Reducing blood transfusion vital signs monitoring frequency in a cancer center: a best practice implementation project

Introduction: Frequent vital signs monitoring during blood transfusion is standard practice to detect adverse reactions. However, intensive monitoring has increased nursing workload without clear added benefit for stable patients. Objective: This project aimed to implement an evidence-based, reduced-frequency vital signs protocol for blood transfusions and evaluate monitoring and documentation compliance during blood transfusion administration in an ambulatory cancer center in Singapore. Methods: Using JBI's seven-phase Evidence Implementation Framework, the team conducted a baseline audit, identified barriers through JBI's Getting Research into Practice (GRiP) approach, implemented change strategies, and conducted follow-up and sustainment audits over 11 months. Outcomes included compliance with monitoring and patient education. Data were analyzed using descriptive statistics (frequencies and percentages). Results: Baseline compliance with the existing protocol was 0% (n = 30). After implementation, compliance with the reduced-frequency protocol increased to 60% (n = 30) and reached 100% at sustainment (n = 10). Patient education improved from 17% at baseline to 96% post-implementation and 100% at sustainment. No adverse events were reported during the implementation period. Conclusions: Implementing an evidence-based reduction in vital signs monitoring frequency for transfusions in an ambulatory cancer setting was practical and improved protocol adherence and patient education. No adverse events were reported during the implementation of surveillance. However, larger prospective evaluations are needed to further assess rare adverse events. The findings support hospital-wide implementation with continued audit and monitoring. Spanish abstract: https://links.lww.com/IJEBH/A733