Knowledge of vascular access among hemodialysis unit nurses and its influencing factors: a cross-sectional study

Abstract

Background: Nurses in hemodialysis (HD) units are the main performers in the maintenance and management of HD patients' vascular access, and the cognition degree of their specialized knowledge of vascular access directly affects the quality of vascular access management. However, most of the investigations on the cognition of vascular access knowledge take HD patients as the research subjects, while there are few studies on nurses in HD units as the research subjects. Herein, we explored the knowledge of vascular access among HD unit nurses and its influencing factors, aiming to inform the training of HD unit nurses on vascular access management.Methods: By using a convenience sampling method, we investigated the knowledge of vascular access in terms of basic knowledge, vascular access assessment and arteriovenous fistula (AVF) puncture technique knowledge of dialysis unit nurses who volunteered to engage in hemodialysis clinical nursing for more than 6 months in HD units in Sichuan Province from March 2022 to May 2022. Data were collected on demographic characteristics, hospital nature, the city and region where the hospital is located, the working time of hemodialysis. Analysis of variance was used to analyze the score of vascular access specialist knowledge of HD unit nurses, and multiple linear regression was used to explore the influencing factors of vascular access specialist knowledge of HD unit nurses. Results: A total of 222 nurses in HD units were included. The total score of the knowledge of vascular access was 87.52±13.71 points, of which the basic knowledge scored 3.88±0.60 points, the vascular access assessment scored 3.62±0.65 points, and the AVF puncture techniques scored 3.22±0.71 points. Multiple linear regression analysis showed that longer working years [beta: 0.381, 95% confidence interval (CI): 3.064-7.188, P=0.000], more advanced training [beta: 0.206, 95% CI: 2.817-10.672, P=0.001], and public hospital [beta: 0.138, 95% CI: 0.839-12.342, P=0.025] positively predicted higher knowledge of vascular access scores among HD unit nurses (all P<0.05). Conclusions: The cognitive degree of vascular access specialized knowledge of hemodialysis nurses is affected by different working years, training experience and the nature of the hospital. Nursing managers can develop different training and assessment programs for vascular access specialized knowledge according to different influencing factors.

Hemodialysis nurses’ knowledge, attitude, and practices in managing vascular access: A cross-sectional study in Saudi Arabia

“…This disparity can be attributed to variations in management policies and nursing practices. [22] Based on our study findings we suggest several recommendations for improving VA management among hemodialysis nurses in Saudi Arabia. These include giving priority to specialized training programs, implementing ongoing training initiatives focused on VA management, and addressing knowledge gaps related to complications and proper cannulation techniques.…”

“…Furthermore, participants reported receiving adequate training and supervision in the early stages of their careers as dialysis nurses prior to performing cannulation procedures. [ 22 ] This highlights the crucial role of specialized training for hemodialysis nurses, as emphasized by 93.0% of participants. Additionally, the study revealed a notable positive attitude toward the cannulation and management of dialysis VA.…”

“…Specifically, nurses working in the hemodialysis unit who had undergone training related to VA demonstrated markedly higher overall scores in their knowledge of VA compared to those who had not participated in such training activities. [22] Furthermore, established guidelines recommend that comprehensive and specialized training is crucial for all medical personnel involved in the management of VA for hemodialysis patients. Additionally, these guidelines advocate for the implementation of ongoing training programs within hemodialysis units that specifically focus on the management of VA. [2,22,23] Table 2 Participants' knowledge on dialysis vascular access (N = 197).…”

“…[22] Furthermore, established guidelines recommend that comprehensive and specialized training is crucial for all medical personnel involved in the management of VA for hemodialysis patients. Additionally, these guidelines advocate for the implementation of ongoing training programs within hemodialysis units that specifically focus on the management of VA. [2,22,23] Table 2 Participants' knowledge on dialysis vascular access (N = 197). The findings of the study indicate that a significant proportion of participants (81.7%) demonstrated accurate recognition of infection as a potential issue when observing swelling and redness in a patient's fistula.…”

“…[ 22 ] Furthermore, established guidelines recommend that comprehensive and specialized training is crucial for all medical personnel involved in the management of VA for hemodialysis patients. Additionally, these guidelines advocate for the implementation of ongoing training programs within hemodialysis units that specifically focus on the management of VA. [ 2 , 22 , 23 ]…”