A system for preventing internal fistula needle dislodgement: Delphi study and pilot evaluation

IF 1.7 4区医学 Q2 NURSING

Japan Journal of Nursing Science Pub Date : 2023-03-03 DOI:10.1111/jjns.12530

Qing Ding

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引用次数: 0

Abstract

Aim

To establish a scoring system for risk assessment (SSRA) for internal fistula needle dislodgement (IND) in hemodialysis (HD) patients.

Methods

The SSRA was constructed based on literature search, medical history review, expert consultations, expert meeting (Delphi study), and analytic hierarchy process. Then, a pilot test was conducted at our hospital between August 1, 2020, and July 30, 2021. Consecutive patients requiring HD were included and randomly assigned to experimental and control groups (1:1 ratio). Control group was treated with the routine procedures, while the experimental group was treated with strengthened nursing measures based on the individual risk assessed by SSRA. Finally, the incidence of IND was compared between the two groups.

Results

For the Delphi study, 16 experts in dialysis nursing in Zhejiang, Shanghai, Guangzhou, and Qinghai were included. The final draft of the SSRA included three first-level indices, 11 second-level indices, and 26 third-level indices. A total of 218 HD patients were included. The IND rate in the experimental group was significantly lower than that in the control group (p < .01).

Conclusion

We established a scientific, reliable, and feasible SSRA for timely identification of HD patients with high risk of IND and the corresponding nursing procedures to prevent IND.

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预防内瘘针移位的系统:德尔菲研究和试点评估

目的建立血液透析(HD)患者内瘘针头移位(IND)风险评估评分系统(SSRA)。方法采用文献检索法、病史回顾法、专家咨询法、专家会议法(德尔菲法)和层次分析法等方法构建SSRA。随后，于2020年8月1日至2021年7月30日在我院进行了中试。纳入连续需要HD的患者，随机分为实验组和对照组(1:1比例)。对照组采用常规护理程序，实验组根据SSRA评估的个体风险，采取强化护理措施。最后比较两组患者IND的发生率。结果德尔菲研究共纳入浙江、上海、广州、青海四省16名透析护理专家。SSRA定稿包括3个一级指标、11个二级指标和26个三级指标。共纳入218例HD患者。试验组IND率显著低于对照组(p < 0.01)。结论建立了一套科学、可靠、可行的SSRA，可及时识别HD患者的IND高危人群，并制定相应的护理程序，预防IND的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japan Journal of Nursing Science 医学-护理

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Japan Journal of Nursing Science is the official English language journal of the Japan Academy of Nursing Science. The purpose of the Journal is to provide a mechanism to share knowledge related to improving health care and promoting the development of nursing. The Journal seeks original manuscripts reporting scholarly work on the art and science of nursing. Original articles may be empirical and qualitative studies, review articles, methodological articles, brief reports, case studies and letters to the Editor. Please see Instructions for Authors for detailed authorship qualification requirement.