Clinical protocol for patients undergoing outpatient blood transfusion: an exploratory descriptive study


Sueli Mendes de Oliveira1, Enéas Rangel Teixeira1, Eliane Ramos Pereira1

1Fluminense Federal University


Aim: To develop a care protocol for guidance to clients undergoing outpatient transfusion. We adopted the pedagogical theoretical framework of the school of critical contents, enabling the change and exchange of knowledge.
Method: This is an exploratory descriptive study set in the outpatient transfusion sector of the blood center at a university hospital in the state of Rio de Janeiro. Data collection will be done through semi-structured interviews and participant observation, in the period between June and July 2014 with transfused patients in the outpatient transfusion sector. Data analysis will be themed. Ethical aspects will be respected according to CNS Resolution 466/2012.
Expected results: to ascertain the health needs of the patients; to create a protocol for care and health education.
Health implications: minimize health risks; promote better quality of life and humanized care.
Descritors: Blood Banking Service; Nursing; Blood Transfusion; Health Education.



Hemotherapy is part of the Unified Health System (UHS) in the form of a specialized rehabilitation service and treatment center, which requires specific infrastructure for its operation.

According to Resolution No. 306/2006 of the Federal Board of Nursing, nursing care in a hemotherapy unit has duties and powers as specified in Article 1. Therefore, the professional nursing staff can fully assist donors, recipients and their families, thus promoting preventive, educational and curative actions between receptors, family and donors; conduct clinical trials for the evaluation of donors and recipients; can perform actions related to the supervision and control of the nursing staff(1).

The patient attending in this service is under the care of the nursing staff at the time of transfusion. This team evaluates the patient’s health status, uses the appropriate techniques and technologies, and is prepared for any changes that are relevant to treatment. After hemotherapy, it is necessary for patients to receive appropriate and specific guidance with regard to carrying out home care, since they will no longer be under the direct supervision of a healthcare professional.

The practice of care teams toward patients undergoing blood transfusions and/or blood components is provided by the UHS and includes the principle of integrality when providing health promotion, protection and recovery of the patient’s health at any level of assistance. SUS also utilizes a concept of health which is not limited to the absence of disease, but also adds to the quality of life.

The theoretical framework of this study starts with Freirean pedagogy, which works with dialogs and problematization, enabling change, knowledge exchange, and favoring the autonomy of the client. We seek to understand the health-disease process in order to promote an interactive participation of patients and professionals in terms of knowledge, aimed at seeking an integral and conscious state of health. This practice is focused in a kind of Nursing that is aimed at health promotion and preventive actions in terms of patients and their families(2). Thus, health education is an activity that allows a dialogic space for comprehensiveness in nursing care(3).



What is the profile of the transfused patients in the transfusion outpatient sector? What are their needs at the time of the transfusion therapy? What are the perceptions and meanings of these patients in terms of hemotherapy?



To identify the profile of transfused patients in the transfusion outpatient unit; to know patients’ needs in terms of adverse events in relation to blood transfusion; to build a clinical protocol of transfusion guidance for patients undergoing outpatient transfusion.



This work is related to research in the context of health care as part of the Professional Masters in Nursing Care. It is a descriptive study in which a qualitative approach is to be used. The research setting is the of outpatient transfusion unit of a university hospital in the state of Rio de Janeiro. The study subjects are over 18 years of age, lucid and oriented, who are undergoing transfusion therapy and agree to take part in the research. The sample will have about 30 participants or until saturation of the data occurs, regardless of the disease and treatment time. Exclusion criteria: patients who are debilitated and unable to participate in the interview and first time consultations.

Data collection will be carried out through semi-structured interviews and participant observation. A form with socio-demographic data and semi-structured interviews will be used as instruments.

The interviews will be recorded, transcribed and performed in the period from June to July 2014. After the transcription of the data, the contents will be organized, categorized and submitted to thematic analysis.

Upon completion of the research, a clinical protocol with nursing guidelines for clients undergoing outpatient blood transfusion will be developed.

The project met the ethical principles and was approved by the Research Ethics Committee of the Faculty of Medicine, Fluminense Federal University. The patients will sign an informed consent form, in accordance with the ethical precepts.



1. Conselho Federal de Enfermagem. Resolução 306, de 25 de abril de 2006. Fixar as competências e atribuições do Enfermeiro na área de Hemoterapia. [ internet ]. Diário Oficial [ da ] União, Brasília (DF); 25 abr 2006. [ cited 2012 Abr 17 ]. Available from:

2. Teston EF, Costa MAR, Baldissera VDA, Marcon SS. Educational views and practices of medical and nursing professionals: a descriptive study. Online Bras J Nurs [internet]. 2013 Dec [cited 2014 Mar 15]12(4). Available from: DOI:

3. Santos NLP, Stipp MAC, Silva ALA, Moreira MC, Leite JL. Nursing care provided to blood donors - from the perspective of integral healthcare. Esc Anna Nery Rev Enferm [ internet ]. 2013 Sept/Dec [ Cited 2014 Jun 05 ]17(4):661-7. Available from: DOI: 10.5935/1414-8145.20130009.



All authors participated in the phases of this publication in one or more of the following steps, in According to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the versión submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in



Received: 06/03/2014
Revised: 08/12/2014
Approved: 08/12/2014