Barriers and facilitators to vascular access point-of-care ultrasound in haemodialysis: An international survey of haemodialysis clinicians

IF 1.5 4区 医学 Q3 NURSING Journal of renal care Pub Date : 2024-05-29 DOI:10.1111/jorc.12503
Monica Schoch PhD, Catherine Fielding MSc, RN, Rosa M. Marticorena PhD, George E. Smith MD, Peter M. Sinclair PhD, Ruben Iglesias RN, Paul N. Bennett PhD
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Abstract

Background

Utilising point-of-care ultrasound for assessment and cannulation of vascular access in people receiving haemodialysis has shown positive clinical results. Nonetheless, there is variation in how renal health care professionals worldwide embrace this method, and there's a lack of research on the factors that promote or hinder its adoption.

Objectives

To explore regional differences, and barriers and facilitators, to the use of point-of-care ultrasound for assessment and cannulation of vascular access in haemodialysis.

Design

Exploratory descriptive cross-sectional web-based survey.

Participants

Healthcare clinicians working in haemodialysis responsible for cannulation of arteriovenous fistula or grafts.

Results

The survey was completed by 645 health care clinicians from 38 countries. 75% to 93% of respondents from Australia/New Zealand, Canada, Europe and United Kingdom/Ireland reported access to ultrasound, compared to 26% (n = 43/167) from the United States. United States respondent's reported lower levels of ultrasound training than other regions. Facilitators for using ultrasound were: the availability of ultrasound training (87%, n = 558), to reduce miscannulations (76%, n = 255/336) and to improve patient outcomes (73%, n = 246/336). Point-of-care ultrasound barriers were lack of access to ultrasound education (82%, n = 196/239), lack of ultrasound machines (33%, n = 212/645) or believing that ultrasound was someone else's role (38%, n = 29/86).

Conclusions

This study revealed national and regional differences related to haemodialysis point-of-care ultrasound. Understanding the regions requiring more education and implementation of ultrasound and what motivates staff, or deters from using ultrasound, is crucial for effectiveness of future implementation and workplace change initiatives.

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血液透析中血管通路护理点超声检查的障碍和促进因素:一项针对血液透析临床医生的国际调查。
背景:在接受血液透析的患者中使用护理点超声波来评估血管通路并为其插管已显示出积极的临床效果。然而,世界各地的肾病医护人员对这种方法的接受程度不尽相同,对促进或阻碍采用这种方法的因素也缺乏研究:目的:探讨在血液透析中使用床旁超声评估和插管血管通路的地区差异、障碍和促进因素:设计:探索性描述性横断面网络调查:调查对象:负责动静脉瘘或移植物插管的血液透析临床医护人员:来自 38 个国家的 645 名医疗临床医生完成了调查。来自澳大利亚/新西兰、加拿大、欧洲和英国/爱尔兰的 75% 至 93% 的受访者表示可以使用超声波,而来自美国的受访者中只有 26% (n = 43/167)表示超声波培训水平低于其他地区。使用超声波的促进因素包括:可获得超声波培训(87%,n = 558)、减少误切(76%,n = 255/336)和改善患者预后(73%,n = 246/336)。护理点超声障碍是缺乏获得超声教育的机会(82%,n = 196/239)、缺乏超声机(33%,n = 212/645)或认为超声是别人的工作(38%,n = 29/86):这项研究揭示了与血液透析护理点超声相关的国家和地区差异。了解哪些地区需要更多的超声波教育和实施,哪些因素会激励员工使用超声波,哪些因素会阻碍员工使用超声波,这对未来实施工作场所变革计划的有效性至关重要。
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来源期刊
Journal of renal care
Journal of renal care Nursing-Advanced and Specialized Nursing
CiteScore
3.50
自引率
5.30%
发文量
36
期刊介绍: The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.
期刊最新文献
Issue Information: Journal of Renal Care 4/2024 Health literacy profiles in kidney transplanted patients: A cluster analysis Patients' perspectives on key aspects influencing needling for haemodialysis: A qualitative study Use of toe systolic blood pressures and toe brachial pressure indices in people receiving dialysis: A scoping review Cultural and linguistic diversity is associated with increased inter-dialytic weight gain among patients on long-term haemodialysis
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