Abstract
BackgroundChronic haemodialysis for adult patients with end-stage kidney failure requires a patent extracorporeal circuit, maintained by anticoagulants such as unfractionated heparin (UFH). Incorrect administration of UFH has safety implications for patients.ObjectivesFirstly, to describe renal practitioners’ self-reported knowledge, attitudes and practice (KAP) regarding the safe use of UFH and its effects; secondly, to determine an association between KAP and selected independent variables.MethodA cross-sectional descriptive survey by self-administered questionnaire and non-probability convenience sampling was conducted in two tertiary hospital dialysis units and five private dialysis units in 2013.ResultsThe mean age of 74/77 respondents (96.1%), was 41.1 years. Most (41/77, 53.2%) had 0–5 years of renal experience. The odds of enrolled nurses having poorer knowledge of UFH than registered nurses were 18.7 times higher at a 95% Confidence Interval (CI) (1.9–187.4) and statistically significant (P = 0.013). The odds of delivering poor practice having ≤ five years of experience and no in-service education were 4.6 times higher at a 95% CI (1.4–15.6), than for respondents who had ≥ six years of experience (P = 0.014) and 4.3 times higher (95% CI 1.1–16.5) than for respondents who received in-service education (P = 0.032), the difference reaching statistical significance in both cases.ConclusionResults suggest that the category of the professional influences knowledge and, thus, safe use of UFH, and that there is a direct relationship between years of experience and quality of haemodialysis practice and between having in-service education and quality of practice.
Highlights
Problem statementPatients with end-stage kidney failure (ESKF) depend on safe chronic haemodialysis therapy to restore homeostasis
Of the total population (N = 104) of renal unit practitioners who met inclusion criteria, 77 (74.0%) participated in the study compared to the estimated sample size (n = 82, 93.9%), no questionnaires were excluded from the final data analysis, even those with missing data
A Scheffé post-hoc test showed that the difference in age between registered nurses (RNs) and clinical technologists (CTs) reached statistical significance (P < 0.001, 95% Confidence Interval (CI) 7.56–19.41) and between enrolled nurses (ENs) and CTs (P = 0.020, 95% CI 1.70–24.24), but not between RNs and ENs
Summary
Problem statementPatients with end-stage kidney failure (ESKF) depend on safe chronic haemodialysis therapy to restore homeostasis. Safe haemodialysis treatment includes correct dosages of unfractionated heparin (UFH), currently the most widely used anticoagulant for this purpose. Failure to adhere to correct dosages of UFH exposes patients to the risk of blood clotting in the extracorporeal circuit or prolonged time for arterio-venous fistulae cannulated sites to stop bleeding (Davenport 2009) at the conclusion of the session. Renal unit practitioners need specialised knowledge and skill pertaining to the use of UFH in haemodialysis. Chronic haemodialysis for adult patients with end-stage kidney failure requires a patent extracorporeal circuit, maintained by anticoagulants such as unfractionated heparin (UFH). Renal unit practitioners are reported to be confused, concerned and even outspoken about safety aspects of UFH when preparing, administering and monitoring its effects (Pittard 2001:75; Baglin et al 2006:21; Brunet et al 2008:794). Renal unit practitioners are reported to be confused, concerned and even outspoken about safety aspects of UFH when preparing, administering and monitoring its effects (Pittard 2001:75; Baglin et al 2006:21; Brunet et al 2008:794). Suranyi and Chow (2010:386) have appealed to nurses to regularly review and update their knowledge regarding UFH
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
