Advancing arteriovenous fistula needling: The role of physical exam and doppler ultrasound.
Background: The success of haemodialysis (HD) critically depends on the effective use of arteriovenous fistulas (AVFs). The precise needling technique is vital to minimise complications and ensure functional vascular access. Objective: This study assesses the effectiveness of a nursing consultation...
| Publicado en: | Journal of Renal Care Vol. 50; no. 4; pp. 426 - 435 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180826316&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180826316 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17556678 56RH jtl: Journal of Renal Care issn: 17556678 maglogo: Y pubinfo: dt: Dec2024 vid: 50 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 180826316 177698151 180826316 180826316 10.1111/jorc.12505 180826316 ppf: 426 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Advancing arteriovenous fistula needling: The role of physical exam and doppler ultrasound. aug: au: Pinto, Rui Barros, João Ferreira, Ricardo Alves, Pedro Sousa, Rui Oliveira, Liliana Pereira, Lénia Correia, Ana Luísa Silva, Ana Rita Henriques, Andreia Magda Guerra Mata, Fernando Salgueiro, Anabela Fernandes, Isabel Alves, Rui Sousa, Clemente affil: Unidade Local de Saúde de Coimbra. Dialysis Unit—Nephrology, University Hospital Centre, Coimbra, Portugal sug: subj: Arteriovenous Fistula Physical Examination Ultrasonography, Doppler Nursing Protocols Hemodialysis Catheterization Quality Improvement Human Cross Sectional Studies Dialysis Patients Dialysis Nurses Comparative Studies Palpation Inspection (Clinical) Auscultation Blood Circulation Nurse Attitudes Referral and Consultation Confidence Nursing Assessment Male Female Adult Middle Age Aged Aged, 80 and Over Descriptive Statistics Data Analysis Software T-Tests Mann-Whitney U Test Wilcoxon Rank Sum Test Intraclass Correlation Coefficient Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Background: The success of haemodialysis (HD) critically depends on the effective use of arteriovenous fistulas (AVFs). The precise needling technique is vital to minimise complications and ensure functional vascular access. Objective: This study assesses the effectiveness of a nursing consultation protocol, which integrates physical examination (PE) with Doppler Ultrasound (DUS), in preparing patients for the first AVF needling. Design/Participants: A cross‐sectional analysis at a Portuguese National Health Service Hospital engaged thirty new HD patients, four HD needling experienced nurses and one HD vascular access nurse. This study examines the accuracy of PE in assessing the matured AVF by the four nurses compared to a trained vascular access nurse encompassing systematic PE and DUS. Measurements: The primary data incorporated AVF characteristics derived from PE (inspection, palpation, and auscultation) and DUS findings (vein depth, diameter, and blood flow). A secondary focus was evaluating the change in nurses' perceived needling complexity following the nursing consultation. Results: The nursing consultation significantly enhanced the identification of crucial AVF features, such as accessory veins (p = 0.002), and improved the accuracy of AVF morphology assessments. This led to identifying longer needling tracks (p = 0.031) and a higher number of safe needling points (p = 0.016). Nurses reported a notable reduction in perceived complexity and potential adverse events following this method (p = 0.027). Conclusions: Integrating structured PE with DUS in a nursing consultation framework significantly improves the preparation for AVF needling. This approach enhances the efficiency and safety of AVF needling and boosts nurse confidence and patient care in HD settings. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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