血透专科护士应用超声引导穿刺疑难动静脉内瘘的阻碍和促进因素的质性研究

Qualitative research on hindering and promoting factors in the application of ultrasound-guided puncture of difficult arteriovenous fistula by hemodialysis specialist nurses

目的了解血透专科护士应用超声引导穿刺疑难动静脉内瘘的阻碍及促进因素,为后续临床开展及应用提供参考依据。方法通过对12名血透专科护士进行半结构式访谈,用Colaizzi分析法分析、提炼。结果提炼出血透专科护士应用超声引导穿刺疑难内瘘的3个阻碍因素:(1)增加临床额外工作时间。(2)加重医患经济负担。(3)缺乏专业的培训与指导。3个促进因素:(1)重视血管通路预保护。(2)可视化技术解决临床穿刺难题。(3)拓宽血透专科护士职业路径。结论血透专科护士应用超声引导穿刺疑难动静脉内瘘存在阻碍及促进因素,建议加强政策扶持,提供专业化培训,建立相应的考核标准及准入制度,促进超声引导下内瘘穿刺技术的广泛应用。

Objective To understand the hindering and promoting factors of ultrasound-guided puncture of difficult arteriovenous fistula in hemodialysis specialist nurses,and to provide reference for subsequent clinical development and application.Methods A total of 12 hemodialysis specialist nurses were conducted by semi-structured interviews,and Colaizzi analysis was used to analyze and refine.Results Three factors hindering the application of ultrasound-guided puncture of difficult internal fistula by hemodialysis specialist nurses were extracted:(1)Increasing clinical extra working time;(2)Increasing the economic burden of doctors and patients;(3)Lack of professional training and guidance.Three promoting factors were extracted:(1)Pay attention to the pre-protection of vascular access;(2)Visualization technology to solve clinical puncture problems;(3)Broaden the career path of hemodialysis specialist nurses.Conclusion There are some hindering and promoting factors in the application of ultrasound-guided puncture of arteriovenous fistula by hemodialysis specialist nurses.It is suggested to strengthen policy support,provide professional training,establish corresponding assessment standards and access systems,and promote the wide application of ultrasound-guided internal fistula puncture technology.