A qualitative exploration of the factors influencing the decision to transfuse elective platelets in cancer care.

Abstract

To explore factors contributing to decisions to transfuse platelets in cancer careoutside guidelines using case study methods. Two case studies were examined, using instrumental case study methodology, toqualitatively explore factors that influence the decision to transfuse platelets. Interviews (n=10) were conducted around cases in haematology and critical care. In-depth review of documentary evidence was undertaken and propositions weredeveloped to provide rigour during the investigation. Thematic analysis andtriangulation of documents was undertaken to find specific factors, and propositionsanalysed, as per instrumental case study methods. Both cases emphasised how patient complexity, and individual response to plateletadministration, was an influencing factor. Other themes includeduncertainty of clinical situations coupled with uncertainty about platelet availability. Other factors worthy of further investigation include the concept of professionalsafety and the trustworthiness of platelet thresholds against platelet monitoring forbleeding episodes. The findings indicated several factors influence decisions to transfuse, includingclinical context, and individual ability to trust guidelines and assume any perceivedrisks.