Leong Felice Fangie, Binte Abu Bakar Aloweni Fazila, Choo Jason Chon Jun, Lim Siew Hoon
Nursing Division, Singapore General Hospital, Singhealth Tower Level 15, 10 Hospital Boulevard Singapore 168582, Singapore.
Department of Renal Medicine, Singapore General Hospital, Singapore.
Int J Nurs Stud Adv. 2023 Sep 28;5:100156. doi: 10.1016/j.ijnsa.2023.100156. eCollection 2023 Dec.
Inadequate training on how to care for haemodialysis and peritoneal dialysis catheters can lead to mechanical issues with the catheters and infectious complications (such as peritonitis) that could endanger patient safety, reduce the effectiveness of the dialysis treatment, and have a negative impact on patient morbidity and mortality. Such incidents can be prevented as they are mostly dependant on controllable factors - proper dialysis catheter care, which can be addressed through effective patient education. Effective patient education is crucial in ensuring that patients are equipped with the knowledge and skills necessary for both peritoneal and haemodialysis catheter care.
To synthesise evidence on the: (1) patient educational interventions on haemodialysis and peritoneal dialysis catheter care; and (2) reported learning and clinical outcomes of the educational interventions provided for patients with haemodialysis and peritoneal dialysis catheter.
Integrative review.
This review followed the framework by Whittemore and Knafl. The literature search was performed using four electronic databases: PubMed, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health. The Joanna Briggs Institute Critical Appraisal Tool was used to appraise the articles that fit the inclusion and exclusion criteria. Studies published in the English language were retrieved.
A total of 14 studies were included. All the studies focused on educating patients who were on either tunnelled (permanent) haemodialysis catheters or peritoneal dialysis catheters. The findings identified: (1) teaching strategies used for educating patients on haemodialysis catheter care (2) teaching strategies for educating peritoneal dialysis patients on peritoneal dialysis catheter care and (3) outcomes of patient education on both haemodialysis and peritoneal dialysis catheters. Written materials and educational videos were used to instruct patients on haemodialysis catheters care. Different educational strategies for educating patients on peritoneal dialysis catheter care were also reported. They varied in terms of the composition and experience of the implementation care team members, educational approach, training duration, training location, timing relative to catheter placement, assessment method and follow-up support. The various teaching strategies were assessed and compared based on the patients' knowledge levels, catheter-related mechanical issues, and catheter-related infectious consequences (such as peritonitis).
This review highlighted various education materials and compared different educational practices on tunnelled (permanent) haemodialysis catheter and peritoneal dialysis catheter care that healthcare providers used to increase knowledge and reduce catheter-related blood stream infections and peritonitis rates.
关于如何护理血液透析和腹膜透析导管的培训不足,可能导致导管出现机械问题以及感染并发症(如腹膜炎),这可能危及患者安全,降低透析治疗效果,并对患者的发病率和死亡率产生负面影响。由于这些事件大多取决于可控因素——适当的透析导管护理,而这可以通过有效的患者教育来解决,所以此类事件是可以预防的。有效的患者教育对于确保患者具备腹膜和血液透析导管护理所需的知识和技能至关重要。
综合关于以下方面的证据:(1)针对血液透析和腹膜透析导管护理的患者教育干预措施;(2)为血液透析和腹膜透析导管患者提供的教育干预措施的学习和临床结果报告。
综合综述。
本综述遵循惠特莫尔和克纳夫的框架。使用四个电子数据库进行文献检索:PubMed、CINAHL、Cochrane图书馆和ProQuest护理与联合健康数据库。使用乔安娜·布里格斯研究所批判性评价工具对符合纳入和排除标准的文章进行评价。检索以英文发表的研究。
共纳入14项研究。所有研究都集中于对使用隧道式(永久性)血液透析导管或腹膜透析导管的患者进行教育。研究结果确定了:(1)用于对患者进行血液透析导管护理教育的教学策略;(2)用于对腹膜透析患者进行腹膜透析导管护理教育的教学策略;以及(3)对血液透析和腹膜透析导管患者教育的结果。书面材料和教育视频被用于指导患者进行血液透析导管护理。还报告了用于对患者进行腹膜透析导管护理教育的不同教育策略。这些策略在实施护理团队成员的组成和经验、教育方法、培训时长、培训地点、相对于导管置入的时间、评估方法和后续支持方面各不相同。根据患者的知识水平、与导管相关的机械问题以及与导管相关的感染后果(如腹膜炎)对各种教学策略进行了评估和比较。
本综述强调了各种教育材料,并比较了医疗保健提供者用于增加知识以及降低与导管相关的血流感染和腹膜炎发生率的关于隧道式(永久性)血液透析导管和腹膜透析导管护理不同教育实践。