Assessment of Nurses’ Safety Practices in relation to Intravenous Iron Administration for Patients Undergoing Hemodialysis.

Mahmoud Elrefaey, Noura; Hassan Ali Awad, Wafaa; Mohamed Abdelaziz, Thoraya

doi:10.21608/ejhc.2021.191029

Assessment of Nurses’ Safety Practices in relation to Intravenous Iron Administration for Patients Undergoing Hemodialysis.

Document Type : Original Article

Authors

¹ lecturer; Medical-Surgical Nursing, Faculty of Nursing, Matrouh University, Egypt.

² Lecturer; Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University. Alexandria, Egypt.

³ Assistant Professor; Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

10.21608/ejhc.2021.191029

Abstract

Iron deficiency is the most common cause of hypo-responsiveness to erythropoiesis-stimulating
agents (ESAs) in end-stage renal disease (ESRD) patients, and is a commonly encountered
reversible cause of chronic kidney disease (CKD) related anemia. In addition to the typical causes
of iron deficiency, patients on hemodialysis experience routine iron loss due to the dialysis
treatment (retention of blood in dialyzer and blood lines), frequent blood draws for laboratory
testing, surgical procedures, accidental blood loss (vascular access), and gastrointestinal blood loss.
Thus, Intravenous (IV) iron is a standard treatment for patients undergoing hemodialysis.
Researches display IV iron more efficacious for restoring iron status compared to oral iron
supplements. In this respect; it should be transmitted judiciously by hemodialysis nursing staff
following restricted safety practices throughout the whole procedure phases: before, during and after
IV iron administration due to its reported serious adverse events risk. The study aimed to assess the
nurses’ safety practices concerning intravenous iron administration for patients undergoing
hemodialysis. Material and method: Data were collected using one tool, “The Hemodialysis
Nurses’ Intravenous Iron Administration Safety Practices Observational Checklist”. A convenient
sample of all (50) nurses who were available at the time of the study at the selected hemodialysis
unit, at Alexandria Main University Hospital, Alexandria, Egypt; was included in the study. Results:
the current study revealed that the studied hemodialysis nurses (100%) had unsatisfactory level of
practice. Moreover, no statistical significance relation was declared between nurses’ socio-
demographic characteristics and their safety practices throughout IV iron administration procedure.
Conclusion: The current study hemodialysis nurses’ safety practices level of performance
concerning safe administration of intravenous iron; were noticeably unsatisfactory.
Recommendations: Updating hemodialysis nurses’ knowledge and practices is mandatory through
providing in- service continuing evidence-based practices training programs; emphasizing on the
significance of safety IV iron administration practices

Keywords