# APBA Kısa Özet

A randomized crossover pilot study in experienced trauma nurses found whole blood administration was associated with significantly shorter transfusion time, lower overall workload, lower mental demand, less effort, and better perceived performance compared to blood component administration. Strong feasibility was demonstrated for simulation-based crossover methodology.

# Çalışma neyi araştırdı?

This pilot study aimed to assess the feasibility of a simulation-based crossover trial and obtain preliminary estimates comparing nursing workload and transfusion completion time between whole blood (WB) and blood component administration during trauma resuscitation. Trauma resuscitation is time-sensitive and complex, and while both WB and blood components are standard treatments for hemorrhage, their impact on nursing workload and efficiency has been underevaluated.

# Yöntem

A randomized crossover pilot study using in situ simulation was conducted with experienced trauma nurses. This design allowed each nurse to serve as their own control, administering whole blood in one scenario and blood components in another, separated by a washout period. Time-motion analysis was used to measure transfusion completion time. The National Aeronautical and Space Administration Task Load Index (NASA-TLX) was employed to assess workload domains, including mental demand, physical effort, and perceived performance. Data collection focused on recruitment, retention, adherence, and completion rates to evaluate the strong feasibility of the methodology.

# Temel bulgular

The results indicated that whole blood administration was associated with significantly shorter transfusion completion times compared to blood component administration. Furthermore, WB was linked to lower overall workload for nurses. Specifically, whole blood use was associated with lower mental demand, less physical effort, and a better perceived performance rating. These preliminary findings suggest that the transfusion method impacts not only speed but also the cognitive and physical burden on the nursing staff.

# Bulgular ne anlama geliyor?

The findings support the feasibility of using a simulation-based crossover design in this clinical context. The data suggests that whole blood may improve resuscitation efficiency and reduce the cognitive burden on nurses during trauma events. By shortening transfusion time and lowering workload metrics, whole blood administration has the potential to improve workflow and, potentially, patient outcomes, although the imprecise nature of the pilot data necessitates further confirmation in larger trials.

# Klinik önem

While this was a pilot study with limitations regarding generalizability, the results justify the design of a fully powered trial. If confirmed in larger studies, the use of whole blood in trauma resuscitation could lead to more efficient nursing workflows and reduced cognitive load, which may translate to improved focus on patient care during critical moments. The study highlights the need to consider transfusion type as a factor in resuscitation efficiency.

# Sınırlılıklar

The pilot study had a small sample size, limiting generalizability. The simulation-based design may not fully reflect real-world clinical settings. The crossover design may have had carryover effects. The study was single-center, and participants were experienced nurses; results may not apply to less experienced staff. Evidence grade is C, indicating imprecise estimates.