Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2023, Vol. 22 ›› Issue (04): 310-315.doi: 10.3969/j.issn.1671-4091.2023.04.014

Previous Articles     Next Articles

Investigation on the nursing operation of hemodialysis installation and pre-flush in China

WANG Ying, LIANG Jun-qing, SU Mo, GAO Ju-lin, GOU Jing-qi, GENG Tong-hui, GENG Ye, HOU Xian-tao, LUO Li, LIU Yao, LIU Yong-ling, MAO Jia-yan, SHEN Peng, WU Su-zhen, YANG Jing, YANG Jia-hui, YANG Wun-jun, YUE Xiao-hong, YANG Zhen-hua, ZHOU Lin, ZHU Ya-mei, ZHU Yue-ping, GAN Liang-ying, ZUO Li   

  1. Department of Nephrology, Peking University People’s Hospital, Beijing 100044, China; 2Blood Purification Center, Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China; 3Department of Severe Renal Diseases and Blood Purification, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; 4Blood Purification Center, Qinghai Provincial People's Hospital, Xi'ning 810000, China; 5Department of Nephrology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China; 6Blood Purification Center, The First Affiliated Hospital of China Medical University, Shenyang 110001, China; 7Hemodialysis Room, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, China; 8Dialysis Center, Peking University International Hospital, Beijing 102206, China; 9Blood Purification Center, Department of Nephrology, Peking University First Hospital, Beijing 100034, China; 10Department of Nephrology, Sichuan Provincial People's Hospital, Chengdu 610072, China; 11Blood Purification Center, Shanxi Provincial People's Hospital, Taiyuan 030012, China; 12Department of Nephrology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; 13Department of Blood purification, Department of Nephrology, the Second Hospital of Tianjin Medical University, Tianjin 300211, China; 14Blood Purification Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; 15Hemodialysis Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China; 16Blood Purification Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 17Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200024, China; 18Blood Purification Center, the Second Xiangya Hospital of Central South University, Changsha 410001, China; 19Department of Nephrology, Ningxia Medical University General Hospital, Yinchuan 750004, China
  • Received:2022-11-23 Revised:2023-01-12 Online:2023-04-12 Published:2023-04-12
  • Contact: 100044 北京，1北京大学人民医院肾内科 E-mail:zuoli@bjmu.edu.cn

PDF

287

Abstract: Objective  To investigate the status quo of hemodialysis installation and pre-flush operation, useful for the forthcoming quality management of clinical nursing operation and specialist training.  Methods This was a nationwide cross-sectional survey. The installation and pre-flush operations were surveyed in the form of video records. Two professionals reviewed the video records according to a scoring scale that was developed by literature review and expert consultation. The scoring tool included four dimensions: time and method of hand hygiene; evaluation and safety check before, during and after operation; installation and connection; and principles of pre-flushing. The scores of each item and each dimension were calculated. Independent sample t test was used to compare the scores among the groups. Professional title of the operators were analyzed by one-way ANOVA. P＜0.05 was considered statistically significant.  Results  ①A total of 270 operation video records were received in this survey, and 229 were valid. There were 66 (28.8%) cases in North China, 3 (1.3%) cases in Northeast China, 23 (10.0%) cases in East China, 5 (2.2%) cases in South China, 71 (31.0%) cases in Central China, 26 (11.4%) cases in Southwest China, and 35 (15.3%) cases in Northwest China. 89 (38.8%) operators were the titles of nurses in charge or above, 111 (48.5%) were nurses, and 29 (12.7%) were primary nurses. In the 229 nurses, 42 (18.3%) were from national blood purification nursing training bases, 113 (49.3%) were from the tertiary hospitals. ②The scoring rates of the four dimensions were: time and method of hand hygiene (76.62%), evaluation and safety check before, during and after operation (78.69%), installation and connection (88.42%), and pre-flush principles (87.75%). ③The total score was higher in the nurses from the tertiary hospitals than in those from non-tertiary hospitals (t=3.918,P＜0.001), and the score was higher in the nurses from teaching bases than in those from non-teaching bases (t=5.540,P＜0.001). There was no significant difference in the total score among different professional titles (F=0.853,P=0.428).  Conclusion  The scoring scale for hemodialysis installation and pre-flushing in this study can help standardize the nursing operation of installation and pre-flushing. Nurses from tertiary hospitals and training bases showed a higher level of the operation. This survey revealed that the application of basic norms/standards for health service professionals was insufficient, mainly in the time and method of hand hygiene, and quality evaluation and safety check before, during and after operation. We recommend that hemodialysis centers should reinforce the operation training for nurses.

Key words: Hemodialysis, Installation and pre-flush, Hand hygiene, Quality improvement

CLC Number: