Nursing Intervention To Shorten The Formation Time Of The Blunt Needle Fistula Of The Hemodialysis Patients

Objective:To investigate the influence factors of the blunt needle fistula formation time of the hemodialysis patients and the nursing intervene for the main factors,and provide a guidance for clinical practice.Methods:130 maintenance(MHD)patients who received arteriovenous fistula(AVF)and agreed with the treatment of blunt needle fistula in a hospital in Changchun from Jul.2017 to Dec.2017 were selected with convenient sampling method.The 130 patients were divided into intervention group and control group randomly.The general situation questionnaire was used to conduct the questionnaire survey before the puncture.The pain self-rating sheet and the hospital anxiety depression sheet were used in the questionnaire survey before puncture,the third time of puncture and the formation process of blunt needle fistula.The pain self-rating sheet was used to investigate the questionnaire after scab.The patients in the intervention group were punctured by fixed nurses and the patients in the control group were punctured by the nurses selected randomly.All the professional nurses in blood purification in this study accepted one-month blunt needle puncture training,and they all had more than 3-years working experience.The two groups were compared for anxiety,pain and fistula formation time.The relationship between pain,anxiety,depression and the time of blunt fistula formation were compared between the two groups under the same psychological intervention.The two groups were treated with different methods of removing eschar.The intervention group was treated with warm aseptic saline cotton ball,and the control group was treated with Iodophor cotton ball.The two groups were compared for the time of scab and the improvement of pain.Epidata3.1 was used to double input data,and SPSS17.0 statistical software was used to analyze the data.The data were analyzed by descriptive statistical analysis,t test and chi 2 test.P<0.05,was difference had statistically significance.Results:1.The pain,anxiety and depression are appeared in patients of two groups before the puncture.The data is statistically significant and comparable(P>0.05).2.The pain,anxiety and depression of patients in two groups at the time of the third time of puncture and the formation process of are improved.The hospital anxiety self-assessment sheet is significantly different for patients in two groups.The data is statistically significant and comparable(P<0.05).Psychological intervention can alleviate patients' pain,anxiety and depression symptoms,and shorten the formation time.3.The time to form a scab of patients in intervention groupis 26.67±2.77 minutes.while the time to form a scab of patients in control groupis 32.77±3.58 minutes.The data is different and statistically significant(P<0.05).4.The forming time of the blunt needle fistula of the hemodialysis patients in two groups are different after nursing intervention: the intervention group is sharp blunt needle point puncture 7.01±1.88 times,and the control group is sharp blunt needle point puncture 8.32±2.63 times.The data is statistically significant and comparable(P<0.05).Conclusion:1.Psychological intervention can alleviate anxiety,depression and pain in MHD patients during blunt needle fistula formation.And fixed nurses' one to one service further reduced the anxiety,depression and pain symptoms of patients.2.The method of the hydrophobic compress by sterile saline cotton ball to scab is obviously effective in shortening the time and reducing the pain than the method of the hydrophobic compress by sterile saline cotton ball.3.The method of fixed nurses to puncture can shorten the time of the blunt needle fistula formation of the hemodialysis patients.4.The pain,self-anxiety,depression condition,the time of removing eschartime and the method of removing eschartime are the main influence factors of the time of the blunt needle fistula formation of the hemodialysis patients.