Keywords
Early activation stage
Puncture management
Evidence summary
Evidence-based nursing
Submitted : 2024-12-08
Accepted : 2024-12-23
Published : 2025-01-07
Abstract
Objective: To retrieve, evaluate, and summarize the best evidence for puncture management during the early initiation stage of autologous arteriovenous fistula (AVF) in hemodialysis patients, providing a reference for clinical nursing practice. Method: Following the “6S” pyramid model system, evidence on puncture management during the initiation stage of AVF in hemodialysis patients was retrieved from domestic and international databases. The search included clinical decision-making tools, guidelines, evidence summaries, systematic reviews, and expert consensus. The retrieval period spanned from database inception to January 2023. Four researchers screened the literature, performed quality evaluations, and extracted and integrated the evidence. Results: A total of nine articles were included, comprising one clinical decision, five guidelines, one evidence summary, one systematic review, and one expert consensus. The evidence encompassed 18 key points across six areas: team building and personnel training, timing of initial puncture, pre-puncture evaluation, puncture methods, post-puncture pressure management, and management of puncture-related complications. Conclusion: Blood purification nursing staff should combine clinical scenarios with evidence-based medicine to adopt scientific, effective, and feasible puncture management strategies during the early initiation stage of AVF. This approach aims to better safeguard the patient’s vascular access and overall treatment outcomes.
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