中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (04): 306-309.doi: 10.3969/j.issn.1671-4091.2023.04.013

• 护理研究 • 上一篇    下一篇

基于患者需求视角下护士动静脉内瘘超声引导穿刺培训效果观察

谢庆磊   张留平   王 越   

  1. 210009 南京，1东南大学附属中大医院血液净化中心
  • 收稿日期:2022-10-08 修回日期:2023-02-06 出版日期:2023-04-12 发布日期:2023-04-12
  • 通讯作者: 张留平 E-mail:shery9926@sina.com
  • 基金资助:
    江苏卫生健康职业学院校级课题(JKC2021068)

Observation on the effect of ultrasound-guided arteriovenous fistula puncture training for nurses based on the perspective of patients’ demands

XIE Qing-lei, ZHANG Liu-ping, WANG Yue   

  1. Blood Purification Center, Zhongda Hospital Affiliated to Southeast University, Nanjing 210009, China
  • Received:2022-10-08 Revised:2023-02-06 Online:2023-04-12 Published:2023-04-12
  • Contact: 210009 南京，1东南大学附属中大医院血液净化中心 E-mail:shery9926@sina.com

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摘要： 目的  观察基于患者需求视角下护士超声引导动静脉内瘘穿刺培训效果。 方法 采用方便抽样方法抽取东南大学附属中大医院血液净化中心34名护士作为研究对象，随机分为试验组和对照组，每组各17名，试验组采用基于患者需求视角下超声引导动静脉内瘘穿刺培训，对照组采用常规培训方法，观察2组护士穿刺例数，首次穿刺成功率，穿刺相关并发症，总体穿刺成功率，护士超声引导穿刺掌握率，掌握该项操作所需的穿刺次数。 结果  共32名护士完成了本研究，试验组与对照组各16名。2组护士共计超声引导穿刺了41名患者，其中试验组28名，对照组13名，2组护士首次穿刺成功率无显著差异(78.6%比76.9%,c2=0.000，P=1.000)，试验组护士总体穿刺成功率高于对照组护士(96.1%比89.9%, c2=8.242，P=0.004)，试验组护士超声引导穿刺掌握率高于对照组(81.3%比43.8%,c2=4.800，P=0.028)，试验组护士掌握超声引导穿刺操作所需穿刺次数为13.0(12.0,14.0)，少于对照组16.0(15.0,17.0)(Z=-13.000，P＜0.001)。 结论  基于患者需求视角下超声引导动静脉内瘘穿刺培训能提高透析患者疑难血管通路总体穿刺成功率，提高护士培训效果。

关键词: 患者需求, 超声检查, 动静脉内瘘, 血管穿刺

Abstract: Objective   To observe the effect of ultrasound-guided arteriovenous fistula puncture training for nurses based on the perspective of patients’ demands.   Methods  Thirty-four nurses in the dialysis center were divided into experimental group or control group by convenience sampling method, with 17 in each group. The experimental group used ultrasound-guided arteriovenous fistula puncture training based on patients' demands, while the control group used conventional training methods. Number of patients subjected to the puncture, success rate of first puncture, puncture-related complications, overall success rate of the puncture, master rate of ultrasound-guided puncture training, and number of puncture required by the operation training were observed in the two groups.  Results  A total of 32 nurses were enrolled and completed the study, and 16 in each group. A total of 41 patients were su  bjected to ultrasound-guided puncture, including 28 in the experimental group and 13 in the control group. There was no significant difference in the success rate of first puncture between the two groups (78.6% vs. 76.9%, c2=0.000,  P=1.000). The overall puncture success rate of experimental group was significantly higher than that of control group (96.1% vs. 89.9%, c2=8.242, P=0.004). The master rate of ultrasound-guided puncture training for nurses in experimental group was significantly higher than that in control group (81.3% vs. 43.8%, c2=4.800, P=0.028). The median number of puncture times (interquartile distance) required for nurses to master ultrasound-guided puncture in experimental group was 13.0 (12.0, 14.0), significantly less than that in control group of 16.0 (15.0, 17.0) (Z=-13.000, P＜0.001).  Conclusions  The method of ultrasound-guided arteriovenous fistula puncture training based on patients' needs can significantly improve the overall puncture success rate in hemodialysis patients with difficult vascular access and the training effect of nurses.

Key words: Patients' demands, Ultrasonography, Arteriovenous fistula, Vascular access

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