Ultrasound for the Clinical Management of Vascular Access Cannulation and Needle Position in Hemodialysis Patients

Nalesso, Federico; Garzotto, Francesco; Muraro, Eva; Cattarin, Leda; Rigato, Matteo; Gobbi, Laura; Innico, Georgie; Calò, Lorenzo A.

doi:10.1016/j.ultrasmedbio.2019.10.018

Cited by 8 publications

(14 citation statements)

References 15 publications

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“…Some individuals from the United Kingdom have recommended the use of POCUS to be added to the curriculum of teaching medical students as it 'requires minimal training to operate, can be quickly performed and easily supervised and also later supervised, if scans are saved' (22). The use of POCUS in connection with DIVA has been proven to increase cannulation success rates and may also reduce the dependence on senior or more experienced doctors (23).The increased practical use of POCUS is not just happening in the medical workforce but becomes also more prevalent amongst nurses and nurse practitioners (24) and also renal nurses (2,3). It is therefore necessary to train and educate novices using this technique through theoretical and practical demonstrations which include subsequent individual hands-on experience for participants to individually learn and perform this skill.…”

Section: Discussionmentioning

confidence: 99%

“…The use of point-of-care ultrasound (POCUS) for vascular access cannulation has been previously described as a useful skill to establish a vascular access for haemodialysis patients (1)(2)(3). Other clinical specialities such as emergency departments have also successfully adopted this method of using POCUS to insert peripheral intravenous catheters (PIVCs) in patients with di cult venous access (DIVA) (4,5).…”

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confidence: 99%

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Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation

Steinwandel

Coventry

Kheirkhah

2023

Preprint

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Background: Point-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by clinicians from multiple disciplines worldwide, prior and during vascular access cannulations. While POCUS is a relatively new method to establish a vascular access in patients with complex vascular conditions, it is also essential to train and educate individuals who are novices in the techniques of cannulation so that they become proficient in performing this task subsequently on patients safely and successfully. A simulated environment may be a helpful tool to help healthcare providers establish skills in using POCUS safely and may also help them to successfully establish vascular access in patients. With this project, we sought to determine if participants of a simulated POCUS workshop for vascular access can use this technique successfully in their individual clinical environment after their attendance of a half-day workshop. Methods: A mixed-methods longitudinal study design was chosen to evaluate a point-of-care ultrasound workshop for peripheral intravenous cannula insertion. The workshops used simulation models for cannulation in combination with multiple ultrasound devices from various manufacturers. Participants self-assessed their cannulation skills using questionnaires prior to and directly after the workshop. Results: A total of 85 Individuals participated in eleven half-day workshops through 2021 and 2022. Workshop participants claimed that attending the workshop had significantly enhanced their clinical skill of using ultrasound for the purpose of cannulating a venous vessel. The level of confidence in using this technique had increased in all participants directly after conclusion of the workshop. Conclusions: Globally, clinicians are increasingly using POCUS to establish vascular access in patients, and it is necessary that they receive sufficient and adequately structured and formal training to successfully apply this technique in their clinical practice. Offering a workshop which uses simulation models in combination with various POCUS devices to demonstrate this technique in a hands-on approach has proven to be useful to establish this newly learned skill in clinicians.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation

Steinwandel

Coventry

Kheirkhah

2023

Preprint

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“…Recent studies on POCUS-guided cannulation have assessed the effect of POCUS guidance on cannulation outcomes (Eves et al, 2020;Kumbar et al, 2018;Luehr, 2018;Nalesso et al, 2020;Niyyar et al, 2021), explored staff confidence with, and perceptions of, POCUS (Ward et al, 2017), and reported how POCUS is Conclusions: Nurses perceived that using point-of-care ultrasound was a positive adjunct to their cannulation practice and provided beneficial outcomes for patients.…”

Section: Introductionmentioning

confidence: 99%

“…In the early 2000s, POCUS was introduced into haemodialysis clinics, specifically to aid accurate fistulae cannulation, but it has not been widely adopted (Schoch et al, 2015). A recent study showed that haemodialysis needles may cause damage to the intimal lining of the vessel even in the absence of haemodynamic or clinical signs of dysfunction, and the only way to detect this is by using ultrasound (Nalesso et al, 2020). Empirically, other researchers have found that the use of POCUS for assessment and cannulation, even though the process can take longer (Eves et al, 2020; Niyyar et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Nurses' perceptions of point‐of‐care ultrasound for haemodialysis access assessment and guided cannulation: A qualitative study

