Abstract: 【Abstract】Objective To explore the application effect of cluster nursing mode on rope ladder puncture of arteriovenous internal fistula (AVF) in hemodialysis patients. Methods A total of 60 patients with AVF for hemodialysis and admitted to our hospital from January 2017 to January 2020 were recruited as the research subjects. They were divided into control group and experimental group according to the random number table method. All patients were treated with the conventional nursing care, while patients in the experimental group were also treated with the cluster nursing mode. The success rate of first puncture, performance rate of rope ladder puncture, self-care ability of AVF, bleeding rate of AVF, incidence of hemangioma, infection rate at the puncture site, and incidence of thrombosis in AVF were compared between the two groups. Results Rope ladder puncture was used in 95.37% patients in experimental group, higher than 88.53% patients in control group (χ2=128.139, P＜0.001). The score of self- care ability of AVF was (131.97 ± 5.09) in experimental group, higher than (111.97±6.41) in control group (t=13.880, P＜0.001). The success rate of first puncture had no significant difference between the two groups (P>0.05). Complications of rope ladder puncture were lower in experimental group than in control group (P<0.05): blood exudation from AVF not found in experimental
group and 8 cases in control group, hemangioma 2 cases in experimental group and 8 cases in control group, infection at puncture site one case in experimental group and 7 cases in control group, and thrombosis in AVF one case in experimental group and 8 cases in control group. Conclusion The application of cluster nursing mode significantly increased the performance rate of rope ladder puncture of AVF and the self-care ability of AVF and decreased the incidence of AVF complications in hemodialysis patients with AVF. Therefore, the cluster nursing mode is worthwhile to be used in clinical practice.

Key words: Hemodialysis, Cluster care, Patients with arteriovenous internal fistula, Rope ladder puncture mode