Nurses' Use of Ultrasound Location for Puncturing Arteriovenous Fistulas in Hemodialysis.

Puncturing an arteriovenous fistula (AVF) in chronic hemodialysis (HD) patients is a source of difficulty even for experienced dialysis nurses. The objective of this study was to compare the failure rate of AVF puncture by the usual technique (visual or by palpation) and after ultrasound location. This nonrandomized prospective single-center study was carried out at the Safi HD Hospital Center for 16 weeks in two successive phases, with the time between each phase dedicated to training nurses in locating punctures by ultrasound. We first evaluated 30 HD patients (300 HD sessions, i.e., 600 punctures) without ultrasound location, then the same patients (300 sessions, i.e., 600 punctures) using ultrasound location for all punctures. Ultrasound location carried out by a single nurse did not show a significant reduction in the rate of failure to puncture the AVF compared with the standard method (2.6% vs. 4%, P = 0.07). However, the rate of complications at the puncture site, recourse to medical advice, or mobilization of a second nurse were significantly reduced (P < 0.05). This single-center study showed no advantage of this approach for the effective cannulation of AVF in HD patients known to be not difficult to cannulate.

[Effect of a hemodialysis patient education on fluid control and dietary]. / Impact de l'éducation du patient en hémodialyse sur le respect des mesures diététiques et sur la restriction aux liquides.

INTRODUCTION: Most chronic hemodialysis patients do not adhere to diet and fluid restrictions, source of clinical complications in the medium and long term, in some cases fatal, this study was conducted to investigate the effect of the training program given to these patients on their adherence to diet and fluid restrictions. MATERIALS AND METHODS: The study was conducted with 50 people, split into 2 groups, set up on a control group with 25 people. No education program has been set up, and the second group with 25 people assigned to the intervention having received an education program. Data were collected using the sociodemographic characteristics questionnaire, dialysis diet and fluid non-adherence questionnaire (DDFQ), and fluid control in hemodialysis patients scale (FCHPS). RESULTS: The measurements made at the end of the education program revealed a statistically significant difference in favor of the intervention group in terms of the mean values for the patients interdialytic weight gain (kg), ultrafilration volume and diastolic blood pressure. Similarly, the means of the scores for the 4 items of the DDFQ questionnaire revealed a statistically significant difference in favor of the intervention group concerning: the frequency of non-adherence to the diet, the degree of non-adherence to the diet, the frequency of non-adherence to liquid restriction and the degree of non-adherence to liquid restriction. CONCLUSION: This monocentric work shows that the establishment of an educational program has a positive impact on patients adherence to dietary measures and restriction of fluids.