Análisis de las prácticas enfermeras en relación a la fijación de las agujas de hemodiálisis en España

Abstract

Objective: To analyse national haemodialysis nursing practices about the fixation of arteriovenous fistula puncture needles.

Material and Method: Cross-sectional descriptive study, conducted in April-May 2024, using an online questionnaire aimed at haemodialysis nurses throughout Spain. Variables collected: socio-demographics, type of centre, factors related to needle exit, fixation material/techniques and knowledge of recommendations.

Results: 363 nurses participated, 83.5% female, mean age: 44.09±10.7 years, mean experience: 15.18±10.94 years; 72.7% worked in public centres.
According to the respondents, the most influential factors for needle exit were “Patient skin condition” (96.7%) and “Fixation technique” (93.9%); the two least influential were “Having a risk assessment system” (53.4%) and “Type of puncture device” (51%). Chevron and Butterfly fixation techniques were used by 35.4% and 55.1% if we also consider U-Method/H-Method. Paper tape was the most used fixation material (75.3%), with 57.7% thought it the most secure. 66.7% were unaware of published documents with recommendations, and 65.4% did not have protocols covering these aspects in their units. Professionals working in subsidised/private centres have protocols for needle fixation (p<0.01), recommendations for patients and professionals (p<0.01) and use Butterfly fixation techniques, U-method/H-method (p<0.01) in a higher proportion than professionals in public centres.

Conclusions: Accidental needle exit during haemodialysis is an area for improvement. Approximately half of the practitioners use fixation techniques other than those recommended (Butterfly/Chevron/Method-U/Method-H).