Overview of the NSQHS Standard

The NSQHS standard sets various guidelines for patients’ safety and especially when it comes to blood transfusion, additional care needs to be taken by the healthcare staff to avoid transfusion-transmissible infections during blood handling (Deshmukh et al., 2024). As per standard 3 of NSQHS, “preventing and controlling infection is important. Under this standard, 3.14 action also highlights the risk factors (Such as non-adherence to hand hygiene, limited focus on sharp discharge after use, and many more), whole handling blood as well as body substances. It ensures that healthcare staff adopt the guidelines to lower the chances of risks for both healthcare staff and patients (Australian Commission on Safety and Quality in Health Care, 2021). Safe handling of blood is a crucial responsibility of the nursing staff as they are frequently exposed to blood as well as body substances during many procedures, such as cannulation, wound care dressings, and others. Without policy adherence by maintaining safety standards, they can experience a lot of exposures, leading to serious infections like HIV, Hepatitis, and many more (Buerger and Jain, 2022). Through maintaining the policy standard, nurses can lower the chances of cross-contamination along infection within the hospital settings.

Critique of the Evidence Base

Safe handling of blood samples is well-documented in many research studies and guidelines, as it is considered a crucial policy that nursing staff should maintain their focus on. As per WHO (2020) numerous guidelines exist for safe blood handling exists, and they recommend following certain credentials, including maintaining standard precautions, using PPE to avoid cross-contamination, if patients have severe infections, which can be transmitted from their body to others, and the usage of safe-engineered devices through which individuals can be safeguarded from direct exposure (Tripathi and Kumawat, 2024). However, many studies have confirmed that most healthcare staff, as well as nurses, possess a limited understanding of blood handling, for which training will be required before describing the safety standards. A study performed by Alhumaid et al. (2021) found that adherence to protocols regarding blood handling successfully lowers the rate of infection. Conversely, many studies focused on self-reporting can lead to unreported incidences. Observational studies did not focus on randomisation, which further initiates difficulties in establishing causation (Anvari et al., 2022). Besides that, most studies were performed in urban areas, which creates biases, as people from rural areas, especially those who are vulnerable, have been less focused (Moorthy et al., 2025). Besides that, a limited number of new updates have been released after the pandemic was pinpointed.

Real-World Application

I recall a situation during my clinical placement in a medical ward, and I noticed the practical aspects of blood handling. I observed that nurses wore PPE, gloves, and other essential resources to avoid infection due to direct exposure from patients while taking blood samples and drawing blood. They also followed safety while disposing of the medical instruments immediately after completing their usage, which confirms that they have already adopted and followed the policy guidelines. I also observed many challenges that nursing staff face while handling blood, including a lack of resources, limited time, inappropriate knowledge of education, and others.

Evidence-Informed Recommendations

Healthcare organizations must provide education as well as training programs for the workers, so that they can understand the importance of handling blood samples to avoid harmful circumstances (Giovanelli et al., 2024). Bloodborne pathogens can be contagious; for this reason, healthcare workers must be aware of transmission-related illnesses. Besides, regular auditing is necessary to ensure that all workers are maintaining the protocol to avoid disease intensity within the healthcare settings (Hut-Mossel et al., 2021). Feedback will be given to workers, as it is a crucial tool that can help workers understand their gaps in their performance during the blood handling procedure.

Rating the Evidence

In this context, the hierarchy of evidence has been followed to review the evidence.

Recommendation 1: Training program

The level of evidence is A as it is of a high quality of evidence. Several randomized and observational studies have been performed based on this aspect to detect the effectiveness of training as well as education to improve the safety in healthcare settings. The confidence based on the aspect is high, as it can spread awareness to reduce the intensity of blood-borne pathogens transmitted to human bodies.

Recommendation 2: Regular feedback and auditing

It can be considered as low-quality evidence, as a limited number of research studies have been performed and investigated regarding this aspect to lower the infection rate. Therefore, the confidence level in this aspect will be low to moderate.

Conclusion

Safe handling of blood is one of the pivotal nursing aspects that needs immediate attention to safeguard patients and healthcare workers who are involved in the blood handling procedure. Proper knowledge about blood handling needs to be understood by individual nurses and other workers, as bloodborne pathogens can be severe and sometimes it can cause immediate clinical deterioration to patients. Furthermore, recommendations have been given that will be effective to consider during blood handling.

References

Alhumaid, S., Al Mutair, A., Al Alawi, Z., Alsuliman, M., Ahmed, G. Y., Rabaan, A. A., Al-Tawfiq, J. A., & Al-Omari, A. (2021). Knowledge of infection prevention and control among healthcare workers and factors influencing compliance: a systematic review. Antimicrobial Resistance & Infection Control, 10(1). https://doi.org/10.1186/s13756-021-00957-0

Anvari, F., Efendić, E., Olsen, J., Arslan, R. C., Elson, M., & Schneider, I. K. (2022). Bias in Self-Reports: An Initial Elevation Phenomenon. Social Psychological and Personality Science, 14(6), 194855062211291. https://doi.org/10.1177/19485506221129160 

Australian Commission on Safety and Quality in Health Care. (2021). Preventing and controlling infections standard. Australian Commission on Safety and Quality in Health Care; ACSQHC. [Accessed on: 16/7/25] Retrieved From: https://www.safetyandquality.gov.au/standards/nsqhs-standards/preventing-and-controlling-infections-standard

Buerger, C. S., & Jain, H. (2022). Infectious Complications Of Blood Transfusion. PubMed; StatPearls Publishing.[Accessed on: 16/7/25] Retrieved From:  https://www.ncbi.nlm.nih.gov/books/NBK585035/

Deshmukh, S., Rathod, Y., Thakore, S., & Jadhav, S. (2024). Prevalence of Transfusion-Transmissible Infections Among Voluntary Blood Donors in a Tertiary Care Hospital. Cureus. https://doi.org/10.7759/cureus.70469

Giovanelli, L., Rotondo, F., & Fadda, N. (2024). Management training programs in healthcare: effectiveness factors, challenges and outcomes. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-11229-z

Hut-Mossel, L., Ahaus, K., Welker, G., & Gans, R. (2021). Understanding how and why audits work in improving the quality of hospital care: A systematic realist review. PLoS ONE, 16(3), 1–25. https://doi.org/10.1371/journal.pone.0248677

Moorthy, V., Siegfried, N., Amuasi, J., Li, J., Makanga, M., Soares-Weiser, K., Sheamini Sivasampu, Xavier, D., Faiez Zannad, & Snewin, V. (2025). Improving the clinical trial environment and infrastructure: moving from global resolution to action. The Lancet Global Health, 13(4), e608–e610. https://doi.org/10.1016/s2214-109x(25)00012-9

Tripathi, P. P., & Kumawat, V. (2024). Blood safety training: Can virtual training replace in-person training? The National Medical Journal of India, 37(6), 322–324. https://doi.org/10.25259/NMJI_142_2024 WHO. (2020). WHO Guidelines on Drawing Blood. Nih.gov; World Health Organization. [Accessed on: 16/7/25] Retrieved From: https://www.ncbi.nlm.nih.gov/books/NBK138650/