NorSimS Simulation Center, Caen University Hospital, Caen, France.
Clinical Research Department, Caen University Hospital, Caen, France.
Trials. 2023 Aug 7;24(1):500. doi: 10.1186/s13063-023-07513-8.
The technique of arteriovenous fistula (AVF) puncture is currently taught by colleagues within hemodialysis units. Even if the main principles of the technique are well known and common to all hemodialysis units, strong rationales are still missing to standardize fine practices such as the relative position of the needles, the angle of the needle at puncture, and the position of the bevel at the time of puncture and after the needle is in the vascular lumen.
We are conducting a prospective, comparative, center-randomized, multicenter study involving 8 hemodialysis centers. The primary objective is to compare the number of adverse events related to AVF puncture between a group receiving theoretical training plus simulation-based training (4 centers) and a group receiving only theoretical training (4 centers). The study will include all adult patients who are scheduled to have an AVF puncture performed by a hemodialysis-trained nurse during a scheduled chronic dialysis session.
We hypothesize that a training program for nurses on the AVF approach in procedural simulation versus theoretical input alone would decrease the adverse events related to AVF punctures and would be beneficial for the patient. This study is innovative for several reasons. First, simulation-based training in continuing education among professionals is not widely used. Furthermore, training allows for the standardization of practices within the team, both technically and relationally.
ClinicalTrials.gov NCT05302505 . Registered on March 17, 2022.
动静脉瘘（AVF）穿刺技术目前由血液透析单位的同事教授。即使该技术的主要原则为所有血液透析单位所熟知且通用，但仍缺乏强有力的依据来规范精细操作，如针的相对位置、穿刺时的针的角度以及穿刺时针的斜面和进入血管腔后的位置。
我们正在进行一项前瞻性、对照、中心随机、多中心研究，涉及 8 个血液透析中心。主要目的是比较接受理论培训加基于模拟的培训（4 个中心）和仅接受理论培训（4 个中心）的组之间与 AVF 穿刺相关的不良事件的数量。该研究将包括所有计划在定期慢性透析期间由接受血液透析培训的护士进行 AVF 穿刺的成年患者。
我们假设，与仅接受理论输入相比，对护士进行程序模拟的 AVF 方法培训将减少与 AVF 穿刺相关的不良事件，并且对患者有益。这项研究有几个创新点。首先，在继续教育中，专业人员的基于模拟的培训并未广泛使用。此外，培训允许在技术和关系方面在团队内部标准化实践。
ClinicalTrials.gov NCT05302505。于 2022 年 3 月 17 日注册。