Schoch,

Bennett,

Currey

et al. 2023

Journal of Clinical Nursing

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AimTo explore nurses' perceptions of using point‐of‐care ultrasound for assessment and guided cannulation in the haemodialysis setting.BackgroundCannulation of arteriovenous fistulae is necessary to perform haemodialysis. Damage to the arteriovenous fistula is a frequent complication, resulting in poor patient outcomes and increased healthcare costs. Point‐of‐care ultrasound‐guided cannulation can reduce the risk of such damage and mitigate further vessel deterioration. Understanding nurses' perceptions of using this adjunct tool will inform its future implementation into haemodialysis practice.DesignDescriptive qualitative study.MethodsRegistered nurses were recruited from one 16‐chair regional Australian haemodialysis clinic. Eligible nurses were drawn from a larger study investigating the feasibility of implementing point‐of‐care ultrasound in haemodialysis. Participants attended a semistructured one‐on‐one interview where they were asked about their experiences with, and perceptions of, point‐of‐care ultrasound use in haemodialysis cannulation. Audio‐recorded data were transcribed and inductively analysed.FindingsSeven of nine nurses who completed the larger study participated in a semistructured interview. All participants were female with a median age of 54 years (and had postgraduate renal qualifications. Themes identified were as follows: (1) barriers to use of ultrasound; (2) deficit and benefit recognition; (3) cognitive and psychomotor development; and (4) practice makes perfect. Information identified within these themes were that nurses perceived that their experience with point‐of‐care ultrasound was beneficial but recommended against its use for every cannulation. The more practice nurses had with point‐of‐care ultrasound, the more their confidence, dexterity and time management improved.ConclusionsNurses perceived that using point‐of‐care ultrasound was a positive adjunct to their cannulation practice and provided beneficial outcomes for patients.Implications for the Profession and/or Patient CareHaemodialysis clinics seeking to implement point‐of‐care ultrasound to help improve cannulation outcomes may draw on these findings when embarking on this practice change.Reporting MethodThis study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ).Patient or Public ContributionPatients were not directly involved in this part of the study; however, they were involved in the implementation study.Trial and Protocol RegistrationThe larger study was registered with Australian New Zealand Clinical Trials Registry: ACTRN12617001569392 (21/11/2017) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373963&isReview=true

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“…Conventional 2-D US plays a key role in assessing AVFs and is well established for initially diagnosing access-related insufficiency of hemodialysis. For experienced sonographers, Doppler sonography provides an excellent tool for real-time imaging in routine assessment and in the initial evaluation of access-related failure in adults and children (Dumars et al 2002;Doelman et al 2005;Thalhammer et al 2007;Visciano et al 2014;Shroff et al 2019;Nalesso et al 2020).…”

Section: Introductionmentioning

confidence: 99%

Sonographic 3-D Power Doppler Imaging Enhances Rapid Assessment of Morphologic and Pathologic Arteriovenous Fistula Variations

Putz

Pfister

Bergler

et al. 2021

Ultrasound in Medicine & Biology

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Early detection of pathologic variations in an arteriovenous fistula (AVF) is essential for preventing fistula dysfunction in individuals undergoing hemodialysis. This study aimed to evaluate the clinical applicability of 3-D tomographic ultrasound (tUS) for rapid and simple visualization of AVF morphology and pathology. We assessed 53 AVFs in 50 consecutive patients using 3-D tUS including secondary, blinded reading. For all examinations, a high-end ultrasound (US) device was used with linear probe, attached to a tUS system to allow freehand 3-D scanning. Participants were examined by 2-D US and 3-D tUS with different raw data (B-mode, power Doppler, B-flow). Additional angiography was available for 15 participants with scheduled interventions. In all participants, 3-D tUS allowed a 3-D representation of AVFs in angiographic-like images with good image quality. The 2-D US assessment took 7.9 § 4.0 min. A 3-D power Doppler scan required, on average, 1.4 § 0.6 min. Diagnostic accuracy of blinded reading for pathologies was high (86.8% for aneurysms and 79.2% for stenoses). BlandÀAltman plots showed an excellent correlation of 3-D tUS with 2-D US and angiography. 3-D tUS is an easily and rapidly applicable method for visualizing morphologic and pathologic AVF variations. Color-coded 3-D reconstruction of power Doppler data simplifies detection of perfused aneurysms and stenoses.

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Ultrasound for the Clinical Management of Vascular Access Cannulation and Needle Position in Hemodialysis Patients

Cited by 8 publications

References 15 publications

Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation

Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation

Nurses' perceptions of point‐of‐care ultrasound for haemodialysis access assessment and guided cannulation: A qualitative study

Sonographic 3-D Power Doppler Imaging Enhances Rapid Assessment of Morphologic and Pathologic Arteriovenous Fistula Variations

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