Abstract: Objective  To investigate the nursing operation status of point-of-care ultrasound (POCUS) assisted difficult arteriovenous fistula (AVF) puncture in 18 hospitals in order to provide a scientific basis for quality management and specialized training of the clinical nursing operations.  Methods   This was a cross-sectional study. The videos of POCUS assisted difficult AVF puncture operation from the 18 hospitals were examined. A scoring rule for the operation was developed as the scoring basis. Six key steps of the manipulation were extracted for the scoring, including routine evaluation and safety verification, nurse-patient communication, infection control, AVF routine evaluation, ultrasound evaluation, and ultrasound guided puncture. The scores were then statistically analyzed.  Results  The average score of the manipulation on video from the 18 cases was 79.25±10.91. For the six key steps of the manipulation, ratios of the steps with low scores were evaluation and safety verification 55.56%, nurse-patient communication 50.00%, AVF routine evaluation 44.44%, infection control 38.89%, ultrasound evaluation 11.11%, and ultrasound guided puncture 0%. The video duration and the operation score were positively correlated (r=0.717, P=0.001).  Conclusion   The scoring standard for POCUS assistant difficult fistula puncture developed in this study is helpful to standardize this procedure and is worth promoting.

Key words: Hemodialysis, Point-of-care ultrasound, Arteriovenous fistula