and there is a formalized program to address this."
Leslie Feldman is a frequent contributor to ADVANCE.