To Construct A Standardized Training Program For Venous Blood Specimen Collection Knowledge Based On The Normalization Process Theory

Objective:The questionnaire of knowledge,belief and practice of venous blood sample collection was prepared to provide a tool for evaluating the knowledge,attitude and behavior of clinical nurses in venous blood sample collection.To construct targeted training programs,so as to improve nurses’ knowledge of sample collection,improve the qualified rate of venous blood samples,and promote the rational application of drugs.Methods:1.Semi-structured interview: The outline of semi-structured interview was drawn up according to the theory of normalized process,and the methods of objective sampling and snowball sampling were adopted to conduct semi-structured interview with clinical nurses in inpatient departments of a third-class A hospital in Shanxi Province,so as to evaluate the blood sample collection process and explore the promotion and hindrance factors faced by them in the practical work of clinical blood collection.2.Delphi Expert Consultation Method: Based on the theory of knowledge,belief and action,and on the basis of reviewing relevant literature at home and abroad,For reference,WS/T 311-2009 Technical Specifications for Hospital Isolation,GBZ/T 213-2009 Guidelines for Occupational Contact Protection of Blood-borne Pathogens,WS/T503-2017 Operational Specifications for Blood Culture in Clinical Microbiology Laboratory and WS/T issued by the National Health Commission were also issued661-2020 Guide for Venous Blood Specimen Collection Centering on the knowledge,attitude and behavior that clinical nurses need to master in venous blood specimen collection,the research team brainstormed to form the questionnaire pool of clinical nurses’ knowledge,belief and practice in venous blood specimen collection,and formed the expert letter questionnaire.Add,delete and modify items according to the feedback opinions and suggestions of experts,and end the letter consultation until expert opinions reach a consensus.The final questionnaire of Knowledge,belief and Practice of Clinical Nurses for Venous Blood Sample Collection is generated.3.Questionnaire delivery method: Taking clinical nurses in a third-class A hospital in Shanxi Province as the object of the questionnaire,306 clinical nurses were investigated with the Questionnaire on Knowledge,Belief and Practice of Venous blood sample Collection,to understand their knowledge,attitude and behavior in venous blood sample collection,and to identify the promoting and hindering factors in the process of blood collection.4.Expert group meeting Method: 7 experts who have been engaged in clinical nursing,nursing management,clinical medicine and hospital infection management for more than 10 years were invited to hold a group meeting to form a standardized training program of venous blood sample collection knowledge.Result:1.Expert consultation results: The final questionnaire on Knowledge,belief and Practice of Clinical Nurses in Venous Blood sample collection consists of 25 items in three dimensions,namely knowledge,attitude and behavior.The effective recoveries of the two rounds of expert correspondence questionnaire were 100% and 94%,respectively.The expert authority coefficients were 0.866 and 0.868,respectively.The expert coordination coefficients of 2 rounds were 0.156 and 0.058,both of which were significant(P<0.05),coefficient of variation(CV)were 0-0.52,0-0.16,respectively;The critical ratio(CR)was 5.642～14.812,and the correlation coefficient r between each item and questionnaire score was 0.426～0.708(P<0.05).The Cronbach’s α coefficient of the questionnaire was0.912.Exploratory factor analysis extracted 6 factors,and the cumulative variance contribution rate was 62.28%.Confirmatory factor analysis showed that X~2/df < 3,RMSEA < 0.1,the model fitted well.The item validity index(I-CVI)and scale validity index(S-CVI)were both up to 1.00.2.Results of questionnaire delivery: the score of knowledge dimension was(6.25±1.825),which was above the medium level.The four items with the worst score were "The blood culture collection process was wrong","Indication of blood culture collection of patients with suspicious infection","disinfection method during blood culture collection",and "tourniquet tying during blood collection".Univariate analysis showed that the working years of clinical nurses and whether they had participated in the training of venous blood sample collection were correlated with knowledge scores.3.Results of scheme construction: Based on the pre-formed Questionnaire of Knowledge and Practice of Clinical Nurses in Collecting venous Blood samples,a standardized training program of knowledge and practice in collecting venous blood samples was formed after discussion in expert group meetings,including 4 first-level indicators and 15 second-level indicators.The scheme is scientific and usable.Conclusion:The Questionnaire of Clinical Nurses’ Knowledge and Practice of Venous blood sample collection compiled in this study is reliable and scientific,and can be used as a convenient tool to evaluate the knowledge,attitude and behavior of clinical nurses in venous blood sample collection.Based on this,a standardized training program of venous blood sample collection knowledge is constructed.Later,experimental studies are needed to verify the effectiveness of the training program.