Text Box: MONITORING PAEDIATRIC PATIENTS RECEIVING BLOOD PRODUCTS ¨C A QUEST FOR AN EVIDENCE BASED POLICY
Jackson R.
Royal Children¡¯s Hospital, Melbourne, Australia

Background: Every day, paediatric nurses throughout the world are called upon to administer blood products to their patients. The frequency of observation that these patients require, in order that any adverse effects may be detected, is often contentious and involves the allocation of significant nursing time.
Objectives:	A Clinical Research Fellowship (CRF) was undertaken at the Victorian Centre of Nursing Practice Research (VCNPR) in conjunction with The Royal Children¡¯s Hospital (RCH), Melbourne. The fellowship aimed to establish an evidence based policy which would improve nursing productivity whilst maintaining appropriate vigilance of potential adverse advents related to the blood products.
Methods: A thorough search and critical appraisal of relevant literature was conducted, and current documented policy at RCH was then critiqued against that evidence. 
Results:	 The CRF found that the current RCH policy was based on historical practice rather than evidence. Whilst there was a small body of nursing literature, the reliable evidence found suggests that nurses ¡®over monitor¡¯ patients while they receive blood. Given that laboratory blood screening techniques have dramatically improved, the frequency of nursing observation has not reflected this change.  Therefore, a new policy for RCH has been drafted based upon this new evidence based understanding and not on historical practice. 
Conclusions: Nurses at RCH have been ¡®over monitoring¡¯ their paediatric patients whilst the patients receive blood products. A new policy, based upon an evidence based understanding, will ensure that adverse blood events are detected in a timely fashion while reducing redundant nursing observations and thus improve nursing productivity.
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