Fostering safe vascular access for adolescents during hemodialysis using cushion cannulation versus common cannulation techniques

Abstract

Background and objective: Chronic hemodialysis is technically feasible in children of all ages. Vascular access is a hemodialysis patient’s lifeline, and successful cannulation is critical to the viability of the vascular access. Common and cushion cannulation techniques can be used by the nurses during cannulation of the patients. However, it is not known which approach is most effective. This study aimed to foster safe vascular access for adolescents during hemodialysis using cushion cannulation versus common cannulation techniques.

Methods: Study design: A quasi-experimental study was used. Setting: The study was conducted at Hemodialysis Units affiliated to King Abdullah Bin Abdul-Aziz Al Saud International Foundation Dialysis Care Center at Jeddah. Subjects: A purposive sample composed of 60 adolescents undergoing hemodialysis and 60 nurses “whom providing care for those adolescents were involved in this study”. Tools: Four tools were used namely; Structured Questionnaire Sheets, Observation Sheet, Adolescents and nurses’ opinion about cushion and common cannulation techniques, and Pain Assessment Scale.

Results: The majority of adolescents felt that using the cushion cannulation technique was more comfortable position. Also, most nurses mentioned that using the cushion technique improves body mechanics and promotes easy access to fistula.

Conclusions: The current study concluded that, using cushion technique was associated with safe vascular access for adolescents during hemodialysis, it also stabilizes the arm and tissues and fully extension of the arm. Negative correlation was observed between cushion technique safety and numeric pain scale. Meanwhile, there was insignificant positive correlation using common cannulation technique and numeric pain scale. Recommendations: Application of the cushion technique in HD centers as part of a routine care for all patients undergoing hemodialysis therapy, and implement in-service training programs related to the cushion technique for all nurses working in Hemodialysis Units.